WCRI: Wisconsin’s Medical Payments per Claim Remain Stable but Highest Among 17 States

December 7, 2023

Medical payments for treatment of injured Wisconsin workers were the highest of 17 study states, according to a recently released report from the Workers Compensation Research Institute (WCRI).

The study, CompScope™ Medical Benchmarks for Wisconsin, 24th Edition, found that medical payments per claim in Wisconsin remained stable between 2019 and 2021 after moderate growth the prior years. Medical payments per claim between 2019 and 2021 are $27,116.

Ramon Tanabe, president and CEO of WCRI, said higher prices for professional services and higher payments to hospitals for common outpatient surgical episodes were drivers of higher than typical medical payments per claim in Wisconsin.

The study found that nonhospital utilization per claim was lower in Wisconsin than most states. The percentage of claims with many nonhospital or hospital outpatient services decreased mostly due to the pandemic, WCRI found.

The study focuses on the payments, prices and utilization of workers’ compensation medical care by examining services in Wisconsin compared to 16 other states overall, by type of provider and by type of medical service.

Topics Wisconsin

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