MEDICAL PAYMENTS PER CLAIM FOR INJURED WORKERS IN LOUISIANA WERE HIGHER THAN MOST OTHER STUDY STATES DESPITE RECENT DECLINES, FINDS WCRI REPORT

CAMBRIDGE, MA, June 22, 2007 – In spite of recent declines, the average payment per claim for the medical care of injured workers in Louisiana remains higher than typical of states examined in a study by the Workers Compensation Research Institute (WCRI).

The study of 13 large states found that in Louisiana, the average medical payment per workers’ compensation claim with more than 7 days of lost time at 36 months post injury was on average $12,346 – 17 percent higher than the 13-state median.

The study pointed out that the higher payments per claim resulted from both higher prices paid for some services and a longer claim duration with more visits per claim for physician office visits, physical therapy visits and diagnostic services.

The data in the reference work, The Anatomy of Workers’ Compensation Medical Costs and Utilization in Louisiana, 6^th Edition, identifies where workers’ compensation medical dollars go and how costs and utilization differ across 13 large states, which represent more than 50 percent of the nation’s workers’ compensation benefit payments.

The study reported that the average medical payment per claim in Louisiana decreased by four percent during the most recent study period of 2003 to 2004, after increasing rapidly – about eight percent per year – in the preceding years.

“The average medical payment per claim in Louisiana declined recently after years of significant increases,” said Dr. Richard Victor, executive director of the Cambridge, Mass.-based independent, not-for-profit research organization.  “However, overall, payments per claim for the medical care of injured workers in the state remain more costly than most states in this study.”   

Payments per claim were higher than typical, “largely because of higher-than-typical prices paid for non-surgical physician services and for hospital outpatient services as well as more frequent visits to doctors’ offices and diagnostic tests and more visits to physical and occupational therapists,” Victor noted.

He also said that more cases than typical received hospital services, particularly for in-patient care, in Louisiana, but the average payment per claim to hospitals was close to the median for out-patient services and significantly lower for in-patient treatment.        

The WCRI study reported that average prices paid to non-hospital providers in Louisiana were higher than the median state overall, particularly for office visits, physical medicine, pathology and neurological testing. 

The study further pointed out that average prices paid in Louisiana were generally the highest among the study states with fee schedules (except for surgery), but lower than the study states without fee schedules at the time.

The study noted that Louisiana had the highest average prices paid for hospital outpatient services, in particular for laboratory, evaluation and management, and physical medicine services.

The study also noted that Louisiana recorded a higher rate of surgery in similar claims. In addition, a higher proportion of those surgeries were done on an inpatient basis than in the other study states.

The Workers Compensation Research Institute is a nonpartisan, not-for-profit membership organization conducting public policy research on workers’ compensation, health care and disability issues.  Its members include employers, insurers, and governmental entities, insurance regulators and state administrative agencies in the U.S., Canada, Australia and New Zealand, as well as several state labor organizations.     

To purchase the report, visit WCRI’s web site at www.wcrinet.org.