Wisconsin: Medical costs per claim rising after years being below average
A 14-state study by the Workers Compensation Research Institute found that medical costs per claim in Wisconsin grew 70 percent over a period of five years
-- 2001-02 to 2006-07 -- while costs per claim in the other study states rose between 47 percent and 54 percent. The report, CompScopeTM Medical Benchmarks for Wisconsin, 9th Edition, found that for 2001 injuries with experience through the first quarter of 2004, employers in Wisconsin paid lower costs per claim than the median of 14 study states. However, by 2004-07, employers paid typical medical costs per claim compared to the other 13 study states.
The WCRI report attributed the shift in the average medical costs per claim in Wisconsin to a number of factors -- faster growth in the medical costs per claim and some of the highest nonhospital prices paid and hospital outpatient payments per service. Specifically, researchers noted that employers in Wisconsin paid among the highest prices for many procedures performed in a nonhospital setting. For example, the price paid for the most frequently-billed nonhospital established patient office visit was $95 compared to $62 in the median state in the study; the price for the most common arthroscopic knee surgery was $3,035 compared to $1,336 in the typical state; and the price for an MRI was $1,997 in Wisconsin compared to $805 in the median state.
Among the highlights of the study, researchers noted that:
- Prices offset by lower utilization of medical services. The study reported that prices paid in Wisconsin were not only substantially higher than the prices in the typical study state, but they were also higher compared to the prices paid in Iowa and Indiana -- two study states that currently do not regulate prices. In general, researchers said higher nonhospital prices paid in Wisconsin were offset by lower utilization of medical services. Similar conclusions apply to hospital outpatient services, the study found.
- Injured workers returned to job quickly. Despite these higher prices paid and payments per service for services delivered in a hospital outpatient setting, the study found that injured workers in Wisconsin reported faster recovery and return to work along with better access and satisfaction with care. Researchers concluded that it might be reasonable for an employer to pay higher costs if workers have improved outcomes over time. WCRI said it is currently conducting a survey of injured workers in Wisconsin to address this question.
Read more at the WORKERSCOMP ForumTM homepage.
October 26, 2009
Copyright 2009© LRP Publications