CompScope – State of the States – WCRI – Blogging Live
States of the States WCRI CompScope annual conference 2016 Blogging Live.
Preliminary Research – Subject to change –
Two New States – Kentucky and Georgia are being added to the CompScope(R)
Wage Loss States that have wage loss and PPD – North Carolina and Georgia
Wage Loss states are not PPD states –
Georgia
TTD = Temporary Total Disability
Georgia is a combined PPD and Wage Loss state
TTD benefits paid – No maximum medical (MMI) in Georgia
TTD maximum weeks = 400 weeks
Maximum 300 PPD Weeks
Georgia – one of higher states for TTD – median state $18,313
Georgia – Approximately $26,000 per claim average on TTD
Weekly TTD benefits rate lower than median state
Average duration of TD benefits were lower than median state
40% lower statutory maximum
31% of claims were limited by maximum TTD rate – highest of all studied states
Georgia and North Carolina had the highest rate of lump sum settlements
Georgia had:
- higher medical benefit involved in PPD settlements than median states
- higher litigation related expense than median state
- higher payments for defense attorney than the median state
- is based on an administrative system
Kentucky
No TPD – Temporary Partial Disability
Longer Temporary Total Disability period
Kentucky is close to median state for TTD length
Kentucky was:
- PPD benefit payments were higher than the median
- Close to median state were for benefit delivery expenses
- Medical-legal services expense were much higher than the median state
Medical trends across the States
Half of studied states – had a moderate growth rate in medical costs
The other half had very low growth rates in medical costs
What factors caused the very low growth rate?
- Illinois –
- 30% reduction in fee schedule rates
- 29 different fee schedules in the state (regions) were reduced to 4
- 76% higher than Medicare fee schedule rates
- North Carolina –
- Outpatient hospital -utilization per claim lowered
- Fee schedule reduced outpatient charges from 95% of charges to 76% of charges
- 2013 – froze rates – cut by 15%
- Outpatient hospital rates were tied to Medicare rates in 2015
- Goal – balance out hospital charges with non-hospital charges
- California –
- SB 863 effects
- Reduced ASC rates from 120% to 80% of Medicare outpatient hospital rates
- Trend of billing frequent complex office visits stopped in 2014
- Neurological testing fees reduced by 43.6%
- Louisiana –
- Colorado – based guidelines introduced
- Decrease in medical visits per claim possibly due to changes in 2011
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