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View WCRI Benchmarks
Interstate Comparison: Medical Claim Costs and Utilization by Provider Type, 2003/2004 Claims with More Than 7 Days of Lost Time, Adjusted for Injury and Industry Mix (12 months' average maturity)
| Measure | AR | CAa | FL | ILb | IN | LA | MA | MD | NC | PA | TN | TX | WI | 13-State Medianc |
| Physician | ||||||||||||||
| Percentage of medical payments | 39% | 40% | 33% | 39% | 40% | 35% | 35% | 31% | 30% | 29% | 40% | 33% | 35% | 35% |
| Percentage of all claims | 96% | 95% | 96% | 93% | 93% | 97% | 90% | 92% | 95% | 93% | 97% | 95% | 89% | 95% |
| Average medical payment per claim | $3,244 | $3,698 | $2,605 | $4,711 | $4,025 | $3,184 | $1,610 | $1,940 | $2,606 | $2,034 | $3,975 | $3,448 | $3,549 | $3,244 |
| Index of per claim utilization | 105 | 121 | 105 | 106 | 102 | 100 | 64 | 88 | 96 | 95 | 100 | 121 | 72 | 100 |
| Average number of visits per claim | 10.2 | 16.2 | 10.5 | 11.8 | 9.4 | 10.1 | 7.2 | 8.8 | 9.5 | 10.0 | 10.0 | 12.4 | 8.3 | 10.0 |
| Average number of services per visitd | 2.3 | 2.9 | 2.3 | 2.6 | 2.3 | 2.4 | 1.9 | 2.3 | 2.3 | 2.7 | 2.3 | 2.8 | 2.0 | 2.3 |
| Index of average prices | 102 | 90 | 82 | 166 | 139 | 108 | 93 | 81 | 98 | 90 | 133 | 92 | 185 | 100 |
| Average payment per visit | $287 | $222 | $245 | $401 | $420 | $310 | $226 | $221 | $272 | $207 | $391 | $270 | $432 | $272 |
| Chiropractor | ||||||||||||||
| Percentage of medical payments | 0% | 10% | 0% | 2% | 0% | 1% | 2% | 2% | 0% | 2% | 0% | 18% | 2% | 2% |
| Percentage of all claims | 3% | 22% | 3% | 8% | 2% | 4% | 9% | 8% | 2% | 7% | 3% | 29% | 12% | 7% |
| Average medical payment per claim | $976 | $3,929 | $809 | $2,340 | $1,187 | $1,849 | $1,136 | $1,333 | $937 | $2,030 | $974 | $5,972 | $1,592 | $1,333 |
| Index of per claim utilization | 70 | 279 | 80 | 118 | 82 | n/ae | 110 | 138 | 67 | 154 | 85 | 305 | 81 | 98 |
| Average number of visits per claim | 16.6 | 38.8 | 10.8 | 18.9 | 11.3 | 18.3 | 19.3 | 18.7 | 11.3 | 20.7 | 11.9 | 30.9 | 17.1 | 18.3 |
| Average number of services per visitd | 2.2 | 3.4 | 3.4 | 3.3 | 3.0 | n/af | 2.8 | 3.6 | 2.9 | 3.5 | 3.5 | 4.1 | 2.4 | 3.4 |
| Index of average pricesg | 104 | 100 | 73 | 135 | 108 | 127 | 65 | 72 | 88 | 100 | 95 | 119 | 122 | 100 |
| Average payment per visit | $66 | $98 | $68 | $120 | $100 | $101 | $59 | $71 | $71 | $93 | $115 | $189 | $92 | $93 |
| PT/OT | ||||||||||||||
| Percentage of medical payments | 6% | 10% | 7% | 12% | 9% | 14% | 9% | 10% | 9% | 13% | 10% | 11% | 5% | 10% |
| Percentage of all claims | 34% | 52% | 45% | 41% | 44% | 50% | 30% | 40% | 44% | 39% | 48% | 49% | 25% | 44% |
| Average medical payment per claim | $1,380 | $1,621 | $1,273 | $3,180 | $2,018 | $2,449 | $1,178 | $1,359 | $1,692 | $2,176 | $1,927 | $2,238 | $1,978 | $1,927 |
| Index of per claim utilization | 71 | 100 | 97 | 122 | 81 | n/ae | 91 | 116 | 104 | 146 | 87 | 100 | 62 | 99 |
| Average number of visits per claim | 12.5 | 19.6 | 13.8 | 17.7 | 12.8 | 18.7 | 15.5 | 16.8 | 15.2 | 18.3 | 13.7 | 14.8 | 11.8 | 15.2 |
| Average number of services per visit | 3.7 | 3.3 | 3.4 | 3.8 | 3.2 | n/af | 3.6 | 3.8 | 3.7 | 4.2 | 3.7 | 3.5 | 2.7 | 3.6 |
| Index of average pricesg | ||||||||||||||