One way to examine the performance of a state workers’ compensation system is in the context of a key value proposition. In WCRI studies, the value proposition used to evaluate the cost and delivery of workers’ compensation medical care has two dimensions.
First, a state system delivers better value than another state if the medical costs borne by employers in the first state are the same or lower than in the second state, while the outcomes achieved by injured workers are better in the first state (interstate comparison of value).
Second, the value delivered by a state system is increasing if the medical costs borne by employers in the first state are stable or falling, while the outcomes achieved by injured workers are improving (trend in value).
The study How Have Worker Outcomes and Medical Costs Changed in Wisconsin?examines how worker outcomes and medical costs and prices have changed in Wisconsin since injuries that occurred in 2001.
Among our findings:
Interstate comparison of value: Compared to 10 other states, Wisconsin most likely provides a good value proposition for workers and their employers in the cost and delivery of medical care. Wisconsin workers who were injured in 2006 and interviewed in 2009 reported better recovery of health and functioning, return to work, access to care and satisfaction with care than workers in most of the other study states. In 2006, the average medical cost borne by employers was 19 percent above the median of 14 states in the WCRI CompScope™ benchmark studies. So workers in Wisconsin get better than average outcomes while employers in Wisconsin pay somewhat higher than average medical costs per claim. Because return to work and worker satisfaction with care in Wisconsin were the highest of the states studied, it is likely that Wisconsin provides a good value proposition on medical care, on balance, to workers and their employers.
Trend in value: The outcomes reported by workers in Wisconsin did not materially change in the five years between the first survey and the 2009 survey of workers injured in 2006. The average medical cost per claim with more than 7 days of lost time rose 70 percent. The average prices paid to nonhospital providers rose by 29 percent during this period, and the average payment per claim to hospitals rose by 58 percent. Medical costs and medical prices for claims with more than 7 days of lost time rose rapidly from 2001 to 2006, while worker outcomes were not materially changed. Although the value proposition in Wisconsin is stronger than in the majority of states studied, the overall trend in value is toward lower value.
How Have Worker Outcomes and Medical Costs Changed in Wisconsin? Sharon E. Belton and Te-Chun Liu. May 2010. WC-10-04.
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