States with no duty for professional services in workers' compensation pay prices 39% to 171% higher for these services than the median of study states with on-site fee schemes, according to a report released on Thursday.
In Cambridge, the Massachusetts-based Work Compensation Research Institute's new study, the WCRI Medical Price Index for Workers Compensation, 11th edition, researchers examined the prices of professional services in 36 states from 2008 to 2018. Professional services account for approximately 44% of labor compensation expenses according to WCRI.
Seven of the states studied did not have professional service fee plans – which include evaluation and management, physical medicine, surgery, major radiology, less radiology, neurological testing, pain relief injections and emergency care ̵
The researchers found that medical rates in most non-fee states grew faster than in states with fee schedules – the median growth rate of the non-fee states was 34% from 2008 to 2018, compared to the typical rate of growth of 6% among the charging schemes. .
Several study states have switched to fee schemes linking workers' compensation payments to Medicare's resource-based relative value scale, leading to some increases and some reductions in professional services prices, WCRI reported. In 2014, California began its four-year transition to a Medicare RBRVS Professional Services Charge Scheme, which has led to an increase in office visits, but a reduction in pricing for major operations, pain management, and emergency services. Prices of professional services between 2013 and 2017 increased by 14 percent in the state. But since then, California has had one of the lowest overall professional services awarded among study states and network participation in the state has increased to 93% from 85% over the same period, researchers reported.
Colorado began tying its professional services fee schedule to Medicare RBRVS in January 2016 and saw prices rise by about 5% for office visits, but prices almost doubled for less radiology and neurological testing. However, the large operating prices fell by 25% and the prices of emergency services were almost halved in the state between 2016 and 2018.
Arizona, which followed Colorado's management in 2017, saw a mixed bag of compromise changes, with special care costs, which operations decreased with 12% while office visit prices increased by 11% between 2017 and 2018.
North Carolina, which introduced a fee schedule in 2015, set prices for professional services at about 158% of 1995 Medicare values, office saw prices and emergency visits are increasing "substantially "from 2014 to 2016 while prices for major surgeries, pain relief injections and neurological testing decreased; and in Virginia, which carried out a fee schedule in January 2018, the cost of professional services decreased by 14% in 2018 compared to 2017, according to the report.
"If you are a politician or other stakeholder and want to understand how medical awards in employee compensation in your state compared to other states, or how prices in your country change over time, you would benefit from this study, Ramona says. Tanabe, WCRI's Vice President and Adviser in a statement. "If you are in one of the many states that have implemented the fee schedule recently or are considering such changes in the future, this study will show how some policy initiatives affect medical prices."
The 36 US states studied, which make up about 88% of work compensation expenses in the United States include Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia and Wisconsin.