Cambridge, MA, November 16, 2023 – A new study from the Workers Compensation Research Institute (WCRI) found that medical payments for the treatment of workers injured on the job in Texas changed little between 2016 and 2021.
“The stability we see in medical payments in Texas over the study period masked offsetting changes, including a decline in utilization of medical care coupled with increases in outpatient and inpatient hospital payments,” said Ramona Tanabe, president and CEO of WCRI. “The decline in payments per claim mainly occurred between 2019 and 2021 and was largely affected by the pandemic.”
The study, CompScope™ Medical Benchmarks for Texas, 24th Edition, focuses on the payments, prices, and utilization of workers’ compensation medical care. It examines medical services in Texas compared with 16 other states overall, by type of provider, and by type of medical service. The study also analyzes how various system performance metrics have changed over time from 2016 to 2021, with claims evaluated as of 2022. In some cases, we use a longer time frame to supply historical context.
The following are some other findings from the study:
- Utilization of nonhospital services decreased by 11 percent from 2020 to 2021, mainly because of fewer visits per claim.
- Hospital outpatient payments per workers’ compensation claim increased from 2019 to 2021 mostly due to growth in payments per service.
- Payments per workers’ compensation claim were lower in Texas than typical for both nonhospital and hospital care.
The results reflect experience on claims through March 2022, including non-COVID-19 claims only from the first and second years of the pandemic period (March 2020–September 2021). The study, therefore, provides a look at how the pandemic impacted non-COVID-19 workers’ compensation claims in the first two years of the pandemic.
Click here for more information about this report or to download a copy. The report was authored by Carol Telles.
The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Cambridge, MA. Organized in late 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.