This report examines medical payments, prices, and utilization in Wisconsin and compares them with 17 other states (Arkansas, California, Florida, Georgia, Illinois, Indiana, Iowa, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, New Jersey, North Carolina, Pennsylvania, Texas, and Virginia).
For several years, workers’ compensation medical costs have been a topic of ongoing interest to Wisconsin policymakers and stakeholders, and they have been the focus of considerable debate by the Workers’ Compensation Advisory Council and the state legislature. Wisconsin is one of seven states nationally that do not regulate professional medical fees and one of eight states nationally that do not regulate hospital fees. At the center of debate has been whether policymakers should take steps to regulate medical prices, and if so, how, and with what consequences for the Wisconsin system with respect to access to care, return to work, and other outcomes.
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 Wisconsin, 17th Edition. Sharon E. Belton. October 2016. WC-16-68.
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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