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Nonhospital fee hikes helped drive up Texas comp payments 8% in 2011

Nonhospital fee hikes helped drive up Texas comp payments 8% in 2011

Texas workers compensation medical payments rose 8% year over year in 2011, driven partly by care provided to injured workers outside of hospitals, the Workers Compensation Research Institute says in a new report.

In a report released Tuesday, the Cambridge, Mass.-based WCRI said Texas workers comp medical payments rose faster than comparable states in 2011. The trend was attributed in part to an increase in fee schedule prices for nonhospital medical services.

That included a 20% increase in prices for neurological testing from 2010 to 2011 and an 18% increase in fees for physical medicine during that period, the report showed. The price changes resulted after a Texas workers comp reform bill in 2005 tied workers comp fee schedule increases to Medicare prices.

“Despite the increases, Texas was still mostly lower than (comparable states) for the nonhospital prices paid for specialty care, hospital outpatient payments per service for radiology and physical medicine services and hospital payments per episode of inpatient care,” the study reads.

Nonhospital health care providers received 63% of medical payments for Texas comp claims in 2011 that had more than seven days of lost time, the WCRI said. That share of nonhospital care was larger than most states studied by the WCRI, including Illinois, Florida, Michigan and New Jersey.

The WCRI noted that a decrease in utilization of nonhospital medical care likely offset medical payment increases for Texas in 2011.