Prices Paid for Professional Medical Services for Treating Injured Workers Were Higher and Growing Faster in States without Fee Schedules, Finds New WCRI Study

Cambridgr, MA (WorkersCompensation.com) - As policymakers and system stakeholders in many states debate rising medical costs, the Workers Compensation Research Institute (WCRI) released a new study today that helps compare prices paid for medical professional services across 36 states and monitor price changes from 2008 to 2018.

The study, WCRI Medical Price Index for Workers’ Compensation, 11th Edition (MPI-WC), found that prices paid in states with no fee schedules for professional services were 39 to 171 percent higher than the median of the study states with fee schedules in 2018. WCRI also found that medical prices in most states with no fee schedules grew faster than in states with fee schedules — the median growth rate among the non-fee schedule states was 34 percent from 2008 to 2018, compared with the typical growth rate of 6 percent among the fee schedule states. 

“If you are a policymaker or other stakeholder and want to understand how medical prices in workers’ compensation in your state compared with other states, or how prices in your state changed over time, you would benefit from this study,” said Ramona Tanabe, WCRI’s executive vice president and counsel. “If you are in one of the many states that implemented fee schedule changes recently or are considering such changes in the future, this study shows how certain policy initiatives impact medical prices.”

This study provides analysis of price trends in a number of states with major fee schedule changes, including Arizona, California, Colorado, Illinois, Kentucky, Massachusetts, North Carolina, Texas, and Virginia.

This annual report focuses on professional services billed by physicians, physical therapists, and chiropractors. The medical services fall into eight groups: evaluation and management, physical medicine, surgery, major radiology, minor radiology, neurological and neuromuscular testing, pain management injections, and emergency care.

The 36 states in the study, which represent 88 percent of the workers’ compensation benefits paid in the United States, are Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Wisconsin.

The authors of this study are Dr. Rebecca (Rui) Yang and Dr. Olesya Fomenko. Click on the following link to download a FREE copy of this report: https://www.wcrinet.org/reports/wcri-medical-price-index-for-workers-compensation-11th-edition-mpi-wc. 

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