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Workers comp medical cost trends vary: WCRI

Mixed results

Medical payments for workers compensation claims grew in several states between 2012 and 2017, but legislative changes in some states have reduced comp payments, according to studies released Thursday by the Workers Compensation Research Institute.

The Cambridge, Massachusetts-based WCRI examined trends in payments, prices and utilization of medical care for injured workers in 18 states, representing more than 60% of the nation’s workers compensation benefit payments, for its CompScope Medical Benchmarks, 20th Edition studies.

The studies cover the period from 2012 through 2017, with claims experience through March 2018.

In Florida, researchers noted that the state reported the lowest prices paid for nonhospital professional services and higher-than-typical payments per claim for ambulatory surgery centers and for hospital outpatient and inpatient services, largely as a result of fee regulations in the state.

Illinois reported medical claim payments for more than seven days of lost time that were 15% greater than the median of other states studied; Wisconsin also saw an increase in medical payments per claim due to an increase in workers comp medical prices paid for nonhospital care and inpatient surgical care.

Minnesota reported increases in ambulatory surgery center and hospital outpatient payments, but decreases in hospital inpatient payments per episode.

In North Carolina, 2015 fee schedule changes led to a continued decrease in medical payments per claim.

The 18 states studied include Arkansas, California, Florida, Georgia, Illinois, Indiana, Iowa, Louisiana, Massachusetts, Michigan, Minnesota, New Jersey, North Carolina, Pennsylvania, Tennessee, Texas, Virginia, and Wisconsin. Individual reports are available for every state except Arkansas and Iowa.




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