WCRI: Medical Payments Decreased in Half of Study States in 2020, Due to COVID-19

Cambridge, MA (WorkersCompensation.com)? Medical payments per claim fell more than 3% in half of the 18 states in the 2020 Injury Study with experience through March 2021, according to a new series of studies from the Workers Compensation Research Institute (WCRI) . This likely reflects factors related to the COVID-19 pandemic. During the previous period from 2015 to 2019, medical payments per claim were stable or increased moderately in the study states.

“Temporary suspensions of elective treatments and procedures, avoidance of care due to concerns about contracting COVID-19, and increased use of telehealth services have contributed to changes in payments and use of medical care,” said Ramona Tanabe, executive vice president and attorney at WCRI. . “In addition, other factors – such as the timing and severity of the pandemic, the speed of resuming elective surgeries and procedures, the degree of reliance on hospital care, and state policies – influenced the differences in trends. between states.”

Here are sample results for some of the states in the study:

  • Florida: Medical payments per claim in Florida decreased by 5% in 2020/2021 (injury claims from September 2019 to October 2020 and experience through March 2021) for non-COVID-19 claims, primarily due to a decrease in the use of medical services, after growth of 4 to 5% per year from 2015 to 2019.
  • Indiana: Medical payments per claim in Indiana decreased 14% in 2020/2021 for non-COVID-19 claims after increasing 11% in 2019.
  • Michigan: Medical payments per claim in Michigan decreased 4% in 2020/2021 for non-COVID-19 claims, following increases of 4% per year from 2015/2016 to 2019/2020.
  • Minnesota: Medical payments per claim in Minnesota saw low growth from 2015 to 2018 and a slight decline in 2019 following the move to Medicare-based fee schedules. In 2020/2021, this metric decreased by 5% for claims unrelated to COVID-19, primarily due to a decrease in the use of medical services.
  • Pennsylvania: Medical payments per claim in Pennsylvania declined 5% in 2020/2021 for non-COVID-19 claims, following moderate growth of 4-5% from 2017 to 2019.

The studies, CompScope™ Medical Benchmarks, 23rd Edition, provide analyzes of recent cost drivers and trends for policy makers and other system stakeholders, reporting how medical payments per claim and cost components vary over time and from state to state. The reports identify where medical costs and patterns of care may change and where medical payments per claim or use may differ from other states. The studies cover the period from 2015 to 2020, with claims experience through March 2021, including non-COVID-19 claims only from the start of the pandemic period (March-September 2020). They therefore provide insight into the impact the pandemic may have had on non-COVID-19 workers’ compensation claims in the early months of the pandemic.

The 18 states of the study? Arkansas, California, Florida, Georgia, Illinois, Indiana, Iowa, Louisiana, Massachusetts, Michigan, Minnesota, New Jersey, North Carolina, Pennsylvania, Tennessee, Texas, Virginia, and Wisconsin? account for more than 60 percent of the nation’s workers’ compensation benefit payments. Individual reports are available for each state except Arkansas, Georgia, Iowa and Tennessee.

For more information on these studies, visit https://www.wcrinet.org.

About WCRI

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Cambridge, MA. Created in 1983, the Institute does not take a position on the issues it studies; rather, it provides information obtained through studies and data collection efforts, which are consistent with accepted scientific methods. Objectivity is further ensured by rigorous and impartial peer review procedures. WCRI’s diverse membership includes employers; insurers; government entities; managed care companies; health care providers; insurance regulators; state trade union organizations; and state administrative agencies in the United States, Canada, Australia and New Zealand.

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