This study examines medical payments, prices, and utilization for various types of services by nonhospital and hospital providers in Minnesota and compares them with 17 other states. It also examines how these metrics of medical payments and care have changed, mainly from 2014 to 2019. Claims with experience through 2020 for injuries up to and including 2019 were analyzed. In some cases, a longer period was used to supply historical context for key metrics. Information from other WCRI studies was also included to provide a more complete picture of the system in Minnesota.

Minnesota implemented several fee schedule changes in recent years. Effective October 1, 2018, Minnesota adopted Medicare ambulatory payment classification (APC)-based fee schedules for hospital outpatient and ambulatory surgery center (services, as provided in House File 3873. This study monitors the impact of these policy changes using data with up to 18 months of experience following the adoption of the new fee schedules. Earlier on, Minnesota adopted a Medicare diagnosis-related group (DRG)-based fee schedule for hospital inpatient care effective January 1, 2016.

The results we report include experience on claims through March 2020, at the very beginning of the coronavirus (COVID-19) pandemic. The study, therefore, provides a pre-COVID-19 baseline for evaluating the impact of the virus on workers’ compensation claims. 

CompScope™ Medical Benchmarks for Minnesota, 22nd Edition. Rebecca Yang. October 2021. WC-21-33.

Copyright: WCRI