Anna Aguillard Oct. 12, 2015, 8:02am


According to a new study released by the Workers Compensation Research Institute (WCRI), medical payments per workers' compensation claim grew 4.1 percent in 2013.

The rise follows a 20 percent decrease in medical payments per claim between 2010 and 2012, the study showed. Researchers attributed the decreases to the state’s 30 percent reduction in fee scheduled rates that occurred during the two-year time frame.

Prior to the medical fee schedule rate reduction reform, the state’s medical payments per claim were among the highest of the study states. However, because the fee schedule rates reduction period has ended, Illinois should expect payments to rise.

“Part of the reason for the increase is due to the way the fee schedule is designed. In Illinois, the fee schedule is tied to the CPI-U [Consumer Price Index for Urban Consumers]. If the CPI-U goes up, then the fee schedule rates go up. Therefore, the costs go up, the prices of medical services increase, and the payment per claim increases. That’s a pretty normal thing,” said Ramona P. Tanabe, Executive Vice President and Counsel for the WCRI.

The 4.1 percent increase resembles the national average, said Tanabe.

“If it is a large increase, it tends to raise the interests of different stakeholders in the workers’ comp community. But the trend increase in Illinois is in the middle of what we saw in the United States. Not high, not low. Kind of typical,” Tanabe said.

The study also revealed that providers of physical medicine billed more visits per claim than in any other study state, and prices paid for professional services remained higher in Illinois.

This follows recent policy discussions in Illinois that have been focused on reducing workers’ comp costs in order to attract more businesses.

The study looked at claims made from 2008 – 2013 in 17 states, including Illinois, that collectively compose more than 60 percent of the nation’s workers comp recipients, and issued individual reports on each.

The full WCRI report can be found here: http://www.wcrinet.org/studies/protected/exec_summaries/csmed16_IL-es.html

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