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Telehealth use among most common cost-containment strategies

Posted On: Mar. 30, 2021 2:21 PM CST


The explosion of the use of telemedicine in workers compensation has made it among one of the most used workers compensation containment strategies, according to research released Tuesday by the Workers Compensation Research Institute.

Medical benefits represent the greatest cost for most state workers compensation systems, and states have continued to implement strategies to contain costs in their jurisdictions. Researchers from Cambridge, Massachusetts-based WCRI studied state use of cost containment strategies such as hospital in-patient and out-patient fee regulations, provider choice and treatment guidelines in all 50 states as of Jan. 1, 2021. 

The 2021 report also includes for the first time reports on the use of telehealth — which has expanded dramatically as a result of the COVID-19 pandemic — as well as state regulations governing ambulance transportation and balance billing and the cost of surgical implants.

One of the biggest changes in workers comp in 2021 is the expanded use of telemedicine. Prior to the pandemic, telemedicine was allowed in workers compensation in fewer than half of all states. However, according to WCRI research, 25 states either newly added telemedicine or expanded its usage in workers compensation.

The study also noted that nearly all states, excluding Arizona, Iowa, New Hampshire and New Jersey, have implemented a hospital in-patient and out-patient fee regulations, and many states also have created fee schedules for ambulatory surgery centers, urgent care facilities and ambulance fees.

The report also compared fee schedule allowances for several common workers compensation surgical procedures, such as arthroscopy, lumbar laminotomy and neurolysis for carpal tunnel. For arthroscopy, fee schedule allowances ranged from a low of $726 in West Virginia to a high of nearly $3,500 in Illinois. For the lumbar surgery, fee schedule allowances by state ranged from $1,280 in South Carolina to $7,500 in Nevada.

The researchers also noted in the study the data is based on surveys completed by state workers compensation authorities and that some responses may be open to interpretation.

More insurance and workers compensation news on the coronavirus crisis here.