Workers Comp Fee Schedules As Cost Controllers
Workers Comp fee schedules are one of the best ways for a state to help employers control WC costs.
Yesterday, I posted an article on the new NCCI study on fee schedules. After talking with a few prognosticators in the health insurance and WC fields, I think I may have been reading the title of the NCCI study incorrectly.
I decided to pull 30 random physician bills in fee-schedule states (approximately 30) from some of the files that we are reviewing. Some of the physician bills had in-network reductions after the fee schedule was applied to the charges.
The results of my quick study were:
Total physician charges of all bills before fee schedule (surgical and non-surgical) $24,876
Total physician bills after fee schedule $13,958
Total physician bills after in-network reduction (post fee schedule) $13,026
Total savings from fee schedule and in-network $11,850
Estimation of what health insurer would have paid $ 9,284
WCRI (Workers Comp Research Institute) had performed a massive study on health vs. Workers Comp payments for outpatient shoulder surgery. This study left no doubt that WC treatment is much more expensive than health.
Could it be that health insurer networks provide a higher volume than WC therefore the physicians are willing to concede more charges?
Analyzing the complexities of how health insurers reimburse medical treatment is something that I do not do as health insurance is not one of my specialties.
Workers Comp fee schedule articles that I have written and are still applicable:
- NCCI Studies Physician Fee Schedules (2013)
- Tennessee and Illinois Fee Schedules Working (2012)
- WCRI Conference – Illinois Fee Schedule Trended Costs Downward (2014)
There are many more articles that can be found on fee schedules by using the search box and typing in WCRI, NCCI, or fee schedule. Feel free to print them.
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