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Wisconsin medical costs per comp claim ‘higher than typical’: Study

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Wisconsin medical costs per comp claim ‘higher than typical’: Study

Wisconsin’s medical payments per workers compensation claim were 46% higher than those of other states studied for 2015 injuries, according to a study released Thursday by the Workers’ Compensation Research Institute.

While growth in Wisconsin’s workers comp medical payments per claim slowed in the past several years, medical payments were still increasing at a faster rate than in other states, the Cambridge, Massachusetts-based institute studied.

During 2010 to 2015, medical payments per claim with more than seven days of lost time at 12 months’ maturity in Wisconsin grew at a moderate rate of 3.9 % per year, on average. This was slower than the 8.8% per year growth experienced in Wisconsin from 2005 to 2010, but was still faster than the 1.9% median annual growth observed among the study states during the study period, according to institute, which examined the costs, prices and utilization of workers comp medical care in Wisconsin in comparison with 17 other states.

The study also found that in 2015 Wisconsin’s workers comp medical payments per claim with more than seven days of lost time were 61% higher than the median study state. These results reflect a widening gap between Wisconsin and the median study state compared with prior studies, according to the report.

Researchers also found “substantially higher prices paid for nonhospital medical services were a factor contributing to higher average medical payments” and that “utilization of nonhospital medical services in Wisconsin was among the lowest of the study states.” 

Other highlights of the 304-page report include:

  • Payments per claim for nonhospital services increased 3% annually from 2010 through 2015, driven more by price increases than utilization.
  • Hospital outpatient payments per claim increased 4.7% per year, on average. Increases in payments per service contributed to this trend; there was little change in utilization of hospital outpatient care.
  •  In 2015, Wisconsin had among the highest percentages of claims receiving hospital outpatient care, due primarily to a higher percentage of workers receiving radiology, physical medicine and office visits from hospital outpatient providers.
  • Injured workers in Wisconsin reported higher rates of satisfaction with their medical care and among the lowest percentages of problems accessing medical care.

 

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