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Interstate Comparison: Percentage Change in Selected Measures for Claims with More Than 7 Days of Lost Time for Claims from 2002/2003 through 2003/2004, Not Adjusted for Injury and Industry Mix

Measure	AR^a	CA	FL	IL	IN^a	LA^a,b	MA	MD	NC^a	PA	TN^a	TX	WI
Physician
Average medical payment per claim	5.2%	2.5%	9.7%	10.7%	3.4%	0.0%	14.2%	2.8%	3.7%	9.0%	7.6%	-11.2%	13.3%
Index of per claim utilization	-0.8%	1.9%	6.0%	5.8%	3.5%	-2.3%	7.9%	1.7%	3.8%	5.2%	5.4%	-2.1%	8.1%
Average number of visits per claim	-1.8%	-2.6%	2.4%	1.5%	0.2%	-2.8%	2.5%	-5.1%	-0.8%	7.2%	3.0%	-3.7%	5.9%
Average number of services per visit	-0.4%	5.3%	5.1%	2.4%	3.2%	4.0%	8.4%	-1.6%	-1.5%	3.4%	6.5%	1.5%	4.2%
Index of average prices	3.4%	-1.4%	0.7%	5.5%	3.4%	1.6%	1.4%	-1.1%	1.6%	1.4%	3.7%	-7.9%	7.7%
Chiropractor
Average medical payment per claim	-8.1%	7.5%	-8.5%	-4.4%	51.2%	-27.3%	1.4%	11.0%	-1.1%	-4.6%	-0.1%	-3.9%	6.0%
Index of per claim utilization	-12.8%	4.4%	-10.9%	-6.5%	57.2%	-28.0%	-1.7%	13.7%	5.0%	-9.9%	25.0%	-9.3%	1.6%
Average number of visits per claim	48.6%	0.0%	-9.7%	-11.3%	16.7%	-17.7%	1.5%	7.4%	1.7%	-9.2%	11.4%	-6.3%	-3.3%
Average number of services per visit	-29.9%	0.8%	0.0%	6.2%	10.0%	-9.0%	-2.7%	8.9%	-6.2%	-0.2%	6.3%	-0.4%	6.1%
Index of average prices	15.3%	2.7%	2.6%	4.3%	4.2%	4.0%	8.9%	1.7%	8.6%	3.9%	3.4%	5.3%	4.0%
PT/OT
Average medical payment per claim	-1.0%	-3.6%	-6.6%	9.4%	5.0%	0.9%	12.3%	-1.5%	2.5%	12.1%	4.1%	-7.5%	2.9%
Index of per claim utilization	-4.3%	-3.6%	-7.3%	6.1%	3.9%	0.1%	1.1%	-0.3%	7.2%	5.6%	4.6%	-6.2%	1.2%
Average number of visits per claim	-5.4%	-6.5%	-3.6%	5.2%	0.5%	3.6%	2.0%	0.1%	2.3%	6.6%	2.9%	-1.4%	2.8%
Average number of services per visit	3.2%	3.6%	2.2%	6.5%	5.6%	10.4%	3.3%	5.5%	10.1%	5.0%	9.9%	-4.9%	-1.7%
Index of average prices	5.0%	1.9%	0.5%	7.8%	-1.2%	1.3%	8.5%	4.5%	-0.4%	3.2%	0.7%	2.2%	1.2%
Hospital outpatient provider^c
Average medical payment per claim	-3.4%	8.4%	15.5%	13.4%	12.1%	-2.4%	12.8%	5.5%	13.6%	8.4%	5.0%	1.7%	14.6%
Index of per claim utilization	-0.7%	3.1%	4.0%	8.8%	6.8%	-5.8%	1.0%	5.9%	4.2%	4.1%	2.7%	1.4%	4.8%
Average number of visits per claim	-0.3%	-9.1%	3.6%	6.5%	12.3%	-7.7%	4.0%	5.8%	-0.2%	-2.4%	4.5%	-1.7%	6.9%
Average number of services per visit	0.5%	1.4%	2.3%	3.6%	0.6%	3.5%	6.0%	6.4%	7.0%	4.3%	1.9%	2.2%	0.4%
Index of average prices	6.3%	5.9%	5.7%	11.9%	7.3%	13.6%	3.1%	2.3%	12.6%	5.7%	6.8%	8.3%	10.4%
Notes: Claims with 12 months' average maturity. 2003/2004 refers to claims from October 2002 through September 2003, evaluated as of March 2004. A trend of 0.0 means the change was less than 0.05 percent.
^a Because the database contains relatively few claims (less than 200) with chiropractic treatment, and this number fluctuates from year to year, we are less confident in the year to year changes in average payments per claim and utilization (visits, services per visit, and service-mix intensity) for chiropractors in Arkansas, Indiana, Louisiana, North Carolina, and Tennessee.
^b We use the Louisiana specific physical therapy and chiropractic codes to analyze trends within Louisiana; therefore, these trends are based on the entire set of physical medicine codes rather than the subset used in the 2003/2004 level table.
^c For the most part, hospital outpatient services do not include payments to ambulatory surgical centers which are not consistently defined in the data, but are most often included in the nonhospital physician category. This does not include payments for hospital inpatient services.
Measures:
• Percentage of medical payments: The sum of payments to each provider type or for each service group, divided by the sum of total medical payments.
• Percentage of all claims: The proportion of all claims with medical bill data with at least 1 service rendered by the provider type.
• Average medical payment per claim: The sum of medical payments to each provider type, divided by the number of claims involving the provider type.
• Index of per claim utilization: Measures the relative utilization compared to other states. The median state = 100. An index of 120 means that the states utilization is 20 percent higher compared to the median state and an index of 80 means that the state's utilization is 20 percent lower compared to the median state. The utilization measures the volume of services provided as well as the relative resource intensity of the services provided per claim.
• Average number of visits per claim: The total number of visits to each provider type, divided by the number of claims involving the provider type or service group.
• Average number of services per visit: The total number of services paid to each provider type, divided by the total number of visits involving the provider type or service group.
• Index of average prices: The index measures average unit prices paid relative to the median state. The median state = 100. If a state's index is 80, this means that prices are on average 20 percent lower than the median state; if a state's index is 120 this means that the prices are on average 20 percent higher than the median state.
Key: physician: medical doctor or doctor of osteopathy; PT/OT: physical or occupational therapist.

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