Virginia Med Payments Per Workers’ Comp Claim Among Highest of Study States

November 4, 2015

Driven primarily by prices, medical payments per workers’ compensation claim with more than seven days of lost time in Virginia were among the highest of the study states, according to a recent study issued by the Workers Compensation Research Institute (WCRI).

The report, CompScope Medical Benchmarks for Virginia, 16th Edition, found that overall medical payments per workers’ compensation claim with more than seven days of lost time were 33 percent higher in Virginia than the median of the study states.

The report studied medical payments, prices, and utilization in 17 states, including Virginia, looking at claim experience through 2014 on injuries that occurred in 2013 and earlier. WCRI’s CompScope Medical Benchmark studies compare payments from state to state and across time.

The 17 states in the study — Arkansas, California, Florida, Georgia, Illinois, Indiana, Iowa, Louisiana, Massachusetts, Michigan, Minnesota, New Jersey, North Carolina, Pennsylvania, Texas, Virginia, and Wisconsin — represent more than 60 percent of the nation’s workers’ compensation benefit payments, WCRI noted.

“As this report shows, medical prices in Virginia were a contributing factor to higher payments that employers pay on workers’ compensation claims, and medical prices continue to grow,” said Ramona Tanabe, WCRI’s executive vice president.

For nonhospital providers (physicians and physical/occupational therapists), overall prices were 13 percent higher than the 17-state median, while utilization — a measure that includes number of visits per claim and services per visit as well as the resource intensity of services provided — was mostly typical.

Higher-than-typical prices also contributed to higher payments per claim for outpatient services, according to WCRI’s study.

The study also found that medical payment per workers’ compensation claim with more than seven days of lost time in Virginia changed little in 2013, after rapid growth in earlier years. This reflects offsetting trends for nonhospital providers—prices for nonhospital services continued growing, while utilization decreased.

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Cambridge, Massachusetts.

Source: The Workers Compensation Research Institute (WCRI)

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