Medical Payments per Workers’ Comp Claim Flatten in Indiana

Medical payments per workers’ compensation claim in Indiana changed little from 2013 to 2014, a sharp contrast to the increases of the prior nine years, according to a new study by the Workers Compensation Research Institute (WCRI).

Before the recent flattening, Indiana’s medical payments per claim had been growing faster than in most of the 17 other states WCRI examined, according to the study CompScope Medical Benchmarks for Indiana, 17th Edition.

“There were offsetting factors behind the flat trend,” said Ramona Tanabe, WCRI’s executive vice president and counsel. “While prices and utilization by nonhospital providers increased, hospital outpatient payments per claim fell. The latter may be related to the fee schedule imposed by House Enrolled Act (HEA) 1320, which became effective in July 2014.”

HEA 1320 enacted a hospital fee schedule with reimbursement set at 200 percent of Medicare in an attempt to control hospital costs. The data in WCRI’s study reflect up to nine months of experience after the fee schedule took effect and may provide an early look at the post-fee-schedule experience.

Among the findings:

• Before the recent trend, Indiana’s medical payments per claim were rising faster than the typical state studied.
• Medical payments per claim in the state remained higher than the typical state studied. The main reason was higher and growing prices, as was the case in other states with no price regulation.

WCRI studied medical payments, prices, and utilization in 18 states, including Indiana, looking at claim experience through 2015 on injuries that occurred mainly from 2009 to 2014.

Source: WCRI

Topics Workers' Compensation