View WCRI Benchmarks

Interstate Comparison: Percentage Change in Selected Measures for Claims with More Than 7 Days of Lost Time for Claims from 2008/2009 through 2009/2010, Not Adjusted for Injury and Industry Mix

Measure CA FL IAa IL INa LAa MA MD MI MN NCa NJ PA TX VA WI
Physician
Average medical payment per claim  8.5 6.6 7.9 8.6 5.3 1.4 19.3 3.7 0.7 3.8 9.2 0.8 6.5 9.6 15.9 9.7
Index of per claim utilization 6.2 2.4 2.3 3.4 -2.3 2.6 8.1 4.6 4.9 -5.6 2.0 8.3 5.5 -1.4 5.9 4.4
Average number of visits per claim 5.6 0.9 1.6 1.6 -1.7 -0.8 2.3 4.6 2.4 0.0 0.8 3.7 4.2 2.4 1.1 0.2
Average number of services per visit 3.8 1.2 -0.1 1.3 -0.5 -2.0 1.8 8.1 1.1 -1.1 2.7 1.4 1.9 -2.6 0.8 0.8
Index of average prices -0.7 3.4 4.8 4.6 6.9 2.5 12.5 -0.2 1.2 3.5 2.0 6.9 1.2 8.0 4.7 5.9
Chiropractor
Average medical payment per claim 5.2 -14.9 -27.0 28.3 14.8 69.9 -3.8 1.9 42.8 13.0 39.1 -21.8 -6.0 0.0 1.2 -0.8
Index of per claim utilization 5.2 -11.4 -29.1 13.2 -43.6 55.6 -5.1 2.8 38.7 7.0 26.6 -12.4 -7.3 -10.0 -8.4 -7.5
Average number of visits per claim 3.3 -10.3 -26.1 3.3 -15.7 37.4 -7.0 5.1 37.4 1.9 34.6 -32.9 -7.6 -8.4 -2.4 -3.2
Average number of services per visit 1.9 -8.3 -7.0 8.6 -6.8 14.4 -2.9 2.8 -0.1 5.8 -3.9 9.0 0.3 -6.4 -1.6 -6.5
Index of average prices 3.1 0.5 9.4 9.1 6.3 2.7 2.6 2.1 0.1 2.4 0.3 2.0 -3.4 6.2 2.7 6.5
PT/OT
Average medical payment per claim  1.9 8.2 7.5 16.2 3.0 11.8 9.3 10.3 7.3 13.9 7.9 4.9 9.3 16.8 23.4 7.1
Index of per claim utilization 0.1 7.2 0.3 3.4 -3.4 7.1 3.4 5.4 1.6 9.7 7.1 6.2 6.2 6.6 15.9 4.2
Average number of visits per claim -1.4 6.4 -2.8 1.3 -4.5 4.9 0.7 1.1 1.4 7.4 4.0 5.7 5.1 6.2 12.9 2.7
Average number of services per visit 2.3 2.0 0.3 2.0 0.2 3.0 0.0 6.4 -1.3 5.8 2.9 -1.6 1.4 0.6 1.1 1.6
Index of average prices 1.7 2.4 1.6 13.3 7.8 3.4 4.3 3.6 2.8 4.8 2.1 4.0 2.9 10.4 8.1 3.1
Hospital outpatient providerb
Average medical payment per claim  n/ac 7.3 13.6 14.4 11.9 10.5 4.5 -1.5 8.4 20.9 1.0 8.4 8.4 3.2 15.2 16.1
Average number of services per claimd n/ac 0.4 3.2 3.4 2.5 -0.5 -0.2 -1.6 5.6 6.3 -4.9 -9.5 4.7 -2.0 2.0 14.0
Average number of visits per claim n/ac -1.6 3.5 3.5 -0.9 -1.8 2.1 -0.7 6.3 5.9 -7.2 1.8 3.5 1.2 4.6 11.7
Average number of services per visit n/ac 2.1 -0.3 0.0 3.5 1.3 -2.2 -0.9 -0.6 0.4 2.5 -4.4 1.1 -3.2 -2.6 2.0
Average payment per serviced n/ac 6.8 10.1 10.6 9.2 11.1 4.7 0.1 2.6 13.7 6.2 20.6 3.6 5.3 12.9 1.9
Notes: Claims with 12 months' average maturity. 2008/2009 refers to claims from October 2007 through September 2008, evaluated as of March 2009. A trend of 0.0 means the change was less than 0.05 percent.
a The data in Indiana, Louisiana, North Carolina, New Jersey, and Virginia contain 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 states utilization is 20 percent higher compared with the median state and an index of 80 means that the state's utilization is 20 percent lower compared with 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. 

 
 

955 Massachusetts Avenue    Cambridge, Massachusetts 02139    617-661-WCRI (9274)

about WCRI  |  what's new  |  search our studies  |  order our publications  |  view WCRI benchmarks  |  members only
Join WCRI  | Conferences & Seminars  |  Media Information  |  Contact Us  |  Site Map