This study examines medical payments, prices, and utilization in North Carolina and compares them with 17 other states (Arkansas, California, Florida, Georgia, Illinois, Indiana, Iowa, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, New Jersey, Pennsylvania, Texas, Virginia, and Wisconsin).
The results we report in this 17th edition study for North Carolina reflect the interim fee schedule changes in 2013. Future editions of this study will monitor the effects of the new fee schedule rules, which base reimbursement on Medicare methodology and went into effect beginning in 2015.
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 North Carolina, 17th Edition. Carol A. Telles. October 2016. WC-16-64.
How are workers' compensation medical payments distributed across providers and services?
How do medical payments, prices and utilization per claim differ across states for similar injures and workers?
How have medical payments, prices and utilization per claim changed over time within a state, and what are the major drivers of those changes?
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