Wisconsin Medical Fee Schedule Absence Very Expensive Option – WCRI

WCRI-Wisconsin Medical Fee Schedule Lacking

A Wisconsin medical fee schedule would likely help out the Badger State.   WCRI ( Workers Comp Research Institute) recently updated its analysis of the Workers Comp environment in Wisconsin.

One of the easiest ways to cut Workers Comp costs in a state is to enact a fee schedule.   I have written many posts on fee schedules as a way for  a State House and Senate to reduce A Wisconsin medical fee schedule is long overdue.   When State Representatives and Senators become Risk Managers, the results can be lacking at best.

The State of Virginia enacted a fee schedule which was surprising to me at the time.   We shall see how their medical costs change over the next few years.

However, medical fee schedules are State Government based  Risk Management at its best.  Reducing the bills upfront lets the providers know what they will be paid and allows claims staffs to better reserve the claim files accurately.

WCRI has confirmed this delineation between fee schedule and non-fee schedule states.  Their newest study on the lack of a Wisconsin Medical Fee Schedule proves my point.

A new study by the Workers Compensation Research Institute (WCRI) found that Wisconsin’s medical payments per workers’ compensation claim were higher than typical for 2015 injuries evaluated as of March 2016. While growth in Wisconsin’s workers’ compensation medical payments per claim slowed in the past several years, medical payments were still increasing at a faster rate than other states that WCRI studied.

The study, CompScope™ Medical Benchmarks for Wisconsin, 18th Edition, examined the costs, prices, and utilization of workers’ compensation medical care in Wisconsin in comparison with 17 states.

The following are among the WCRI study findings:

• In 2015, Wisconsin’s workers’ compensation medical payments per claim with more than seven days of lost time were 61 percent higher than the median study state; medical payments per all paid claims were 46 percent higher than typical. These results reflect a widening gap between Wisconsin and the median study state compared with prior editions of the CompScope™ report, which showed Wisconsin’s average medical payments as being closer to the median study state.

• Substantially higher prices paid for non-hospital medical services were a factor contributing to higher average medical payments. Utilization of non-hospital medical services in Wisconsin was among the lowest of the study states.

• Payments per claim for non-hospital services increased 3 percent annually from 2010 through 2015, driven more by price increases than utilization.

• Similarly, hospital outpatient payments per claim increased 4.7 percent per year, on average. Increases in payments per service contributed to this trend; there was little change in utilization of hospital outpatient care.

• In 2015, Wisconsin had among the highest percentages of claims receiving hospital outpatient care, due primarily to a higher percentage of workers receiving radiology, physical medicine, and office visits from hospital outpatient providers.

WCRI studied medical payments, prices, and utilization in 18 states, including Wisconsin, looking at claim experience through 2016 on injuries that occurred mainly in 2010 to 2015. WCRI’s CompScope™ Medical Benchmarks studies compare payments from state to state and across time.

To purchase this report, visit https://www.wcrinet.org/reports/compscope-medical-benchmarks-for-wisconsin-18th-edition.

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