WCRI: Prices Paid for Similar Professional Medical Services for Treating Injured Workers Varied Significantly across 36 States

Cambridge, MA (WorkersCompensation.com) - Today, the Workers Compensation Research Institute (WCRI) released an updated version of its study that compares prices paid for medical professional services across 36 states and monitors price changes from 2008 to 2021, which includes just over a year of medical services delivered during the COVID-19 pandemic.

“The objectives of this study are twofold,” said Ramona Tanabe, WCRI’s executive vice president and counsel. “The first is to help policymakers and stakeholders conduct meaningful comparisons of prices across states and track the price changes in their states. The second objective is to discuss the price comparison results and price trends in relation to the principal policy tool for regulating prices—fee schedules.”

The study, WCRI Medical Price Index for Workers’ Compensation, 14th Edition (MPI-WC), focuses on professional services (evaluation and management, physical medicine, surgery, major and minor radiology, neurological testing, pain management injections, and emergency care) billed by physicians, physical and occupational therapists, and chiropractors. The following are among the study’s findings:

• Prices paid for a similar set of professional services varied significantly across states, ranging from 29 percent below the 36-state median in Florida to 164 percent above the 36-state median in Wisconsin in 2021.
• States with no fee schedules for professional services had higher prices paid compared with states with fee schedules—36 to 174 percent higher than the median of the study states with fee schedules in 2021.
• Most states with no workers’ compensation fee schedules experienced faster growth in prices paid for professional services compared with states with fee schedules—the median growth rate among the non-fee schedule states was 34 percent from 2008 to 2021, compared with the median growth rate of 11 percent among the fee schedule states.
• Eight study states (Arizona, Illinois, Kentucky, Massachusetts, New York, North Carolina, Texas, and Virginia) had substantial changes (i.e., an increase or a decrease of 10 percent or more) in overall prices paid following major fee schedule changes during the study period.

This edition covers 36 states that represent 88 percent of the workers’ compensation benefits paid in the United States. These 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 Yang and Dr. Olesya Fomenko. To download a FREE copy of this report, visit WCRI’s website at https://www.wcrinet.org/reports/wcri-medical-price-index-for-workers-compensation-14th-edition-mpi-wc.   

Share This Article: