This 20th edition of the CompScope™ Medical Benchmarks report examines medical payments, prices, and utilization in the Georgia workers’ compensation system and compares Georgia with 17 other states. This report also examines how these metrics have changed primarily from 2012 to 2017, though in some cases, we used a longer time frame to provide historical context for key metrics.

The report can help policymakers and other stakeholders in the system identify current cost drivers and emerging trends in payments, prices, and utilization of medical services among nonhospital and hospital providers. We analyzed claims with injuries up to and including 2017 (evaluated as of 2018). We also added information from other Workers Compensation Research Institute (WCRI) studies to provide a more complete picture of the system in Georgia.

During the study period, Georgia changed its reimbursement approach for outpatient providers (both ambulatory surgery centers [ASCs] and hospital outpatient providers). Effective May 2014, the outpatient reimbursement method in Georgia changed from an ICD-9-CM-based fee schedule to a Medicare hospital outpatient prospective payment system (OPPS)-based fee schedule. This report can help policymakers and stakeholders in the Georgia workers’ compensation system monitor the impact of this regulation change.

CompScope™ Medical Benchmarks for Georgia, 20th Edition. William Monnin-Browder. October 2019. WC-19-30.

Copyright: WCRI