A new study by the Workers Compensation Research Institute (WCRI) found that, despite the fact that the average cost per claim for the medical care of injured workers in Massachusetts has risen “significantly in recent years, ” the state is still has the lowest costs of the eight states examined by the study (See IJ Website April 24).
The WCRI, which is based in Cambridge Mass., concluded that, “The lower cost results in substantial measure from lower use of medical services per claim – fewer visits and services provided to injured workers by doctors, chiropractors, physical therapists and hospitals. ”
The study compared the costs and services provided by workers compensation plans in California, Connecticut, Florida, Georgia, Massachusetts, Pennsylvania, Texas and Wisconsin. It found that Mass. “still has the lowest average medical claim cost ($2,999) among the study states – 44 percent below the median ($5,334). This is primarily due to a lower payment per visit – 34 percent lower than the eight-state median – and especially lower prices due to the low fee schedule in Massachusetts. ”
The WCRI found that in Mass. “the average medical payment per claim is consistently below the eight-state median for each provider type analyzed. The percentage differences range from 34 percent below the median for physical therapists to 52 percent below for physicians. ”
Concerning hospital visits, the study found that they are involved in more claims than the median state in the study. “23 percent more claims with more than seven days of lost time and 77 percent more claims with less than or equal to seven days of lost time involve at least one visit billed by a hospital. This could be care rendered at a hospital or at a related site,” said the report.
“When hospitals are involved they have substantially more visits per claim (67 percent higher) than hospitals in the median state. But both the number of services per visit for hospitals and the average price of a service are lower than in the other states studied. The study observed that this may mean that hospitals in Massachusetts deliver fewer services per visit at lower prices but treat more patients and require more visits than hospitals in the other study states,” it concluded.
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