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Workers' complications for health care fees affect access to care: Study



State workers compensation regulations that set low medical fees may affect access to care for injured workers, according to a study released Thursday by the Labor Compensation Research Institute.

In the extensive study of charge schemes in 45 states that have them, researchers examined the average fee schedule of what Medicare established and found the data "varied substantially" from 1% over what Medicare pays in Massachusetts to 179% over Medicare in Alaska, according to report.

Since the Massachusetts Massachusetts organization last studied fee plans in 2016, five states – Arizona and Virginia – made significant changes. Arizona adopted "Resource-Based Relative Value Scale", which takes into account the availability of the population and vendor, and Virginia introduced a fee schedule with historical actual average spending or community fees, the report said. Three states ̵

1; Florida, Kentucky and North Dakota – had "significant changes in their schedule of charges" which resulted in double-digit growth in the total rates from 2016 to 2019, researchers found.

Overall, access to fee schemes in 2019, the District of Columbia, Florida, Massachusetts, and New York established their employees' compensation fee rates, on average, across all professional service groups, to be within 20% of Medicare prices. In turn, Alaska, Arizona, Idaho, Nevada, North Dakota and Virginia set the fee schedule rates at levels more than double the Medicare at state level, according to the data.

In the case of healthcare service groups, approximately 25% of fee schedule states determined their remuneration rates for evaluation and management services, otherwise known as office visits, "near the Medicare level or below." Four states – Massachusetts, New York, Oklahoma and Wyoming – had fees for physical medicine near or below the Medicare rate. Researchers noted that "such a level could potentially compromise access to primary and physical medical care for injured workers".

Meanwhile, 20% of the fee schedule states determined their charges for major surgery at triple Medicare price or more in each state, according to the report.

                    


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