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Interstate Comparison: Percentage Change in Selected Measures for Claims with More Than 7 Days of Lost Time for Claims from 2006/2007 through 2007/2008, Not Adjusted for Injury and Industry Mix

Measure CA FL IAa IL INa LAa MA MD MI MN NCa PA TNa TX WI
Physician
Average medical payment per claim  7.1 5.4 7.9 8.4 -6.1 -8.3 1.3 -3.5 -1.8 4.4 4.7 3.5 -0.5 -2.1 7.4
Index of per claim utilization 4.3 5.4 2.4 1.8 -7.7 -8.5 0.2 -4.9 0.0 0.6 0.1 2.0 -0.6 -3.5 2.4
Average number of visits per claim 2.5 4.7 -1.3 -1.7 -9.0 -9.2 1.1 -3.6 -6.8 -3.8 -1.5 -0.6 -1.4 -1.6 -2.5
Average number of services per visit 1.5 1.1 3.9 -0.7 -4.0 0.0 8.6 4.7 0.2 1.3 0.5 5.4 2.0 -1.7 -0.7
Index of average prices 4.7 0.0 4.5 7.3 4.6 2.4 1.8 0.2 1.3 1.0 0.2 3.9 0.9 -1.1 7.4
Chiropractor
Average medical payment per claim -5.7 2.2 41.5 -2.8 -22.6 -5.3 -0.4 -10.0 18.8 22.5 46.3 2.1 -26.7 -25.0 -4.0
Index of per claim utilization -4.6 -6.2 35.2 -1.1 -27.8 -4.0 -2.9 -11.8 21.8 10.5 49.4 -0.9 -27.5 -18.7 -3.0
Average number of visits per claim -5.1 0.1 41.6 -6.5 -2.7 4.0 5.1 -8.6 12.4 9.1 55.8 -0.3 -21.8 -21.2 -6.9
Average number of services per visit 0.5 -0.1 0.5 -1.2 -21.1 6.2 -3.1 -0.6 18.1 3.4 8.0 0.5 -10.6 -1.8 5.1
Index of average prices 0.3 -1.1 -10.9 -0.7 -6.1 -8.3 -4.1 -6.9 -4.1 0.0 -2.7 -5.1 -7.4 -10.1 -6.4
PT/OT
Average medical payment per claim  -0.7 19.8 -5.7 8.5 2.8 -8.9 -0.1 -4.0 -0.7 0.5 -0.2 3.3 -1.9 -5.0 1.2
Index of per claim utilization -1.0 15.8 -4.2 7.1 -0.3 -5.8 -0.5 -1.4 -4.4 -4.2 1.1 4.9 4.4 -0.4 0.2
Average number of visits per claim -2.6 5.9 -5.8 5.0 -3.2 -9.7 -3.4 -2.0 -2.4 -2.6 0.7 2.6 -2.1 -1.6 1.9
Average number of services per visit 1.9 10.2 2.5 1.2 1.3 -0.2 5.2 1.6 -2.0 1.0 1.0 1.5 4.7 0.7 -1.5
Index of average prices 1.7 -0.7 1.3 5.5 6.1 2.9 6.1 0.8 3.3 3.3 2.4 0.0 0.4 -1.7 7.0
Hospital outpatient providerb
Average medical payment per claim  n/ac 4.2 2.2 2.2 -4.7 6.9 16.6 1.5 3.0 8.3 1.2 3.7 -4.4 8.4 1.8
Average number of services per claimd n/ac -5.5 -9.1 -9.1 -11.0 -9.9 -0.9 3.3 6.2 9.0 5.4 -3.7 -9.0 11.2 -7.3
Average number of visits per claim n/ac -4.4 -10.5 -10.5 -11.8 -14.1 -4.0 -3.1 3.5 11.9 9.1 -5.6 -7.9 8.6 -6.8
Average number of services per visit n/ac -1.2 1.6 1.6 0.9 4.8 3.2 6.6 2.7 -2.6 -3.4 2.0 -1.2 2.5 -0.6
Average payment per serviced n/ac 10.2 12.5 12.5 7.1 18.7 17.7 -1.7 -3.0 -0.7 -4.0 7.8 5.0 -2.6 9.9
Notes: Claims with 12 months' average maturity. 2007/2008 refers to claims from October 2006 through September 2007, evaluated as of March 2008. A trend of 0.0 means the change was less than 0.05 percent.
a The data in Iowa, Indiana, Louisiana, North Carolina, and Tennessee contains relatively few claims with chiropractic treatment (less than 200) and the numbers may fluctuate from year to year. Therefore the data should be used with caution.
b For the most part, hospital inpatient or outpatient services do not include payments to stand-alone ambulatory surgical centers, which are not consistently defined in the data but are most often included in the nonhospital physician category.
c Trends in hospital outpatient payment per claim, outpatient services per claim, visits per claim, and visits per service are not shown for California because underlying data in our sample are not sufficiently representative of the state's trends. 
d For hospital outpatient services, because the revenue codes often used in hospital billing are too broadly defined to support a robust marketbasket of services and an estimate of the relative intensity of services, we report average payment per service and number of services per claim.
Measures:
• 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 state's 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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