Worker compensation payments in states with Medicare-linked fee schemes tend to pay less for outpatient hospital care or treatment at outpatient surgery centers than those without, according to the Workers Compensation Research Institute.
Researchers analyzed on Wednesday the effects of government workers compensating outpatient compensation fee schedules during Cambridge, Massachusetts-based WCRI's virtual annual issues and research conference.
"States use different methods to regulate compensation for facilities," said Rebecca Yang, senior public policy analyst at WCRI. "There is a growing interest among decision makers and stakeholders to understand the role of fee provisions for facility payments."
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States with a fixed fee schedule where reimbursement levels are assigned to each procedure or group of procedures – and are usually based on a percentage of Medicare reimbursement – generally had lower outpatient payments than states without a fee schedule or a fee-based fee schedule, where payments are based on a percentage of hospital fees or on a quota allowance, she said.
Using research from 2018, the latest available data, WCRI found that Alabama, which has a percentage-based fee schedule, paid 136% above the median for hospital outpatient claims that year.  Massachusetts, Nevada, New York, Oklahoma and West Virginia – which all use a fixed amount schedule – paid about 50% less than the median state for hospital outpatient claims in 2018, with Nevada salary the lowest amount, about 66% below the median.