Medical Cost Containment Inventory From 51 Jurisdictions
WCRI Releases National Inventory of Medical Cost Containment Initiatives Adopted In 51 Jurisdictions. Last week, WCRI (Workers Compensation Research Institute released an authoritative work on the initiatives adopted nationally.
Medical costs have almost become runaway when compared to indemnity costs in most Workers Compensation claims. State legislatures have become accustomed to tweaking or even overhauling fee schedules and other medical components. Many states have attempted to reign in costs without much of an effect.
“This study provides a basic understanding of the cost containment initiatives adopted in 51 jurisdictions and provides additional references for those who want more detail,” said Ramona Tanabe, author of the report and WCRI’s executive vice president and counsel.
According to the study, medical cost containment became a focus for many states in the early 1990s when the medical portion of the workers’ compensation benefit dollar began to grow more quickly than other claim costs. This led to growth in the adoption and variety of cost containment initiatives since the 1990s.
I would have to agree with that assessment. Indemnity cost containment was on the front burner in the 1980’s when I began my insurance career. Medical cost containment was still on the back burner until the mid-1990’s.
The inventory includes tables of statutory provisions, administrative rules, and administrative procedures used by states as of January 1, 2015. Medical cost containment initiatives include price management methods, such as fee schedules and utilization management (e.g., utilization review or medical networks).
The initiatives outlined in the study aim to curb the cost of a particular service or to reduce the amount of services provided. Cost containment regulatory initiatives entail a balancing act of limiting the cost of services and inappropriate or unnecessary treatment without negatively affecting the quality of treatment or access to care for injured workers.
For more information on this study or to purchase it, click on the following link: http://www.wcrinet.org/result/MCC_2015_result.html.
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