This study examines the impact of the 30 percent reduction in Illinois’s medical fee schedule that was enacted in 2011. Prior to the reduction, the Illinois fee schedule was one of the highest in the nation. The study focuses on the following policy questions:

Whether the fee schedule change produced prices that are too low or too high.

Whether the 30 percent reduction in the fee schedule would produce a 30 percent change in the average medical cost of a claim.

Since the pre-reform prices in Illinois were higher than most states, how did the post-reform prices compare? 

The data in this study were from Illinois workers’ compensation physician fee schedules as of July 2011 and January 2012 and from Illinois Medicare fee schedules for 2011 and 2012. Also, this study used medical billing data from payors of workers’ compensation coming from the WCRI Detailed Benchmark/Evaluation database and group health claims from Thomson Reuters MarketScan® database.

The Effect of Reducing the Illinois Fee Schedule. Rui Yang and Olesya Fomenko. January 2014. WC-14-01.

Copyright: WCRI