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Outpatient costs higher where the compensation fee rules are limited



States with percentage-fee-based fee regulations or no outpatient hospital care plans saw exponentially higher costs nationwide, according to a report released Thursday by the Workers' Compensation Research Institute.

Cambridge, a Massachusetts-based researcher compared hospital payments for a group of standard outpatient surgery operations in 36 states from 2005 to 2019 and found that costs were more than double in some cases compared to costs in states with pay schedules.

Specifically, hospital payments per outpatient surgical episode in states with percentage-based fee rules were 73% to 209% higher than the median for studies with fixed fee schedules 2019. In states without fee schedules, they were 61

% to 130

The study also showed that growth in Outpatient hospital payments per episode among non-fee schedules ranged from 25% in Iowa to 54% in Missouri from 2011 to 2,019, while payments in the median fee for fixed amount determined without significant changes in the rules increased by approximately 4% over the same period.

The variation between average workers' compensation payments and Medicare prices for a common set of procedures between states ranged from a minimum of 38%, or $ 2,294, below the Medicare prices in Nevada to a maximum of 502%, or $ 24,758 above the Medicare prices in Alabama.

Study data were limited to payments for services provided and billed by hospitals, with such costs as professional services billed by non-hospital providers, transactions for sustainable medical equipment and medicines billed by non-hospital providers and payments to outpatient surgical centers excluded .

The study covers 36 major states representing 88% of workers' benefits paid in the United States. The states are Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Jersey , New Mexico, New York, North Carolina, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, West Virginia and Wisconsin. Catalog

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