Cambridge, MA – Medical payments per claim decreased more than 3 percent in most of the 17 study states for 2021 injuries with experience through March 2022, according to a new set of studies by the Workers Compensation Research Institute (WCRI). The main driver of this was a decrease in utilization of medical services, likely the result of the pandemic.
“While stay-at-home orders and suspensions of nonemergency surgeries and procedures largely lapsed or were withdrawn over the spring and summer of 2020, pandemic-related factors continued to impact the delivery and usage of medical services,” said Ramona Tanabe, President and CEO of WCRI. “As the pandemic continued, labor shortages and burnout among health care professionals may have also led to limited access to care in some areas.”
The following are sample findings for some of the study states:
- Illinois: Medical payments per workers’ compensation claim decreased by 3 percent per year between 2019/2020 and 2021/2022.
- Indiana: Utilization of most services decreased more in Indiana than in most other study states, but payments per workers’ compensation claim remained stable.
- Minnesota: Medical payments per workers’ compensation claim in Minnesota decreased by 2 percent in 2021/2022, reflecting the impact of changes to the state’s fee schedule in addition to the pandemic.
- Texas: With a decrease in utilization of nonhospital services of 11 percent, Texas also saw a decrease in payments per workers’ compensation claim of 6 percent, a faster decrease than most study states.
- Wisconsin: In contrast to many other study states, payments per workers’ compensation claim in Wisconsin rose 3 percent for nonhospital and 5 percent for outpatient services.
The studies, CompScope™ Medical Benchmarks, 24th Edition, examined medical payments, prices, and utilization across 17 states and how these metrics of medical payments have changed over time. The studies cover the period from 2016 through 2021, with claims experience through March 2022, including non-COVID-19 claims from the first and second years of the COVID-19 pandemic (March 2020 through September 2021). The study, therefore, provides insights into how the pandemic likely impacted non-COVID-19 workers’ compensation claims in the first two years of the pandemic.
The 17 states in the study―Arkansas, California, Florida, Illinois, Indiana, Iowa, Louisiana, Massachusetts, Michigan, Minnesota, New Jersey, North Carolina, Pennsylvania, Tennessee, Texas, Virginia, and Wisconsin―represent more than 60 percent of the nation’s workers’ compensation benefit payments. Individual reports are available for every state except Arkansas, Iowa, and Tennessee.
More info or purchase: WCRI CompScope™ Medical Benchmarks, 24th Edition