The prices paid for medical professional services for injured workers were higher and rising faster in states without fee schedules compared with states that have them in place, according to the Workers Compensation Research Institute’s (WCRI) study, Medical Price Index for Workers' Compensation, Fourth Edition (MPI-WC). 

This WCRI study is designed to help public policymakers and system stakeholders understand how prices paid for medical professional services for injured workers in their states compare with other states and know if prices in their state are rising rapidly or relatively slowly.  They can also learn if the reason for price growth in their state is part of a national phenomenon or whether the causes are unique to their state and hence, subject to local management or reform.

 Sample of Major Findings:

• States with no fee schedule regulation on reimbursement for professional services had higher prices paid and more rapid price growth over time compared with states with fee schedules.
• Fee schedule changes were an important factor driving changes in actual prices paid.  In states that did not have changes in their fee schedules for a while, prices paid remained fairly stable.
• In states with fee schedule reforms, changes in the actual prices paid reflected the impact of the policy changes.
• In states with certain types of services not covered by their fee schedules, often the growth in prices paid for those services was more rapid than for the services covered by the fee schedules.
• Unlike the consumer price index for medical care (CPI-M), which measures general prices paid for medical goods and services, the MPI-WC focuses only on the prices paid for the medical care that injured workers receive under their state’s workers’ compensation system.

The MPI-WC tracks medical prices paid in 25 large states from calendar year 2002 through June 2011 for non-hospital, non-facility services billed by physicians, physical therapists, and chiropractors.  The medical services fall into eight major groups: evaluation and management, physical medicine, surgery, major radiology, minor radiology, neurological and neuromuscular testing, pain management injections, and emergency care. 

The 25 states included in the MPI-WC, which represent nearly 80 percent of the workers' compensation benefits paid in the United States, are Arizona, Arkansas, California, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, New Jersey, New York, North Carolina, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Wisconsin.  

WCRI Medical Price Index for Workers’ Compensation, Fourth Edition (MPI-WC). Rui Yang and Olesya Fomenko. March 2012. WC-12-20.

Copyright: WCRI