This 2026 edition of CompScope™ Medical Benchmarks helps policymakers and other system stakeholders identify current cost drivers and emerging trends in workers’ compensation medical costs. New features of this edition include an expanded set of 27 study states, a more concise format for summary reports, and deeper perspectives drawn from WCRI’s broader research.

The studies examine trends in payments, prices, and utilization of medical care for workers with injuries. They provide analyses of recent costs and trends, reporting how medical payments per claim and their components vary over time and from state to state. The studies cover the period from 2019 through 2024, with claims experience through March 2025.

The 27 study states—Alabama, Arkansas, California, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, Mississippi, Nevada, New Hampshire, New Jersey, New Mexico, North Carolina, Pennsylvania, South Carolina, Tennessee, Texas, and Wisconsin—account for about 70 percent of workers’ compensation benefit payments nationwide. We conducted detailed analyses in the form of individual reports for 12 of the states; each of these includes comparative data for all 27 states.

The studies also provide an overview of factors likely to have affected medical payments and treatment in recent years. Where relevant, we include findings from other recent Workers Compensation Research Institute studies to provide a more comprehensive picture.

CompScope™ Medical Benchmarks, 2026 Edition. Terence Cawley, William Monnin-Browder, Evelina Radeva, Karen Rothkin, Bogdan Savych, and Rebecca Yang. September 2026. WC-26-24 to WC-26-35.

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This study informs policymakers and stakeholders in California by identifying current cost drivers and emerging trends in the payments, prices, and utilization of medical services across both hospital and nonhospital providers in the state’s workers’ compensation system.

It compares these medical payment metrics in California with those in 26 other states and analyzes recent changes through 2025. Additionally, we draw on findings from other WCRI studies to create a more comprehensive overview of the system in California.

The study also provides an overview of how recent system changes, shifts in the composition of workers’ compensation claims, and external factors—such as the economy, inflation, and medical care—have likely affected medical payments and treatment in recent years.

CompScope™ Medical Benchmarks for California, 2026 Edition. William Monnin-Browder. September 2026. WC-26-24.

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This study informs policymakers and stakeholders in Delaware by identifying current cost drivers and emerging trends in the payments, prices, and utilization of medical services across both nonhospital and hospital providers in the state’s workers’ compensation system.

The report compares these medical payment metrics in Delaware with those in 26 other states and analyzes changes through 2025. It also monitors the impact of regulatory changes on the system, including the annual updates to the rates set by the state’s workers’ compensation fee schedule. Additionally, we draw on findings from other WCRI studies to create a more comprehensive overview of the system in Delaware.

The study also provides an overview of how shifts in the composition of workers’ compensation claims and external factors—such as the changes in the workforce, inflation, and new medical treatments—have likely affected medical payments and treatment in recent years.

CompScope™ Medical Benchmarks for Delaware, 2026 Edition. Evelina Radeva. September 2026. WC-26-25.

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This study informs policymakers and stakeholders in Florida by identifying current cost drivers and emerging trends in the payments, prices, and utilization of medical services across both hospital and nonhospital providers in the state’s workers’ compensation system.

The report compares these medical payment metrics in Florida with those in 26 other states and analyzes recent changes through 2025. It also monitors the impact of regulatory changes on the system, notably changes to the medical fee schedule implemented in 2023 and 2025. Additionally, we draw on findings from other WCRI studies to create a more comprehensive overview of the system in Florida.

The study also provides an overview of how recent system changes, shifts in the composition of workers’ compensation claims, and external factors—such as inflation, other economic changes, and new medical treatments—have likely affected medical payments and treatment in recent years.

CompScope™ Medical Benchmarks for Florida, 2026 Edition. Rebecca Yang. September 2025. WC-26-26.

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This study informs policymakers and stakeholders in Illinois by identifying current cost drivers and emerging trends in the payments, prices, and utilization of medical services across both hospital and nonhospital providers in the state’s workers’ compensation system.

It compares these medical payment metrics in Illinois with those in 26 other states and analyzes recent changes though 2025. It also monitors the impact of regulatory changes on the system, including the annual updates to the rates set by the state’s workers’ compensation fee schedule. Additionally, we draw on findings from other WCRI studies to create a more comprehensive overview of the system in Illinois.

The study also provides an overview of how recent system changes, shifts in the composition of workers’ compensation claims, and external factors—such as the economy, inflation, and medical care—have likely affected medical payments and treatment in recent years.

CompScope™ Medical Benchmarks for Illinois, 2026 Edition. Evelina Radeva. September 2026. WC-26-27.

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This study informs policymakers and stakeholders in Indiana by identifying current cost drivers and emerging trends in the payments, prices, and utilization of medical services across both hospital and nonhospital providers in the state’s workers’ compensation system.

The report compares these medical payment metrics in Indiana with those in 26 other states and analyzes recent changes through 2025. It also monitors the impact of regulatory changes on the system, notably the introduction of a fee schedule for ambulatory surgery center services. Additionally, we draw on findings from other WCRI studies to create a more comprehensive overview of the system in Indiana.

CompScope™ Medical Benchmarks for Indiana, 2026 Edition. Bogdan Savych. September 2026. WC-26-28.

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This study informs policymakers and stakeholders in Massachusetts by identifying current cost drivers and emerging trends in the payments, prices, and utilization of medical services across both hospital and nonhospital providers in the state’s workers’ compensation system.

The report compares these medical payment metrics in Massachusetts with those in 26 other states and analyzes recent changes through 2025. Additionally, we draw on findings from other WCRI studies to create a more comprehensive overview of the system in Massachusetts.

The study also provides an overview of how recent system changes, shifts in the composition of workers’ compensation claims, and external factors—such as inflation, other economic changes, and new medical treatments—have likely affected medical payments and treatment in recent years.

CompScope™ Medical Benchmarks for Massachusetts, 2026 Edition. Terence Cawley. September 2026. WC-26-29.

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This study informs policymakers and stakeholders in Michigan by identifying current cost drivers and emerging trends in the payments, prices, and utilization of medical services across both nonhospital and hospital providers in the state’s workers’ compensation system.

The report compares these medical payment metrics in Michigan with those in 26 other states and analyzes recent changes through 2025. Additionally, we draw on findings from other WCRI studies to create a more comprehensive overview of the system in Michigan.

The study also provides an overview of how recent system changes, shifts in the composition of workers’ compensation claims, and external factors—such as inflation, other economic changes, and new medical treatments—have likely affected medical payments and treatment in recent years.

CompScope™ Medical Benchmarks for Michigan, 2026 Edition. Terence Cawley. September 2026. WC-26-30.

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This study informs policymakers and stakeholders in Minnesota by identifying current cost drivers and emerging trends in the payments, prices, and utilization of medical services across both hospital and nonhospital providers in the state’s workers’ compensation system.

The report compares these medical payment metrics in Minnesota with those in 26 other states and analyzes recent changes through 2025. It also monitors the impact of regulatory changes on the system, including changes to the hospital outpatient fee schedule that took effect since October 2023. Additionally, we draw on findings from other WCRI studies to create a more comprehensive overview of the system in Minnesota.

The study also provides an overview of how recent system changes, shifts in the composition of workers’ compensation claims, and external factors—such as inflation, other economic changes, and new medical treatments—have likely affected medical payments and treatment in recent years.

CompScope™ Medical Benchmarks for Minnesota, 2026 Edition. Rebecca Yang. September 2026. WC-26-31.

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This study informs policymakers and stakeholders in New Jersey by identifying current cost drivers and emerging trends in the payments, prices, and utilization of medical services across both hospital and nonhospital providers in the state’s workers’ compensation system.

The report compares these medical payment metrics in New Jersey with those in 26 other states and analyzes recent changes through 2025. Additionally, we draw on findings from other WCRI studies to create a more comprehensive overview of the system in New Jersey.

The study also provides an overview of how recent system changes, shifts in the composition of workers’ compensation claims, and external factors—such as inflation, other economic changes, and new medical treatments—have likely affected medical payments and treatment in recent years.

CompScope™ Medical Benchmarks for New Jersey, 2026 Edition. Evelina Radeva. September 2026. WC-26-32.

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This study informs policymakers and stakeholders in North Carolina by identifying current cost drivers and emerging trends in the payments, prices, and utilization of medical services across both hospital and nonhospital providers in the state’s workers’ compensation system.

The report compares these medical payment metrics in North Carolina with those in 26 other states and analyzes recent changes through 2025. Additionally, we draw on findings from other WCRI studies to create a more comprehensive overview of the system in North Carolina.

The study also provides an overview of how shifts in the composition of workers’ compensation claims and external factors—such as the economy, inflation, and medical care—have likely affected medical payments and treatment in recent years.

CompScope™ Medical Benchmarks for North Carolina, 2026 Edition. William Monnin-Browder. September 2026. WC-26-33.

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This study informs policymakers and stakeholders in Pennsylvania by identifying current cost drivers and emerging trends in the payments, prices, and utilization of medical services across both hospital and nonhospital providers in the state’s workers’ compensation system.

The report compares these medical payment metrics in Pennsylvania with those in 26 other states and analyzes recent changes through 2025. It also monitors the impact of regulatory changes on the system, including statewide average weekly wage (SAWW)-based increases to the state’s workers’ compensation fee schedule. Additionally, we draw on findings from other WCRI studies to create a more comprehensive overview of the system in Pennsylvania.

The study also provides an overview of how shifts in the composition of workers’ compensation claims and external factors—such as the economy, inflation, and medical care—have likely affected medical payments and treatment in recent years.

CompScope™ Medical Benchmarks for Pennsylvania, 2026 Edition. William Monnin-Browder and Terence Cawley. September 2026. WC-26-34.

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This study informs policymakers and stakeholders in Wisconsin by identifying current cost drivers and emerging trends in the payments, prices, and utilization of medical services across both hospital and nonhospital providers in the state’s workers’ compensation system.

The report compares these medical payment metrics in Wisconsin with those in 26 other states and analyzes recent changes through 2025. Additionally, we draw on findings from other WCRI studies to create a more comprehensive overview of the system in Wisconsin.

The study also provides an overview of how recent system changes, shifts in the composition of workers’ compensation claims, and external factors—such as inflation, other economic changes, and new medical treatments—have likely affected medical payments and treatment in recent years.

CompScope™ Medical Benchmarks for Wisconsin, 2026 Edition. Evelina Radeva. September 2026. WC-26-35.

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With workers' compensation medical costs continuing to rise, this new study examines payment and utilization patterns for services without established fee schedule reimbursement rates and how they vary across states.

Forty-four states and the District of Columbia use professional medical fee schedules to reimburse treatments provided to injured workers. However, many commonly used services are reimbursed without an established fee schedule rate. This study helps policymakers better understand where those gaps exist and whether they may contribute to growth in medical payments.

The study focuses on durable medical equipment and professional services billed by nonhospital providers. It analyzes medical services provided from January 1, 2019, through June 30, 2025, in workers' compensation systems with fee schedules, which account for approximately 99.5 percent of workers' compensation benefits paid in the United States.

Trends in Non-Price-Controlled Medical Services—A WCRI FlashReport. Olesya Fomenko and Rebecca Yang. July 2026. FR-26-03.

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This annual study compares prices paid for medical professional services across 36 states from 2008 to 2025. It focuses on services commonly billed by physicians, physical therapists, and chiropractors, such as evaluation and management, physical medicine, surgery, radiology, neurological testing, pain management injections, and emergency care.

Unlike broader health care indices, this report is a more relevant benchmark of medical inflation in workers’ compensation because it focuses on services typically provided to injured workers. It also offers a state-level price index to help policymakers and stakeholders compare prices and track trends tied to changes in fee schedules.

This edition covers 36 states, representing 88 percent of workers’ compensation benefits paid in the United States: Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Wisconsin.

(This is a free report. If you have a member user name and password, please log into the website to access this report. All others can access the report for free by adding it to the shopping cart and going through the checkout process.)

WCRI Medical Price Index for Workers’ Compensation, 2026 Edition (MPI-WC). Rebecca Yang and Olesya Fomenko. May 2026. WC-26-21.

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This study provides a high-level view of changing prescription drug costs in workers’ compensation across 31 states.

It categorizes prescription drugs into key groups, including dermatological agents, NSAIDs, and opioids, and shows where prescribing dollars are being spent and whether spending on these drug groups is increasing or decreasing.

This edition adds migraine drugs as a separate category and includes new information on pharmacies that ship or deliver medications directly to injured workers, in addition to physician dispensing.

The analysis is based on prescriptions dispensed for non‑COVID-19 claims, with injuries occurring within three years of the prescription fill date (first quarter of 2022 to first quarter of 2025) and paid under workers’ compensation each quarter.

The 31 states included in the study are Alabama, Arizona, Arkansas, California, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nevada, New Jersey, New Mexico, New York, North Carolina, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Wisconsin.

Interstate Variation and Trends in Workers’ Compensation Drug Payments, 6th Edition—A WCRI FlashReport. Vennela Thumula, Te‑Chun Liu, and Dongchun Wang. May 2026. FR-26-02.

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As many states consider revising hospital fee regulations, this new report benchmarks hospital outpatient payments related to surgeries in 36 states, covering 88 percent of U.S. workers’ compensation benefits. It also compares workers’ compensation payments with Medicare rates and examines the impact of major fee regulation changes from 2005 to 2024.

The report captures payments for services provided and billed directly by hospitals, such as facility services, operating room, etc. It excludes professional services billed by nonhospital providers, including physicians, physical therapists, and chiropractors, as well as payments for pharmaceuticals and durable medical equipment billed by nonhospital providers. It also excludes services at ambulatory surgery centers.

States included in the study are Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Jersey, New Mexico, New York, North Carolina, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, West Virginia, and Wisconsin.

Hospital Outpatient Payment Index: Interstate Variations and Policy Analysis, 2026 Edition. Olesya Fomenko and Rebecca Yang. May 2026. WC-26-20.

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With hospital closures increasing, this study examines how closures in both urban and rural areas affect access to care, use of care, claim costs, and duration of disability for workers recovering from work‑related injuries.

According to the study, examining hospital closures within the workers’ compensation system allows the analysis of outcomes not previously examined, including speed of recovery after a work‑related injury. Understanding patient‑level impacts of hospital closures is central to health policy decision‑making, particularly as care shifts across providers and settings.

The analysis covers more than 12 million non-fatal injury claims with injuries occurring between October 1, 2012, and September 30, 2023, and outcomes measured 12 months after injury. This study covers 29 states, representing over 80 percent of workers’ compensation benefits paid in 2021.

Impact of Hospital Closures on Access to Care and Claim Outcomes. Bogdan Savych and Olesya Fomenko. April 2026. WC-26-19.

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These comprehensive reports help workers’ compensation policymakers and other system stakeholders identify current cost drivers and emerging trends in total costs per claim and key components.

They compare the performance of state workers’ compensation systems in 18 states, focusing on overall medical payments, income benefits, use of benefits, duration of temporary disability, benefit delivery expenses, timeliness of payments, and other metrics.

Additionally, the studies examine how these system performance metrics have changed, primarily from 2020 to 2025, for claims at various maturities. We analyze claims with experience through 2025 for injuries up to and including 2024, and in some cases, we use a longer time frame to supply historical context.

The 18 states in the study are Arkansas, California, Delaware, Florida, Illinois, Indiana, Iowa, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, New Jersey, North Carolina, Pennsylvania, Texas, Virginia, and Wisconsin. There are individual reports for every state except Arkansas, Iowa, Kentucky, Louisiana, Texas, and Virginia.

CompScope™ Benchmarks, 2026 Edition. Terence Cawley, Roman Dolinschi, William Monnin-Browder, Evelina Radeva, Karen Rothkin, Bogdan Savych, and Rebecca Yang. April 2026. WC-26-06 to WC-26-17.

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This 2026 edition of CompScope™ Benchmarks for Wisconsin helps policymakers and other system stakeholders identify current cost drivers and emerging trends in the state workers’ compensation system. The report provides meaningful comparisons between Wisconsin and 17 other study states on key measures including indemnity benefits, duration of temporary disability, lump-sum settlements, medical payments, and benefit delivery expenses. It also examines how these metrics have changed from 2020 to 2025; in some cases, we use a longer time period to supply historical context for key metrics. Where relevant, we include information from other Workers Compensation Research Institute (WCRI) studies to provide a more complete picture of the Wisconsin system.

CompScope™ Benchmarks for Wisconsin, 2026 Edition. Evelina Radeva. April 2026. WC-26-17.

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This 2026 edition of CompScope™ Benchmarks for New Jersey helps policymakers and other system stakeholders identify current cost drivers and emerging trends in the state workers’ compensation system. The report provides meaningful comparisons between New Jersey and 17 other study states on key measures including indemnity benefits, duration of temporary disability, lump-sum settlements, medical payments, and benefit delivery expenses. It also examines how these metrics have changed from 2020 to 2025; in some cases, we use a longer time period to supply historical context for key metrics. Where relevant, we include information from other Workers Compensation Research Institute (WCRI) studies to provide a more complete picture of the system.

CompScope™ Benchmarks for New Jersey, 2026 Edition. Evelina Radeva. April 2026. WC-26-14.

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This 2026 edition of CompScope™ Benchmarks for Illinois helps policymakers and other system stakeholders identify current cost drivers and emerging trends in the state workers’ compensation system. The report provides meaningful comparisons between Illinois and 17 other study states on key measures including indemnity benefits, duration of temporary disability, lump-sum settlements, medical payments, and benefit delivery expenses. It also examines how these metrics have changed from 2020 to 2025; in some cases, we use a longer time period to supply historical context for key metrics. Where relevant, we include information from other Workers Compensation Research Institute (WCRI) studies to provide a more complete picture of the system in Illinois.

CompScope™ Benchmarks for Illinois, 2026 Edition. Evelina Radeva. April 2026. WC-26-09.

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This 2026 edition of CompScope™ Benchmarks for Delaware helps policymakers and other system stakeholders identify current cost drivers and emerging trends in the state workers’ compensation system. The report provides meaningful comparisons between Delaware and 17 other study states on key measures including indemnity benefits, duration of temporary disability, lump-sum settlements, medical payments, and benefit delivery expenses. It also examines how these metrics have changed from 2020 to 2025; in some cases, we use a longer time period to supply historical context for key metrics. Where relevant, we include information from other Workers Compensation Research Institute (WCRI) studies to provide a more complete picture of the Delaware system.

CompScope™ Benchmarks for Delaware, 2026 Edition. Evelina Radeva. April 2026. WC-26-07.

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This 2026 edition of CompScope™ Benchmarks for Michigan helps policymakers and other system stakeholders identify current cost drivers and emerging trends in the state workers’ compensation system. The report provides meaningful comparisons between Michigan and 17 other study states on key measures including indemnity benefits, duration of temporary disability, lump-sum settlements, medical payments, and benefit delivery expenses. It also examines how these metrics have changed from 2020 to 2025; in some cases, we use a longer time period to supply historical context for key metrics. Where relevant, we include information from other Workers Compensation Research Institute (WCRI) studies to provide a more complete picture of the Michigan system.

CompScope™ Benchmarks for Michigan, 2026 Edition. Terence Cawley. April 2026. WC-26-12.

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This 2026 edition of CompScope™ Benchmarks for Minnesota helps policymakers and other system stakeholders identify current cost drivers and emerging trends in the state workers’ compensation system. The report provides meaningful comparisons between Minnesota and 17 other study states on key measures including indemnity benefits, duration of temporary disability, lump-sum settlements, medical payments, and benefit delivery expenses. It also examines how these metrics have changed from 2020 to 2025. In particular, we monitor the ongoing impact of the fee schedule decrease in 2023 on the state workers’ compensation system. In some cases, we use a longer time period to supply historical context for key metrics. We also include information from other Workers Compensation Research Institute (WCRI) studies to provide a more complete picture of the system in Minnesota.

CompScope™ Benchmarks for Minnesota, 2026 Edition. Rebecca Yang. April 2026. WC-26-13.

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This 2026 edition of CompScope™ Benchmarks for Florida helps policymakers and other system stakeholders identify current cost drivers and emerging trends in the state workers’ compensation system. The report provides meaningful comparisons between Florida and 17 other study states on key measures including indemnity benefits, duration of temporary disability, lump-sum settlements, medical payments, and benefit delivery expenses. It also examines how these metrics have changed from 2020 to 2025; in some cases, we use a longer time period to supply historical context for key metrics. Where relevant, we include information from other Workers Compensation Research Institute (WCRI) studies to provide a more complete picture of the system.

The results reflect claims experience through March 2025. The study thus provides early insights into how recent changes to Florida’s nonhospital fee schedule have affected workers’ compensation payments.

CompScope™ Benchmarks for Florida, 2026 Edition. Rebecca Yang. April 2026. WC-26-08.

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This 2026 edition of CompScope™ Benchmarks helps policymakers and other system stakeholders identify current cost drivers and emerging trends in the Commonwealth’s workers’ compensation system. The report provides meaningful comparisons between Massachusetts and 17 other study states on key measures including indemnity benefits, duration of temporary disability, lump-sum settlements, medical payments, and benefit delivery expenses. It also examines how these metrics have changed from 2020 to 2025; in some cases, we use a longer time period to supply historical context for key metrics. Where relevant, we include information from other Workers Compensation Research Institute (WCRI) studies to provide a more complete picture of the system in Massachusetts.

CompScope™ Benchmarks for Massachusetts, 2026 Edition. Roman Dolinschi. April 2026. WC-26-11.

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This 2026 edition of CompScope™ Benchmarks for Indiana helps policymakers and other system stakeholders identify current cost drivers and emerging trends in the state workers’ compensation system. The report provides meaningful comparisons between Indiana and 17 other study states on key measures including indemnity benefits, duration of temporary disability, lump-sum settlements, medical payments, and benefit delivery expenses. It also examines how these metrics have changed from 2020 to 2025; in some cases, we use a longer time period to supply historical context for key metrics. Where relevant, we include information from other Workers Compensation Research Institute (WCRI) studies to provide a more complete picture of the system in Indiana.

CompScope™ Benchmarks for Indiana, 2026 Edition. Roman Dolinschi. April 2026. WC-26-10.

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This 2026 edition of CompScope™ Benchmarks for Pennsylvania helps policymakers and other system stakeholders identify current cost drivers and emerging trends in the Commonwealth’s workers’ compensation system. The report provides meaningful comparisons between Pennsylvania and 17 other study states on key measures including indemnity benefits, duration of temporary disability, lump-sum settlements, medical payments, and benefit delivery expenses. It also examines how these metrics have changed from 2020 to 2025. In some cases, we use a longer time period to supply historical context for key metrics. Where relevant, we include information from other Workers Compensation Research Institute (WCRI) studies to provide a more complete picture of the system in Pennsylvania.

CompScope™ Benchmarks for Pennsylvania, 2026 Edition. William Monnin-Browder and Terence Cawley. April 2026. WC-26-16.

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This 2026 edition of CompScope™ Benchmarks for North Carolina helps policymakers and other system stakeholders identify current cost drivers and emerging trends in the state workers’ compensation system. This report provides meaningful comparisons between North Carolina and 17 other study states on key measures including costs, income and indemnity benefits, overall medical payments, duration of temporary disability, frequency and payments of permanent partial disability/lump-sum claims, benefit delivery expenses, and timeliness of payments. It also examines how these metrics have changed, primarily from 2020 to 2025; in some cases, we use a longer time period to supply historical context for key metrics. Where relevant, we include findings from other recent Workers Compensation Research Institute (WCRI) studies to provide a more comprehensive picture.

CompScope™ Benchmarks for North Carolina, 2026 Edition. William Monnin-Browder. April 2026. WC-26-15.

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This 2026 edition of CompScope™ Benchmarks helps policymakers and other system stakeholders identify current cost drivers and emerging trends in the California state workers’ compensation system.

The report provides meaningful comparisons between California and 17 other study states on key measures including costs, income benefits, overall medical payments, use of benefits, duration of temporary disability, frequency and payments of permanent partial disability/lump-sum claims, benefit delivery expenses, timeliness of payments, and other metrics.

It examines how these system performance metrics have changed, primarily from 2020 to 2025, for claims at various claim maturities; in some cases, we use a longer time frame to provide historical context.

Where relevant, we include findings from other recent Workers Compensation Research Institute (WCRI) studies to provide a more comprehensive picture.

CompScope™ Benchmarks for California, 2026 Edition. William Monnin-Browder. April 2026. WC-26-06.

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Air ambulances play a critical role in workers’ compensation by providing rapid emergency transport for workers with severe or life‑threatening injuries. This study examines air ambulance use and payments in workers’ compensation claims and helps clarify key questions about costs and access to services, particularly in remote areas.

The analysis is based on workers’ compensation claims from 32 states covering injuries through 2024. The states include Alabama, Arizona, Arkansas, California, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nevada, New Jersey, New Mexico, New York, North Carolina, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Wisconsin.

Use and Cost of Air Ambulance Transport Services in Workers’ Compensation—A WCRI FlashReport. Bogdan Savych. April 2026. FR-26-01.

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As medical provider networks have become a standard feature of workers’ compensation systems over the past two decades, a new WCRI study examines how these networks affect medical payments, access to care, and the use of medical services.

The study also looks at broader claim outcomes, including disability duration, indemnity benefits, and total claim costs, and compares how network effects differ in rural and urban areas.

The analysis is based on a matched comparison of in‑network and out‑of‑network claims with more than seven days of lost work time. This approach allows for a meaningful evaluation of differences in outcomes. The study also explores how state policy choices influence the effectiveness of medical provider networks.

Impact of Networks on Claim Outcomes. Olesya Fomenko and Rebecca Yang. March 2026. WC-26-05.

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Many states are grappling with the appropriate prescription of controlled substances, using an array of different regulatory strategies, overseen by different agencies. This report gathers in one place the numerous state regulations affecting prescription drugs in all 50 states, including workers with injuries. The report also provides information on some of the most prominent prescription drug issues stakeholders are concerned about in 2026, such as the following:

• Workers’ compensation drug formularies
• Rules for limiting and monitoring opioid prescriptions
• Price regulations for pharmacy- and physician-dispensed drugs
• Expanded role for pharmacists in patient care
• Prescription drug monitoring programs
• Pharmacy benefit manager regulations
• Medical marijuana regulations

The tables in this report were compiled from completed surveys of two agencies for each of the 50 states and the District of Columbia. Since prescription drug regulations are changing rapidly in the United States, the information in this report is a snapshot in time, as of January 1, 2026.

Workers’ Compensation Prescription Drug Regulations: A National Inventory, 2026. Karen Rothkin and Terence Cawley. February 2026. WC-26-04.

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This report examines recent trends in benefit delivery expenses and their key components, including medical cost containment and litigation expenses in the New York workers’ compensation system. It also takes a closer look at the subcomponents of medical cost containment and litigation expenses. For medical cost containment, the study reviews recent trends in payments per claim and the share of claims with bill review, utilization review, and case management services. For litigation-related expenses, the report examines defense attorney fees, medical-legal expenses, and other legal-related costs.

The analysis is based on data from WCRI’s Detailed Benchmark/Evaluation database and includes non-COVID-19 claims with indemnity payments from injury years 2005 through 2023.

Benefit Delivery Expenses in the New York Workers’ Compensation System. William Monnin-Browder and Carol A. Telles. February 2026. WC-26-03.

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With joint replacement surgeries increasing in workers’ compensation, this study offers a consistent framework for tracking these surgeries and provides a better understanding of who receives them, where they occur, and how surgical decisions influence claim costs and outcomes.

The report focuses on shoulder, hip, and knee replacements, which represent the majority of joint replacement surgeries. The study also discusses several implications from its findings, including the growing importance of health promotion and musculoskeletal wellness programs, and explores how state policies may influence patterns and trends of joint replacement surgeries.

Recent Trends in Joint Replacement Among Workers’ Compensation Claims. Dongchun Wang, Vennela Thumula, and Randall D. Lea. January 2026. WC-26-02.

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Injectable therapies play a key role in workers’ compensation care, yet information on their use and costs has been limited—until now. This new study addresses that gap by examining utilization, costs, key cost drivers, and recent trends across 28 states through early 2024.

The report classifies distinct subgroups of injectable therapies by medication type and injection procedure, identifies those most commonly used in workers’ compensation, and highlights early signs of growth in emerging biologic and regenerative treatments. Establishing this baseline provides a foundation for tracking evolving patterns and understanding their implications for medical costs and care provided to injured workers.

These findings are particularly valuable for policymakers and stakeholders because injectable therapies are often clinically complex, invasive, and costly. Understanding their use has important implications for treatment pathways, appropriate care, and overall patient safety and recovery. The relatively high cost of some injectables also underscores the need for oversight aimed at managing medical costs.

The analysis draws on medical billing and prescription data for non-COVID-19 claims from 28 states, representing more than 75 percent of workers’ compensation benefits nationwide.

Injectable Therapies in Workers’ Compensation. Vennela Thumula, Te-Chun Liu, Dongchun Wang, and Randall D. Lea. January 2026. WC-26-01.

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The factors behind trends in medical payments per claim in 18 state workers’ compensation systems and the impact of legislative and regulatory changes on those costs are examined in this 2025 edition of CompScope™ Medical Benchmarks.

The studies examine trends in payments, prices, and utilization of medical care for workers with injuries. They provide analyses of recent costs and trends for policymakers and other system stakeholders, reporting how medical payments per claim and their components vary over time and from state to state. The studies cover the period from 2018 through 2023, with claims experience through March 2024.

The 18 study states—Arkansas, California, Delaware, Florida, Illinois, Indiana, Iowa, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, New Jersey, North Carolina, Pennsylvania, Texas, Virginia, and Wisconsin—account for about 60 percent of workers’ compensation benefit payments nationwide.  States with hyperlinks have dedicated individual reports; each hyperlinked report includes comparative data for all 18 states.

The studies also provide an overview of how recent system changes, shifts in the composition of workers’ compensation claims, and external factors—such as the economy, inflation, and medical care—have likely affected medical payments and treatment since 2018. Some of these changes were prompted or accelerated by the COVID-19 pandemic. The results reflect experience with non-COVID-19 claims.

CompScope™ Medical Benchmarks, 2025 Edition. Terence Cawley, Roman Dolinschi, William Monnin-Browder, Evelina Radeva, Karen Rothkin, Bogdan Savych, Carol A. Telles, and Rebecca Yang. October 2025. WC-25-27 to WC-25-39.

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This study assists policymakers and stakeholders in Virginia’s workers’ compensation system by identifying current cost drivers and emerging trends in payments, prices, and utilization of medical services among both nonhospital and hospital providers.

It compares these medical payment metrics in Virginia with those in 17 other states and analyzes changes from 2018 to 2023 (evaluated as of March 31, 2024). It also monitors the impact of regulatory changes on the system, including the medical fee schedule implemented on January 1, 2018. In some instances, we include data from before 2018 to provide historical context for key metrics. Additionally, we draw on findings from other WCRI studies to create a more comprehensive overview of the system in Virginia.

The study also provides an overview of how recent system changes, shifts in the composition of workers’ compensation claims, and external factors—such as the economy, inflation, and medical care—have likely affected medical payments and treatment since 2018. Some of these changes were prompted or accelerated by the COVID-19 pandemic. The results reflect experience with non-COVID-19 claims.

CompScope™ Medical Benchmarks for Virginia, 2025 Edition. Bogdan Savych. October 2025. WC-25-38.

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This study assists policymakers and stakeholders in Michigan’s workers’ compensation system by identifying current cost drivers and emerging trends in payments, prices, and utilization of medical services among both nonhospital and hospital providers.

It compares these medical payment metrics in Michigan with those in 17 other states and analyzes changes from 2018 to 2023 (evaluated as of March 31, 2024). In some instances, we include data from before 2018 to provide historical context for key metrics. Additionally, we draw on findings from other WCRI studies to create a more comprehensive overview of the system in Michigan.

The study also provides an overview of how recent system changes, shifts in the composition of workers’ compensation claims, and external factors—such as the economy, inflation, and medical care—have likely affected medical payments and treatment since 2018. Some of these changes were prompted or accelerated by the COVID-19 pandemic. The results reflect experience with non-COVID-19 claims.

CompScope™ Medical Benchmarks for Michigan, 2025 Edition. Terence Cawley. October 2025. WC-25-33.

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This study assists policymakers and stakeholders in Massachusetts’s workers’ compensation system by identifying current cost drivers and emerging trends in payments, prices, and utilization of medical services among both nonhospital and hospital providers.

It compares these medical payment metrics in Massachusetts with those in 17 other states and analyzes changes from 2018 to 2023 (evaluated as of March 31, 2024). In some instances, we include data from before 2018 to provide historical context for key metrics. Additionally, we draw on findings from other WCRI studies to create a more comprehensive overview of the system in Massachusetts.

The study also provides an overview of how recent system changes, shifts in the composition of workers’ compensation claims, and external factors—such as the economy, inflation, and medical care—have likely affected medical payments and treatment since 2018. Some of these changes were prompted or accelerated by the COVID-19 pandemic. The results reflect experience with non-COVID-19 claims.

CompScope™ Medical Benchmarks for Massachusetts, 2025 Edition. Roman Dolinschi. October 2025. WC-25-32.

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This study assists policymakers and stakeholders in Indiana’s workers’ compensation system by identifying current cost drivers and emerging trends in payments, prices, and utilization of medical services among both nonhospital and hospital providers.

It compares these medical payment metrics in Indiana with those in 17 other states and analyzes changes from 2018 to 2023 (evaluated as of March 31, 2024). It also monitors the impact of regulatory changes on the system, notably a change in the definition of medical service facility and the resulting shift of ambulatory surgery center services under the fee schedule for medical service facilities. In some instances, we include data from before 2018 to provide historical context for key metrics. Additionally, we draw on findings from other WCRI studies to create a more comprehensive overview of the system in Indiana.

The study also provides an overview of how recent system changes, shifts in the composition of workers’ compensation claims, and external factors—such as the economy, inflation, and medical care—have likely affected medical payments and treatment since 2018. Some of these changes were prompted or accelerated by the COVID-19 pandemic. The results reflect experience with non-COVID-19 claims.

CompScope™ Medical Benchmarks for Indiana, 2025 Edition. Roman Dolinschi and Evelina Radeva. October 2025. WC-25-31.

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This study assists policymakers and stakeholders in Minnesota’s workers’ compensation system by identifying current cost drivers and emerging trends in payments, prices, and utilization of medical care received by workers with injuries. It examines these medical services by type of provider and service.

It compares these medical payment metrics in Minnesota with those in 17 other states and analyzes changes from 2018 to 2023 (evaluated as of March 31, 2024). It also monitors the impact of regulatory changes on the system, including updates to the medical fee schedule in 2022. In some instances, we include data from before 2018 to provide historical context for key metrics. Additionally, we draw on findings from other WCRI studies to create a more comprehensive overview of the system in Minnesota.

The study also provides an overview of how recent system changes, shifts in the composition of workers’ compensation claims, and external factors—such as the economy, inflation, and medical care—have likely affected medical payments and treatment since 2018. Some of these changes were prompted or accelerated by the COVID-19 pandemic. The results reflect experience with non-COVID-19 claims.

CompScope™ Medical Benchmarks for Minnesota, 2025 Edition. Rebecca Yang. October 2025. WC-25-34.

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This study assists policymakers and stakeholders in Florida’s workers’ compensation system by identifying current cost drivers and emerging trends in payments, prices, and utilization of medical care received by workers with injuries. It examines these medical services by type of provider and service.

It compares these medical payment metrics in Florida with those in 17 other states and analyzes changes from 2018 to 2023 (evaluated as of March 31, 2024). It also monitors the impact of regulatory changes on the system, notably changes to the medical fee schedule implemented in 2023. In some instances, we include data from before 2018 to provide historical context for key metrics. Additionally, we draw on findings from other WCRI studies to create a more comprehensive overview of the system in Florida.

The study also provides an overview of how recent system changes, shifts in the composition of workers’ compensation claims, and external factors—such as the economy, inflation, and medical care—have likely affected medical payments and treatment since 2018. Some of these changes were prompted or accelerated by the COVID-19 pandemic. The results reflect experience with non-COVID-19 claims.

CompScope™ Medical Benchmarks for Florida, 2025 Edition. Rebecca Yang. October 2025. WC-25-29.

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This study assists policymakers and stakeholders in Wisconsin’s workers’ compensation system by identifying current cost drivers and emerging trends in payments, prices, and utilization of medical services among both nonhospital and hospital providers.

It compares these medical payment metrics in Wisconsin with those in 17 other states and analyzes changes from 2018 to 2023 (evaluated as of March 31, 2024). In some instances, we include data from before 2018 to provide historical context for key metrics. Additionally, we draw on findings from other WCRI studies to create a more comprehensive overview of the system in Wisconsin.

The study also provides an overview of how recent system changes, shifts in the composition of workers’ compensation claims, and external factors—such as the economy, inflation, and medical care—have likely affected medical payments and treatment since 2018. Some of these changes were prompted or accelerated by the COVID-19 pandemic. The results reflect experience with non-COVID-19 claims.

CompScope™ Medical Benchmarks for Wisconsin, 2025 Edition. Evelina Radeva. October 2025. WC-25-39.

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This study assists policymakers and stakeholders in New Jersey’s workers’ compensation system by identifying current cost drivers and emerging trends in payments, prices, and utilization of medical services among both nonhospital and hospital providers.

It compares these medical payment metrics in New Jersey with those in 17 other states and analyzes changes from 2018 to 2023 (evaluated as of March 31, 2024). In some instances, we include data from before 2018 to provide historical context for key metrics. Additionally, we draw on findings from other WCRI studies to create a more comprehensive overview of the system in New Jersey.

The study also provides an overview of how recent system changes, shifts in the composition of workers’ compensation claims, and external factors—such as the economy, inflation, and medical care—have likely affected medical payments and treatment since 2018. Some of these changes were prompted or accelerated by the COVID-19 pandemic. The results reflect experience with non-COVID-19 claims.

CompScope™ Medical Benchmarks for New Jersey, 2025 Edition. Evelina Radeva. October 2025. WC-25-35.

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This study assists policymakers and stakeholders in Illinois’s workers’ compensation system by identifying current cost drivers and emerging trends in payments, prices, and utilization of medical services among both nonhospital and hospital providers.

It compares these medical payment metrics in Illinois with those in 17 other states and analyzes changes from 2018 to 2023 (evaluated as of March 31, 2024). It also monitors the impact of regulatory changes on the system, including the annual updates to the rates set by the state’s workers' compensation fee schedule. In some instances, we include data from before 2018 to provide historical context for key metrics. Additionally, we draw on findings from other WCRI studies to create a more comprehensive overview of the system in Illinois.

The study also provides an overview of how recent system changes, shifts in the composition of workers’ compensation claims, and external factors—such as the economy, inflation, and medical care—have likely affected medical payments and treatment since 2018. Some of these changes were prompted or accelerated by the COVID-19 pandemic. The results reflect experience with non-COVID-19 claims.

CompScope™ Medical Benchmarks for Illinois, 2025 Edition. Evelina Radeva. October 2025. WC-25-30.

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This study assists policymakers and stakeholders in Delaware’s workers’ compensation system by identifying current cost drivers and emerging trends in payments, prices, and utilization of medical services among both nonhospital and hospital providers.

It compares these medical payment metrics in Delaware with those in 17 other states and analyzes changes from 2018 to 2023 (evaluated as of March 31, 2024). It also monitors the impact of regulatory changes on the system, including the annual updates to the rates set by the state’s workers’ compensation fee schedule. In some instances, we include data from before 2018 to provide historical context for key metrics. Additionally, we draw on findings from other WCRI studies to create a more comprehensive overview of the system in Delaware.

The study also provides an overview of how recent system changes, shifts in the composition of workers’ compensation claims, and external factors—such as the economy, inflation, and medical care—have likely affected medical payments and treatment since 2018. Some of these changes were prompted or accelerated by the COVID-19 pandemic. The results reflect experience with non-COVID-19 claims.

CompScope™ Medical Benchmarks for Delaware, 2025 Edition. Evelina Radeva. October 2025. WC-25-28.

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This study assists policymakers and stakeholders in Pennsylvania’s workers’ compensation system by identifying current cost drivers and emerging trends in payments, prices, and utilization of medical services among both nonhospital and hospital providers.

It compares these medical payment metrics in Pennsylvania with those in 17 other states and analyzes changes from 2018 to 2023 (evaluated as of March 31, 2024). It also monitors the impact of regulatory changes on the system, including statewide average weekly wage (SAWW)-based increases to the state’s workers’ compensation fee schedule. In some instances, we include data from before 2018 to provide historical context for key metrics. Additionally, we draw on findings from other WCRI studies to create a more comprehensive overview of the system in Pennsylvania.

The study also provides an overview of how recent system changes, shifts in the composition of workers’ compensation claims, and external factors—such as the economy, inflation, and medical care—have likely affected medical payments and treatment since 2018. Some of these changes were prompted or accelerated by the COVID-19 pandemic. The results reflect experience with non-COVID-19 claims.

CompScope™ Medical Benchmarks for Pennsylvania, 2025 Edition. William Monnin-Browder and Terence Cawley. October 2025. WC-25-37.

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This study assists policymakers and stakeholders in North Carolina’s workers’ compensation system by identifying current cost drivers and emerging trends in payments, prices, and utilization of medical services among both nonhospital and hospital providers.

It compares these medical payment metrics in North Carolina with those in 17 other states and analyzes changes from 2018 to 2023 (evaluated as of March 31, 2024). In some instances, we include data from before 2018 to provide historical context for key metrics. Additionally, we draw on findings from other WCRI studies to create a more comprehensive overview of the system in North Carolina.

The study also provides an overview of how recent system changes, shifts in the composition of workers’ compensation claims, and external factors—such as the economy, inflation, and medical care—have likely affected medical payments and treatment since 2018. Some of these changes were prompted or accelerated by the COVID-19 pandemic. The results reflect experience with non-COVID-19 claims.

CompScope™ Medical Benchmarks for North Carolina, 2025 Edition. Carol A. Telles and William Monnin-Browder. October 2025. WC-25-36.

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This study assists policymakers and stakeholders in California’s workers’ compensation system by identifying current cost drivers and emerging trends in payments, prices, and utilization of medical services among both nonhospital and hospital providers.

It compares these medical payment metrics in California with those in 17 other states and analyzes changes from 2018 to 2023 (evaluated as of March 31, 2024). In some instances, we include data from before 2018 to provide historical context for key metrics. Additionally, we draw on findings from other WCRI studies to create a more comprehensive overview of the system in California.

The study also provides an overview of how recent system changes, shifts in the composition of workers’ compensation claims, and external factors—such as the economy, inflation, and medical care—have likely affected medical payments and treatment since 2018. Some of these changes were prompted or accelerated by the COVID-19 pandemic. The results reflect experience with non-COVID-19 claims.

CompScope™ Medical Benchmarks for California, 2025 Edition. William Monnin-Browder. October 2025. WC-25-27.

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With policymakers at the local, state, and federal levels debating heat safety standards, this study offers measurable evidence of how California’s 2005 heat standard impacted the frequency of injuries in occupations with substantial exposure to outdoor heat, like construction, agriculture, and transportation. The heat standard requires employers to provide water, shade, rest breaks, acclimatization plans, and emergency response protocols during excessive heat.

Previous WCRI research found that excessive heat not only causes heat-related illnesses such as heat exhaustion but also impairs judgment and perception, increasing the risk of accidents such as being struck by machinery. Heat-related illnesses are 11 to 18 times more frequent on days above 95°F compared with days between 75 and 80°F, yet they represent 20 to 25 percent of all injuries attributable to heat.

Impact of California’s Heat Standard on Workers’ Compensation Outcomes. Olesya Fomenko, Melissa McInerney, and Sebastian Negrusa. September 2025. WC-25-44.

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Behavioral health is increasingly recognized as a key factor in workers’ compensation recovery. Psychosocial risks—like fear of movement, poor coping skills, and low mood—can significantly affect outcomes for knee and shoulder injuries. Building on WCRI’s earlier findings of recovery from low back injuries, this new study extends the scope to include common musculoskeletal conditions.

The study examines a large sample of patients with knee and shoulder pain using data from Focus on Therapeutic Outcomes (FOTO) collected from 2021 to 2024. The dataset for the study includes approximately 65,000 episodes each of knee and shoulder physical therapy. Among these, more than 8,000 shoulder and 5,000 knee episodes were covered under workers’ compensation. The large sample enables a robust examination of differences in psychosocial risks and functional outcomes by payor type.

Psychosocial Factors and Functional Outcomes Following Physical Therapy. Vennela Thumula, Te-Chun Liu, and Randall D. Lea. September 2025. WC-25-43.

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This study examines the key factors associated with high-cost workers’ compensation claims involving back and shoulder injuries, where medical expenses exceed $65,000 within 36 months of injury.

In a previous WCRI study, we identified factors that increase the likelihood of high medical payments by looking at all injury types together. This new study refines that analysis by focusing on back and shoulder injuries to better understand what contributes to higher claim costs.

The study looks at four back conditions (neurologic back pain; disc disorders; degenerative back conditions; and sprains, strains, and non-specific pain) and three shoulder injuries (rotator cuff disorders, frozen shoulders, and shoulder osteoarthritis).

The analysis is based on about 194,000 workers’ compensation claims with more than seven days of lost time, from 32 states. These claims involve injuries that occurred between October 1, 2015, and March 31, 2019, with detailed treatment and billing data tracked for up to 36 months after the injury, through March 31, 2022.

Patterns and Trends of High-Cost Claims Involving Back and Shoulder Injuries. Dongchun Wang, Kathryn L. Mueller, and Randall D. Lea. August 2025. WC-25-42.

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As the shortage of primary care physicians grows, more injured workers are receiving initial care from advanced practitioners—nurse practitioners and physician assistants. This study asks a timely question: Does it make a difference?

There’s growing interest in understanding how provider type influences outcomes. Some worry that advanced practitioners may lack the specialized experience to manage certain injuries. This study sheds light on how care provided by nurse practitioners and physician assistants shapes patterns of care and claim outcomes.

WCRI tested these concerns by comparing claim outcomes when the initial provider was an advanced practitioner versus a primary care physician. Key measures included the following:

• Time to first nonemergency office visit
• Number of medical visits
• Use and timing of specialty care
• MRI use within six weeks
• Medical and indemnity payments
• Duration of temporary disability

The analysis for the study draws on detailed claims and medical data from 29 states, covering over 80 percent of workers’ compensation benefits paid in 2022. It includes injuries from October 1, 2012, to September 30, 2022, and tracks outcomes up to 6 or 12 months postinjury.

Advanced Practitioners and Workers’ Compensation Claim Outcomes. Bogdan Savych and Olesya Fomenko. July 2025. WC-25-26.

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This study examined the association between condition-specific factors and the likelihood of a claim becoming high cost (defined as medical payments exceeding $65,000 within 36 months of injury).

It provides a deeper understanding of how varying levels of rotator cuff tears and their surgical treatment patterns contribute to elevated medical costs. Given the clinical complexity and claims management challenges these injuries present, the findings can inform effective care strategies and resource utilization.

The analysis draws on nearly 50,000 rotator cuff disorder claims from a larger dataset of over 930,000 lost-time claims across 32 states. These claims involved injuries occurring between October 2015 and March 2019, with detailed medical billing and treatment data tracked for three years postinjury.

Patterns and Trends of High-Cost Claims Involving Rotator Cuff Disorders. Dongchun Wang, Randall D. Lea, and Kathryn L. Mueller. July 2025. WC-25-25.

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This study examines how the high-inflation period of 2021–2023 has affected medical payments in workers’ compensation through 2025—particularly in states that tie their medical fee schedules to general economic inflation measures. The findings are especially relevant as policymakers and stakeholders continue to grapple with inflationary pressures.

The report analyzes how different fee schedule update methods—ranging from broad economic indexes like the Consumer Price Index and wage measures to medical-specific indexes such as the Producer Price Index for health care services—have influenced medical cost growth in workers’ compensation since 2020. While general health care prices rose steadily at about 3 percent per year, the study explores why workers’ compensation medical payments varied more widely across states.

Drawing on multiple data sources, the report uses inflation figures from the U.S. Bureau of Labor Statistics and workers’ compensation data from WCRI’s CompScope™ studies and Detailed Benchmark/Evaluation database, which includes claims from insurers, state funds, and self-insured employers. Nonhospital price trends are tracked through WCRI’s Medical Price Index for Workers’ Compensation, and hospital outpatient trends are based on WCRI’s Hospital Outpatient Payment Index. Fee schedule data come from WCRI’s 2025 fee schedule study, RefMed® data, and Medicare. The analysis covers trends from 2012 through 2025.

Post-Inflation Trends in Medical Payments Through 2025—A WCRI FlashReport. Rebecca Yang and Olesya Fomenko. June 2025. FR-25-03.

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In recent years, interest in the role of artificial intelligence (AI) in workers’ compensation has grown rapidly. This study represents an important step toward understanding how stakeholders perceive the opportunities and risks associated with these emerging technologies by examining their views on the promises and challenges of AI in the workers’ compensation system.

To develop the study, WCRI researchers conducted semi-structured interviews with 34 leaders from 20 organizations—including employers, insurers, medical providers, worker advocates, and regulators—supplemented by informal discussions. They also reviewed relevant literature and regulations concerning AI developments and applications.

By outlining current and emerging uses of AI in workers’ compensation and identifying associated risks and potential safeguards, the study aims to provide a common language for stakeholders and inform policy discussions that promote responsible AI use to improve injured workers’ recovery and experience.

Artificial Intelligence in Workers’ Compensation: An Overview of Promises and Challenges. Bogdan Savych and Vennela Thumula. June 2025. WC-25-22.

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As policymakers consider implementing or revising medical fee schedules to control costs in their state workers’ compensation systems, this new study highlights the critical design choices involved in adopting, updating, and reforming these schedules.

Crafting a medical fee schedule requires a delicate balance. If rates are set too low, treating injured workers may become uneconomical for providers, jeopardizing access to care. Conversely, rates set too high may reduce potential savings and weaken the fee schedule’s cost-containment goals.

This study outlines the key decisions public officials face when establishing or revising physician fee schedules. It examines how 44 states with fee schedules and the District of Columbia have addressed these challenges as of March 31, 2025, and analyzes major changes to professional medical service fee schedules since March 2022—particularly in light of elevated inflation in the broader economy.

It also compares fee schedule levels across states for professional services, which account for about 41 percent of workers’ compensation medical costs. The study does not assess whether rates are appropriate or explore broader policy impacts, such as access to care or patterns of medical utilization

Designing Workers’ Compensation Medical Fee Schedules, 2025. Olesya Fomenko and Te-Chun Liu. June 2025. WC-25-41.

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As many states consider revising hospital fee regulations, this new study compares hospital outpatient payments across 36 states and examines the impact of fee schedule reforms from 2005 to 2023. It also includes a benchmark comparing workers’ compensation hospital outpatient payments with Medicare rates and tracks the effects of recent policy changes.

The report captures payments for services provided and billed directly by hospitals, such as outpatient surgeries. It excludes professional services billed by nonhospital providers (e.g., physicians, physical therapists, and chiropractors), as well as payments for pharmaceuticals, durable medical equipment, and services at ambulatory surgery centers.

States included in the study: Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Jersey, New Mexico, New York, North Carolina, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, West Virginia, and Wisconsin.

Hospital Outpatient Payment Index: Interstate Variations and Policy Analysis, 14th Edition. Olesya Fomenko and Rebecca Yang. May 2025. WC-25-24.

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This annual study compares prices paid for medical professional services across 36 states from 2008 to 2024. It focuses on services commonly billed by physicians, physical therapists, and chiropractors, including evaluation and management, physical medicine, surgery, major and minor radiology, neurological testing, pain management injections, and emergency care.

Unlike other indices measuring prices of all medical professional services provided to the general population, this index is a more relevant benchmark of medical inflation in workers’ compensation as it focuses on those services commonly provided to workers with injuries. Since workers’ compensation price regulations are set at the state level, this study provides a state-level price index to help policymakers and stakeholders conduct meaningful comparisons of prices paid across states and to monitor price trends in relation to changes in fee schedules.

This edition covers 36 states that represent 88 percent of the workers’ compensation benefits paid in the United States. These states are Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Wisconsin.

WCRI Medical Price Index for Workers’ Compensation, 17th Edition (MPI-WC). Rebecca Yang and Olesya Fomenko. May 2025. WC-25-23.

(This is a free report. If you have a member user name and password, please log into the website to access this report. All others can access the report for free by adding it to the shopping cart and going through the checkout process.)

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As more states adopt recreational marijuana laws (RMLs), this new study examines changes in workers’ compensation claim frequency and outcomes such as per-claim medical payments, indemnity benefits, temporary disability duration, and prescription drug utilization and costs.

This research is important as marijuana use continues to rise. Our study highlights the complex effects RMLs have on work injury risk and workers’ compensation claim costs.

The study’s findings can inform debates on issues such as marijuana rescheduling, occupational treatment guidelines, state THC (tetrahydrocannabinol) regulations, or marijuana taxes. The analysis covers 31 states, using data from workers’ compensation claims filed between October 2012 and March 2022.

Impact of Recreational Marijuana Laws on Workers’ Compensation Benefits. Vennela Thumula, Johanna Catherine MacLean, David Powell, and Sebastian Negrusa. April 2025. WC-25-21.

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These studies help workers’ compensation policymakers and other system stakeholders identify current cost drivers and emerging trends in total costs per claim and key components.

They compare the performance of state workers’ compensation systems in 18 states, focusing on overall medical payments, income benefits, use of benefits, duration of temporary disability, benefit delivery expenses, timeliness of payments, and other metrics.

Additionally, the studies examine how these system performance metrics have changed, mainly from 2018 to 2023, for claims at various maturities. We analyze claims with experience through 2024 for injuries up to and including 2023, and in some cases, we use a longer time frame to supply historical context.

The 18 states in the study are Arkansas, California, Delaware, Florida, Illinois, Indiana, Iowa, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, New Jersey, North Carolina, Pennsylvania, Texas, Virginia, and Wisconsin. There are individual reports for every state except Arkansas, Iowa, Kentucky, and Texas.

The results reflect claims experience through March 2024, including non-COVID-19 claims. As a result, the study provides a detailed look at how the pandemic-related disruptions affected non-COVID-19 workers’ compensation claims in the early pandemic years (2019–2021) and more recently (2021–2023).

CompScope™ Benchmarks, 2025 Edition. Terence Cawley, Roman Dolinschi, William Monnin-Browder, Evelina Radeva, Karen Rothkin, Bogdan Savych, Carol A. Telles, and Rebecca Yang. April 2025. WC-25-03 to WC-25-16.

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This 2025 edition of the CompScope™ Benchmarks study examines changes in the California workers’ compensation system and compares the performance of the California system with 17 other state systems. The report focuses on costs, income benefits, overall medical payments, use of benefits, duration of temporary disability, frequency and payments of permanent partial disability (PPD)/lump-sum claims, benefit delivery expenses, litigiousness, timeliness of payments, and other metrics. It examines how these system performance metrics have changed, primarily from 2018 to 2023 for claims at various claim maturities; in some cases, we use a longer time frame to provide historical context.

Note that the results we report reflect experience on claims through March 2024, including non-COVID-19 claims from the pandemic period. The study, therefore, provides a look at how the pandemic impacted non-COVID-19 workers’ compensation claims.

CompScope™ Benchmarks for California, 2025 Edition. William Monnin-Browder. April 2025. WC-25-03.

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The study provides policymakers and other system stakeholders in Delaware with ongoing annual monitoring of changes in indemnity benefits, medical payments, and benefit delivery expenses per claim. It also compares the Delaware workers’ compensation system with 17 other study states on these key metrics.

This edition analyzes claims with injury dates between 2018 and 2023 (evaluated as of March 31, 2024). In some cases, we use a longer time frame to supply historical context for key metrics and to provide a broader context for monitoring changes in Delaware’s system performance. Where relevant, we include findings from other recent Workers Compensation Research Institute (WCRI) studies to provide a more comprehensive picture of the Delaware workers’ compensation system.

The results reflect claims experience through March 2024, including non-COVID-19 claims. As a result, the study provides a detailed look at how the pandemic-related disruptions affected non-COVID-19 workers’ compensation claims in the early pandemic years (2019–2021) and more recently (2021–2023).

CompScope™ Benchmarks for Delaware, 2025 Edition. Evelina Radeva. April 2025. WC-25-04.

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This study helps policymakers and other system stakeholders in Florida identify current cost drivers and emerging trends in total costs per claim and key components, namely indemnity benefits, medical payments, and benefit delivery expenses.

It compares the performance of the Florida workers’ compensation system with 17 other states, focusing on income benefits, overall medical payments, use of benefits, duration of temporary disability, frequency and payments of permanent partial disability (PPD)/lump-sum claims, benefit delivery expenses, litigiousness, timeliness of payments, and other metrics.

Additionally, the study examines how these system performance metrics have changed, mainly from 2018 to 2023, for claims at various claim maturities. We analyze claims with experience through 2024 for injuries up to and including 2023, and, in some cases, a longer time frame is used to supply historical context. Information from other studies is also used to provide a more complete picture of the system.

The results reflect claims experience through March 2024, including non-COVID-19 claims. As a result, the study provides a detailed look at how the pandemic-related disruptions affected non-COVID-19 workers’ compensation claims in the early pandemic years (2019–2021) and more recently (2021–2023).

CompScope™ Benchmarks for Florida, 2025 Edition. Rebecca Yang. April 2025. WC-25-05.

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The study provides policymakers and other system stakeholders in Illinois with ongoing annual monitoring of changes in indemnity benefits, medical payments, and benefit delivery expenses per claim. It also compares the Illinois workers’ compensation system with 17 other study states on these key metrics.

This edition analyzes claims with injury dates between 2018 and 2023 (evaluated as of March 31, 2024). In some cases, we use a longer time frame to supply historical context for key metrics and to provide a broader context for monitoring changes in Illinois’s system performance. Where relevant, we include findings from other recent Workers Compensation Research Institute (WCRI) studies to provide a more comprehensive picture of the Illinois workers’ compensation system.

The results reflect claims experience through March 2024, including non-COVID-19 claims. As a result, the study provides a detailed look at how the pandemic-related disruptions affected non-COVID-19 workers’ compensation claims in the early pandemic years (2019–2021) and more recently (2021–2023).

CompScope™ Benchmarks for Illinois, 2025 Edition. Evelina Radeva. April 2025. WC-25-06.

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This study helps policymakers and other system stakeholders in Indiana identify current cost drivers and emerging trends in indemnity benefits, medical payments, and benefit delivery expenses. It compares the performance of state workers’ compensation systems in Indiana and 17 other states, focusing on income benefits, overall medical payments, use of benefits, duration of temporary disability, benefit delivery expenses, timeliness of payments, and other metrics.

Additionally, the study examines how these system performance metrics have changed, mainly from 2018 to 2023, for claims at various claim maturities. We analyze claims with experience through 2024 for injuries up to and including 2023, and, in some cases, a longer time frame is used to supply historical context. Information from other studies is also used to provide a more complete picture of the system.

The results reflect claims experience through March 2024, focusing on non-COVID-19 claims. As a result, the study provides a detailed look at how the pandemic-related disruptions affected non-COVID-19 workers’ compensation claims in the early pandemic years (2019–2021) and more recently (2021–2023).

CompScope™ Benchmarks for Indiana, 2025 Edition. Roman Dolinschi and Evelina Radeva. April 2025. WC-25-07.

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This study helps policymakers and other system stakeholders in Louisiana identify current cost drivers and emerging trends in indemnity benefits, medical payments, and benefit delivery expenses.

It compares the performance of the Louisiana workers’ compensation system with 17 other states, focusing on income benefits, costs, overall medical payments, use of benefits, duration of temporary disability, benefit delivery expenses, timeliness of payment, and other metrics.

Additionally, the study examines how these system performance metrics have changed, mainly from 2018 to 2023, for claims at various claim maturities. We analyze claims with experience through 2024 for injuries up to and including 2023, and, in some cases, we use a longer time frame to supply historical context.

The results reflect claims experience through March 2024, including non-COVID-19 claims. As a result, the study provides a detailed look at how the pandemic-related disruptions affected non-COVID-19 workers’ compensation claims in the early pandemic years (2019–2021) and more recently (2021–2023).

CompScope™ Benchmarks for Louisiana, 2025 Edition. Carol A. Telles. April 2025. WC-25-08.

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This study helps policymakers and other system stakeholders in Massachusetts identify current cost drivers and emerging trends in indemnity benefits, medical payments, and benefit delivery expenses. It compares the performance of the Massachusetts workers’ compensation system with 17 other states, focusing on income benefits, costs, overall medical payments, use of benefits, duration of temporary disability, benefit delivery expenses, timeliness of payments, and other metrics.

Additionally, the study examines how these system performance metrics have changed, mainly from 2018 to 2023, for claims at various claim maturities. We analyze claims with experience through 2024 for injuries up to and including 2023, and, in some cases, a longer time frame is used to supply historical context. Information from other studies is also used to provide a more complete picture of the system.

The results reflect claims experience through March 2024, focusing on non-COVID-19 claims. As a result, the study provides a detailed look at how the pandemic-related disruptions affected non-COVID-19 workers’ compensation claims in the early pandemic years (2019–2021) and more recently (2021–2023).

CompScope™ Benchmarks for Massachusetts, 2025 Edition. Roman Dolinschi. April 2025. WC-25-09.

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This 2025 edition of CompScope™ Benchmarks for Michigan helps policymakers and other system stakeholders identify current cost drivers and emerging trends in a wide variety of performance measures of state workers’ compensation systems. This report provides meaningful comparisons between Michigan and 17 other study states on key measures including income benefits, duration of temporary disability, lump-sum settlements, medical payments, and benefit delivery expenses.

It also examines how these metrics have changed from 2018 to 2023. In some cases, we use a longer time frame to supply historical context for key metrics. We also include information from other Workers Compensation Research Institute (WCRI) studies to provide a more complete picture of the system in Michigan.

Note that the results we report reflect experience on claims through March 2024, including non-COVID-19 claims since the onset of the COVID-19 pandemic in the United States in March 2020. The study, therefore, provides a look at how the pandemic impacted non-COVID-19 workers’ compensation claims.

CompScope™ Benchmarks for Michigan, 2025 Edition. Terence Cawley. April 2025. WC-25-10.

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This study helps policymakers and other system stakeholders in Minnesota identify current cost drivers and emerging trends in total costs per claim and key components, namely indemnity benefits, medical payments, and benefit delivery expenses.

It compares the performance of state workers’ compensation systems in Minnesota and 17 other states, focusing on income benefits, overall medical payments, use of benefits, duration of temporary disability, frequency and payments of permanent partial disability (PPD)/lump-sum claims, benefit delivery expenses, litigiousness, timeliness of payments, and other metrics.

Additionally, the study examines how these system performance metrics have changed, mainly from 2018 to 2023, for claims at various claim maturities. We analyze claims with experience through 2024 for injuries up to and including 2023, and, in some cases, a longer time frame is used to supply historical context. Information from other studies is also used to provide a more complete picture of the system.

The results reflect claims experience through March 2024, including non-COVID-19 claims. As a result, the study provides a detailed look at how the pandemic-related disruptions affected non-COVID-19 workers’ compensation claims in the early pandemic years (2019–2021) and more recently (2021–2023).

CompScope™ Benchmarks for Minnesota, 2025 Edition. Rebecca Yang. April 2025. WC-25-11.

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The study provides policymakers and other system stakeholders in New Jersey with ongoing annual monitoring of changes in indemnity benefits, medical payments, and benefit delivery expenses per claim. It also compares the New Jersey workers’ compensation system with 17 other study states on these key metrics.

This edition analyzes claims with injury dates between 2018 and 2023 (evaluated as of March 31, 2024). In some cases, we use a longer time frame to supply historical context for key metrics and to provide a broader context for monitoring changes in New Jersey’s system performance. Where relevant, we include findings from other recent Workers Compensation Research Institute (WCRI) studies to provide a more comprehensive picture of the New Jersey workers’ compensation system.

The results reflect claims experience through March 2024, including non-COVID-19 claims. As a result, the study provides a detailed look at how the pandemic-related disruptions affected non-COVID-19 workers’ compensation claims in the early pandemic years (2019–2021) and more recently (2021–2023).

CompScope™ Benchmarks for New Jersey, 2025 Edition. Evelina Radeva. April 2025. WC-25-12.

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This study helps policymakers and other system stakeholders in North Carolina identify current cost drivers and emerging trends in total costs per claim and key components.

It compares the performance of North Carolina’s workers’ compensation system with 17 other states, focusing on income benefits, overall medical payments, use of benefits, duration of temporary disability, benefit delivery expenses, timeliness of payments, and other metrics.

Additionally, the study examines how these system performance metrics have changed, mainly from 2018 to 2023, for claims at various maturities. We analyze claims with experience through 2024 for injuries up to and including 2023, and in some cases, we use a longer time frame to supply historical context. For example, major legislation enacted in 2011 focused on indemnity benefits and fee schedule changes enacted in 2015 impacted medical payments. Using longer time frames, we can observe how the legislation impacted trends in indemnity benefit components and medical payments.

The results reflect claims experience through March 2024, including non-COVID-19 claims. As a result, the study provides a detailed look at how the pandemic-related disruptions affected non-COVID-19 workers’ compensation claims in the early pandemic years (2019–2021) and more recently (2021–2023).

CompScope™ Benchmarks for North Carolina, 2025 Edition. Carol A. Telles. April 2025. WC-25-13.

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This 2025 edition of CompScope™ Benchmarks for Pennsylvania helps policymakers and other system stakeholders identify current cost drivers and emerging trends in a wide variety of performance measures of state workers’ compensation systems. This report provides meaningful comparisons between Pennsylvania and 17 other study states on key measures including indemnity benefits, duration of temporary disability, lump-sum settlements, medical payments, and benefit delivery expenses. It also examines how these metrics have changed from 2018 to 2023. In some cases, we use a longer time period to supply historical context for key metrics. We also include information from other Workers Compensation Research Institute (WCRI) studies to provide a more complete picture of the system in Pennsylvania.

Note that the results we report reflect experience on claims through March 2024, including non-COVID-19 claims from the pandemic period. The study, therefore, provides a look at how the pandemic impacted non-COVID-19 workers’ compensation claims.

CompScope™ Benchmarks for Pennsylvania, 2025 Edition. William Monnin-Browder. April 2025. WC-25-14.

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This study helps policymakers and other system stakeholders in Virginia identify current cost drivers and emerging trends in total costs per claim and key components. It also helps them monitor the ongoing impact of the medical fee schedule implemented on January 1, 2018.

It compares the performance of the Virginia workers’ compensation system with 17 other states, focusing on overall medical payments, income benefits, use of benefits, duration of temporary disability, benefit delivery expenses, timeliness of payments, and other metrics.

Additionally, the study examines how these system performance metrics have changed, mainly from 2018 to 2023, for claims at various claim maturities. Claims with experience through 2024 for injuries up to and including 2023 were analyzed, and, in some cases, a longer time frame was used to supply historical context. Information from other studies was also used to provide a more complete picture of the system.

The results reflect claims experience through March 2024, including non-COVID-19 claims. As a result, the study provides a detailed look at how the pandemic-related disruptions affected non-COVID-19 workers’ compensation claims in the early pandemic years (2019–2021) and more recently (2021–2023).

CompScope™ Benchmarks for Virginia, 2025 Edition. Bogdan Savych. April 2025. WC-25-15.

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The study provides policymakers and other system stakeholders in Wisconsin with ongoing annual monitoring of changes in indemnity benefits, medical payments, and benefit delivery expenses per claim. It also compares the Wisconsin workers’ compensation system with 17 other study states on these key metrics.

This edition analyzes claims with injury dates between 2018 and 2023 (evaluated as of March 31, 2024). In some cases, we use a longer time frame to supply historical context for key metrics and to provide a broader context for monitoring changes in Wisconsin’s system performance. Where relevant, we include findings from other recent Workers Compensation Research Institute (WCRI) studies to provide a more comprehensive picture of the Delaware workers’ compensation system.

The results reflect claims experience through March 2024, including non-COVID-19 claims. As a result, the study provides a detailed look at how the pandemic-related disruptions affected non-COVID-19 workers’ compensation claims in the early pandemic years (2019–2021) and more recently (2021–2023).

CompScope™ Benchmarks for Wisconsin, 2025 Edition. Evelina Radeva. April 2025. WC-25-16.

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Degenerative and comorbid conditions often coexist with primary work-related injuries, complicating treatment and recovery, leading to increased costs and extended duration of temporary disability. 

This study compares claims with and without comorbidities, as well as those involving one or multiple comorbid conditions. It highlights the importance of early detection and intervention to reduce the impact of these conditions on claim costs and outcomes. 

The analysis for this study is based on 930,000 claims with more than seven days of lost time across 32 states. The report includes measures on medical payments, indemnity benefits, and duration of temporary disability.

Degenerative and Comorbid Conditions in Workers’ Compensation. Dongchun Wang, Randall D. Lea, and Kathyrn L. Mueller. March 2025. WC-25-20.

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