This report examines medical payments, prices, and utilization in Florida compared with 17 other states (Arkansas, California, Georgia, Illinois, Indiana, Iowa, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, New Jersey, North Carolina, Pennsylvania, Texas, Virginia, and Wisconsin).
Florida underwent several medical fee schedule changes after 2014. To help policymakers and stakeholders in the Florida workers’ compensation system understand the implications of these policy changes, the study analyzes the early indications of the effect of the hospital outpatient fee schedule change (effective January 2015), using data from January through June 2015, and conducts estimations of the possible impact of this policy change based upon the new fee schedule rates. It also discusses the implications of the professional fee schedule update (effective July 2016) in Florida according to the findings from a WCRI FlashReport.
The report can help identify changes over time in the provision of workers’ compensation medical care; detect areas where medical payments per claim, prices, or utilization may be higher or lower compared with other study states for a set of similar claims; or reveal areas where legislative changes or state system features and processes may be impacting the costs or delivery of medical services.
This study covers 2009 to 2014, with claims experience through March 2015. Where relevant, findings from other Workers Compensation Research Institute (WCRI) studies are added to provide a more complete picture of the system.
CompScope™ Medical Benchmarks for Florida, 17th Edition. Rui Yang and Roman Dolinschi. October 2016. WC-16-54.
How are workers' compensation medical payments distributed across providers and services?
How do medical payments, prices and utilization per claim differ across states for similar injures and workers?
How have medical payments, prices and utilization per claim changed over time within a state, and what are the major drivers of those changes?
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