This study examines medical payments, prices, and utilization in Georgia compared with 17 other states (Arkansas, California, Florida, Illinois, Indiana, Iowa, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, New Jersey, North Carolina, Pennsylvania, Texas, Virginia, and Wisconsin). 

Effective May 2014, the outpatient reimbursement method in Georgia changed from an ICD-9-CM based fee schedule to a Medicare OPPS based fee schedule. The data in this report reflect up to 11 months of experience after this fee schedule change and may help policymakers and stakeholders in the Georgia workers’ compensation system monitor the early impact of this regulation change. 

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. The following are among the questions the study answers:

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 Georgia, 17th Edition. Rui Yang. October 2016. WC-16-55.