MASSACHUSETTS MEDICAL COSTS STAY LOW:

The average medical payment per claim for the care of injured workers in Massachusetts rose 13 percent in the most recent period but still remained the lowest of the 12 states analyzed in a study by the Cambridge-based Workers Compensation Research Institute (WCRI). An earlier WCRI study found that workers in Massachusetts report similar or better outcomes than those in states with higher medical costs. The lower medical payment per claim—51 percent less than the median of the 12 states—was due to significantly lower payments per visit, likely the result of the lowest-in-the-nation medical fee schedule, the study said. The number of visits per claim to physicians, chiropractors and physical and occupational therapists in Massachusetts was somewhat lower than the 12 state median, but the number of visits per claim was significantly higher than the median (40 percent) for hospitals. For example, in Massachusetts medical payments per claim were 34 percent to 45 percent lower than typical for non-hospital providers such as physicians, chiropractors and physical and occupational therapists and 71 percent lower for hospitals, primarily because of lower average prices and fewer services per visit. “This new study confirms that while Massachusetts was the lowest cost state when it came to payments per claim for medical services to injured workers, these costs were accelerating at a double-digit rate,” Dr. Richard Victor, executive director of the research organization, said. The study found that the average medical cost per claim in Massachusetts ($3,333) was more than 50 percent lower than that in the median state studied ($6,736). Average prices were substantially lower for all non-hospital services except for office visits and major surgery, for which prices were near the median in Massachusetts despite having the lowest fee schedule. The study also pointed out that hospitals in the state might have provided services that patients in other states more often received from physicians. Hospitals in Massachusetts were involved in 14 percent more claims compared with the 12-state median, generating 40 percent more visits per claim. In addition to Massachusetts, the states analyzed in the WCRI study were California, Connecticut, Florida, Illinois, Indiana, Louisiana, Pennsylvania, North Carolina, Tennessee, Texas and Wisconsin.

Topics Workers' Compensation Massachusetts