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Comp reforms yield lower medical claims costs in some states: Study

Comp reforms yield lower medical claims costs in some states: Study

Several states have seen decreases in medical payments per workers compensation claim after reform measures, according to a batch of new studies released Thursday by the Cambridge, Massachusetts-based Workers Compensation Research Institute.

The studies looked at prices and utilization of workers comp medical care through March 2016 for injuries occurring between 2010 and 2015, pre- and post-reform in many of the states, featured in 16 individual reports. 

For example, California historically showed high-than-average medical costs when compared to other states, researchers noted. But the study on California shows that after 2013 — when Senate Bill 863 introduced a series of reforms reined in payments, prices, and utilization — the state’s costs plummeted to the median range among all 18 states studied. 

Prescription costs in California dropped by 36% between 2012 and 2016, according to the study, which highlighted California as seeing the largest dip in prescriptions costs post-reform for claims of 12 months in duration or longer. 

Also notable is the Indiana report, which showed that medical payments per claim decreased 10% from 2014 to 2015 — the first such decrease in more than a decade, according to the report. The decrease follows the adoption of a hospital fee schedule in 2014, researchers noted.

In North Carolina, medical payments per claim decreased 6% per year from 2013 through 2015, more than in all other study states, largely reflecting the effects of its adoption of a fee schedule change, the study highlights.

The other states included in the research are Arkansas, Florida, Georgia, Illinois, Iowa, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, New Jersey, Pennsylvania, Texas, Virginia and Wisconsin, with individual reports for every state except Arkansas and Iowa.

“This research can help policymakers and other stakeholders identify cost drivers and emerging trends in payments, prices, and utilization of medical providers,” said Ramona Tanabe, the institute’s executive vice president and counsel in a press statement.  


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