New Study Examines Effect of Reducing
the Illinois Fee Schedule
CAMBRIDGE, MA, January 13, 2014
– A new study by the Workers Compensation Research
Institute (WCRI) examines the impact of the 30 percent
reduction in the Illinois medical fee schedule that was
enacted in 2011. Prior to the reduction, the Illinois fee
schedule was one of the highest in the nation.
The study, The Effect of Reducing the Illinois Fee Schedule,
looks at how prices paid for medical services changed and
whether there were any services for which the cuts may have
been so large as to raise concerns about access to care for
For example, the workers’ compensation prices paid for the
most common office visit were 18 percent lower than the
estimated group health prices and 15 percent lower than the
Medicare rates in 2012.
“Given that the workers’ compensation prices were below the
group health prices and Medicare rates, policymakers might
need to consider whether the fee schedule decrease was too
much for office visits and whether access to care for
primary care may have been impaired,” said Richard Victor,
WCRI’s executive director.
The study observed the following after the fee schedule
On average, medical prices paid fell by 24 percent.
Prices paid for common surgeries were 107–231 percent
higher than prices paid by Illinois group health
insurers and 237–455 percent higher than the Medicare
rates in Illinois. This raises the question about
whether the reductions could have been even larger
without affecting access to care by surgeons.
Prices for common office visits (primary care) were
12–18 percent lower than group health prices and up to
15 percent lower than the Illinois Medicare rates. This
raises a concern about access to primary care for
The study also found that the 30 percent reduction in the
fee schedule in Illinois resulted in a smaller decrease of
24 percent in the average price paid for professional
services. Furthermore, more frequent billing of more complex
office visits with higher prices in Illinois was observed
after the fee schedule cut.
To purchase a copy of this study, click on the following
The Cambridge-based WCRI is recognized as the leader in
providing high-quality, objective information about
public policy issues involving workers' compensation
The Workers Compensation Research Institute (WCRI) is an
independent, not-for-profit research organization based in
Cambridge, MA. Since 1983, WCRI has been a catalyst for
significant improvements in workers' compensation systems
around the world with its objective, credible, and
high-quality research. WCRI's members
include employers; insurers; governmental
care companies; health care providers;
insurance regulators; state labor
organizations; and state administrative agencies in the
U.S., Canada, Australia and New Zealand.