Florida Outpatient Costs for Injured Workers Rising Rapidly: WCRI

November 11, 2013

The average cost per claim of outpatient hospital care for injured workers in the Florida workers’ compensation system continued to grow rapidly and was a main driver of growth in medical payments per claim in the state, according to a new study by the Workers Compensation Research Institute (WCRI).

The report, Benchmarks for Florida, CompScop 14th Edition, states that the rapid growth in hospital outpatient payments per claim was driven by increases in the average payment per service for those services. These increases averaged 10 percent per year from 2005 to 2010.

WCRI said this trend may be related to some features in the percent-of-charge-based fee regulation in the state, compared with the fixed amount fee schedules that are in effect in many of the other 15 study states.

While outpatient hospital payments per claim rose, the study noted that medical payments per claim moderated after 2008, counterbalanced by other components of medical payments.

Among other findings:

  • Wage replacement benefits, called indemnity benefits, remained stable between 2008 and 2011, mainly driven by fairly stable wages and duration of temporary disability.
  • Defense attorneys were involved more often in workers’ compensation claims and with higher payments per claim in Florida than in most of the other states studied.
  • The speed of injury reporting in Florida was the fastest in the study states.

“The study will help policymakers and other stakeholders understand how the Florida workers’ compensation system measures up with other states and serves as an invaluable tool in monitoring system improvements,” said Ramona Tanabe, WCRI’s deputy director and counsel.

The Cambridge, Mass.-based WCRI is an independent, non-partisan research center for public policy issues involving workers’ compensation systems.

 

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