This study helps policymakers and other stakeholders in the Florida workers’ compensation system identify current cost drivers and emerging trends in payments, prices, and utilization of medical services provided for treating workers with injuries.

The study examines medical payments, prices, and utilization for various types of services by nonhospital and hospital providers in Florida, and compares them with 17 other states. The study also examines how these metrics of medical payments and care have changed, mainly from 2013 to 2018. Claims with experience through 2019 for injuries up to and including 2018 were used. In some cases, a longer time frame was used to supply historical context for key metrics.

Since 2015, Florida has implemented multiple medical fee schedule updates for hospital outpatient and inpatient services, ambulatory surgery center (ASC) services, and nonhospital professional services. We also discuss the trends in medical prices and payments for different types of services after these fee schedule changes.

CompScope™ Medical Benchmarks for Florida, 21st Edition. Rui Yang. October 2020. WC-20-28.

Copyright: WCRI