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Medical payments flat in Indiana after fee schedule enacted

Posted On: Nov. 3, 2016 1:32 PM CST

Medical payments flat in Indiana after fee schedule enacted

Average medical payments for Indiana workers compensation claims remained relatively stable in the last few years as a fee schedule helped drive down payments for hospital outpatient services by nearly 10% during that time, according to a study from the Workers Compensation Research Institute.

Cambridge, Massachusetts-based WCRI studied medical payments, prices and utilization in 18 states including Indiana in its study released Tuesday. The study looked at workers comp claim experience through 2015 for injuries that occurred mainly from 2009 to 2014. 

WCRI found that average medical payments for Indiana workers comp claims with more than seven days of lost time increased 1.5% from the 2013-14 accident year to the 2014-15 accident year. That's compared with a median increase of 1.4% for the 18 states studied by WCRI during that time.

Previous WCRI data showed that Indiana’s average medical payments per claim had been growing faster than in most other states. From 2009-10 to 2013-14, average medical payments per claim in Indiana grew 5% per year. 

Meanwhile the average hospital outpatient payment per Indiana workers comp claim fell 9.9% from the 2013-14 accident year to the 2014-15 accident year. That's compared with a median increase of 4.6% for hospital outpatient payments among the 18 studied states during the same period.

WCRI credited an Indiana bill enacted in 2014 with offsetting workers comp medical payments in the state. House Enrolled Act 1320 established a fee schedule for workers comp hospital services with reimbursement set at 200% of Medicare prices.