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Hospital Outpatient Cost Index for Workers' Compensation, 4th Edition

Rising hospital costs have been a concern and focus of recent public policy debates in many states. To assist policymakers and business decision makers in managing this growth, WCRI has created this unique study, which is updated regularly, to compare hospital outpatient costs across states, identify key cost drivers, and measure the impact of reforms.
 

The 33 states included in this study are Alabama, Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Jersey, New York, North Carolina, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, West Virginia, and Wisconsin.
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Predictors of Worker Outcomes

Four new state-specific studies identified new predictors of worker outcomes that can help public officials, payors, and health care providers improve the treatment and communication an injured worker receives after an injury―leading to better outcomes. The states examined were Arkansas, Connecticut, Iowa and Tennessee. The studies represent Phase 2 of a multi-phase study to examine worker outcomes.  

The studies are based on telephone interviews with 4,915 injured workers across the following 12 states: Arkansas, Connecticut, Indiana, Iowa, Massachusetts, Michigan, Minnesota, North Carolina, Pennsylvania, Tennessee, Virginia, and Wisconsin. The surveys were conducted in 2013 and 2014 for injuries in 2010 and 2011.

To read the abstract, executive summary, or to order a report, click on the state below.

Arkansas

Iowa

Connecticut

Tennessee

Are Physician Dispensing Reforms Sustainable?

After 18 states enacted reforms to limit the prices paid to doctors for prescriptions they write and dispense, this WCRI study finds that physician-dispensers in Illinois and California discovered a new way to continue charging and to get paid two to three times the price of a drug when compared with pharmacies. The study identifies the mechanism that allows doctors in Illinois and California to dispense drugs from their offices at much higher prices when compared with pharmacies. Although this study uses data from two large states, it raises questions for all states where physician-dispensing prices are regulated.
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The Impact of Physician Dispensing on Opioid Use   

This study found evidence that physician dispensing encouraged some physicians to unnecessarily prescribe strong opioids. The study examined changes in physician prescribing and dispensing of opioids for newly injured workers after the implementation of a ban on physician dispensing of strong opioids, which went into effect on July 1, 2011. Although the findings are based on Florida data, the lessons may apply to other states where physician dispensing is common.
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Hospital Outpatient Cost Index for Workers’ Compensation, 3rd Edition

Rising hospital costs have been a concern and focus of recent public policy debates in many states. This study assists policymakers and business decision makers in managing this growth by allowing them to compare hospital outpatient costs across states, identify key cost drivers, and evaluate the impact of reforms. 

The hospital outpatient cost indices compare payments paid for common outpatient surgical episodes under workers’ compensation from state to state in each study year and compare the trends within each state from 2005 to 2012. This study covers 33 large states representing nearly 90 percent of the workers’ compensation benefits paid in the United States.
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Early Impact of Tennessee Reforms on Physician Dispensing

This study, Early Impact of Tennessee Reforms on Physician Dispensing, examines the early results of Tennessee’s changes to the rules governing reimbursement to Tennessee physicians for prescriptions that they both write and dispense. Policymakers in Tennessee adopted new rules, effective August 9, 2012, to address the rapid increase in physician dispensing and associated costs. The data used in this analysis came from payors in Tennessee that represented 55 percent of all medical claims in the state workers’ compensation system, covering physician- and pharmacy-dispensed prescriptions filled by injured workers through March 2013.
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Early Impact of South Carolina Reforms on Physician Dispensing

This study examines the effects of changes to the rules governing reimbursement to South Carolina physicians for prescriptions that they both write and dispense. South Carolina is one of 18 states that have made significant changes to such reimbursement rules in the past 10 years, motivated by concerns about the higher costs of physician dispensing. The data used in this analysis covers the time period from 2011 to the first quarter of 2013.
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Early Impact of Connecticut Reforms on Physician Dispensing

In many states across the country, policymakers are debating whether doctors should be paid significantly more than pharmacies for dispensing the same drug. Policymakers in Connecticut adopted new rules, effective July 15, 2012, to narrow the price difference.  

The purpose of this study is to examine the early results of Connecticut’s changes to the rules governing reimbursement to Connecticut physicians for prescriptions that they both write and dispense. Connecticut is one of 18 states that have made significant changes to such reimbursement rules in the past 10 years.  
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Estimating the Effect of California’s Fee Schedule Changes: Lessons from WCRI Studies  

When California Senate Bill (SB) 863 took effect January 1, 2013, it ushered in several important fee schedule changes in the California workers’ compensation system.  

To better understand the possible effect of these changes on prices and payments in California relative to other states, as well as their potential impact on behavior and access to care, the Workers Compensation Research Institute (WCRI) has released a new study that pulls together relevant findings from a variety of WCRI studies.
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CompScope™ Medical Benchmarks, 15th Edition

The 15th edition of the CompScope™ Medical Benchmarks studies is now available. The studies examine 16 different state workers’ compensation systems and can help policymakers and other stakeholders in the system to identify current cost drivers and emerging trends in payments, prices, and utilization of medical services among nonhospital and hospital providers.

The studies cover the time period of 2007 to 2012, with claims' experience up through March 2013. The 16 study states—Arkansas, California, Florida, Illinois, Indiana, Iowa, Louisiana, Massachusetts, Michigan, Minnesota, New Jersey, North Carolina, Pennsylvania, Texas, Virginia, and Wisconsin—represent more than 60 percent of the nation’s workers’ compensation benefit payments.   

To read the abstract, executive summary, or to order a report, click on the state below.

California

Minnesota

Florida

New Jersey

Illinois

North Carolina

Indiana

Pennsylvania

Louisiana Texas
Massachusetts Virginia
Michigan Wisconsin

Impact of Physician Dispensing Reform in Georgia, 2nd Edition

This study is an update to the 2013 WCRI study that examined the early results of Georgia’s reform using pre- and post-reform data. With an additional year of data, the study found that there was little change in the prevalence of physician dispensing in the second post-reform period.
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Physician Dispensing in Pennsylvania, 2nd Edition

This report is an update of the previous study that examined the prevalence and costs of physician-dispensed prescriptions in Pennsylvania. With an additional year of data, the study continued to find higher and growing prices paid for physician-dispensed drugs.
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Monitoring Trends in the New York Workers' Compensation System

This new study is the seventh annual report to regularly track key metrics of the performance of the state’s workers’ compensation system following the implementation of major reforms enacted in 2007. 

This regular monitoring of system performance helps policymakers and system stakeholders to focus attention on objectives that are being met, objectives that are not being met, and unintended consequences that have emerged.  
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Discover WCRI


Are you new to WCRI and the research we do?  Looking to learn more about us? 

 

FREE STUDY

 

Our Medical Price Index, Sixth Edition, published in July 2014 is available free as a PDF. Click on the links below for a no charge look at the work we do and the value of the findings we present.

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WCRI E-Mail List


 

Would you like to be notified when a new study is published, a web briefing is being offered, a public briefing is scheduled, or new information on our conference is available? Join WCRI's e-mail list and you will receive monthly e-mail updates about upcoming events and publications.  Click on the link below to be added to the WCRI e-mail list.

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In the News


WCRI's recent media releases

Articles referencing WCRI research.

Balitmore Sun

Md. lawmakers won't seek to limit doctors' ability to prescribe drugs

Maryland doctors who dispense under the state's workers' compensation system charge four times more than pharmacies for pills of painkillers Vicodin and Percocet and nearly seven times more for muscle-relaxer Soma, according to the Massachusetts-based Workers Compensation Research Institute.
full article

New York Times

New Dosages of Old Drugs Are Used to Raise Their Prices

Over the last two years, states nationwide have moved to crack down on so-called physician dispensing of prescription drugs, a practice largely limited to doctors who treat injured workers. But doctors and companies have responded by exploiting loopholes in those rules and adopting new strategies to stay one step ahead, recent studies suggest.
full article

The Gazette

Study: Workers cite trust issue with injuries - Fear layoff, firing after being hurt on the job

A new study has found that some workers fear they will be laid off or fired after sustaining an on-the-job injury. The study from the Workers’ Compensation Research Institute examined predictors of worker outcomes that can help Iowa public officials, insurers, and health care providers improve the treatment and communication an injured worker receives after an injury.
full article

CFO Magazine

New Rules on Drugs Not Curbing Workers' Comp Costs

In a trend that may perplex self-insured companies trying to rein in workers’ compensation costs, doctors who prescribe drugs from their offices are exploiting a loophole in new regulations designed to limit what they can charge for prescriptions, according to a new study.
full article


WCRI 2015 Annual Report/Research Review

We would like to provide you with a copy of WCRI's 2015 Annual Report & Research Review. 

We are proud of the impact our research has had in providing public officials and various system stakeholders with the information-based data they need to make better decisions. Examples of where our research has had an impact can be found starting on page 6.

We encourage you to pass this along to others in or outside your organization. Our research is funded by member organizations so enlarging our membership base allows us to expand our research agenda.  If you or a colleague are interested in becoming a member of WCRI, please let us know.

Click on the following link to download a copy of the report in PDF format. Please know it may take a minute to download.
download the free PDF for the Annual Report

 

   
 

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