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

Legislation enacted in 2015 changed Minnesota’s hospital inpatient reimbursement from a charge-based system to the use of Medicare severity diagnosis-related groups (MS-DRGs) effective for discharges after January 1, 2016. This 17th edition report benchmarks the Minnesota system prior to the implementation of the new inpatient fee regulations. Future editions of the CompScope™ Medical Benchmarks reports will help Minnesota policymakers monitor trends in inpatient payments under the new DRG-based reimbursement regulations. 

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 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 Minnesota, 17th Edition. Sharon E. Belton. October2016. WC-16-62.