Medical costs per claim have begun to rise following a perio
d of relative stability post-pandemic, a new report shows.
A new Workers Compensation Research Institute report shows medical payments per claim recently started
increasing, fueled by an increase in medical utilization, medical prices, and updates to state fee schedules.
The WCRI report examined medical payments, prices, and utiliza
tion by provider and by type of service across 18 states.
After several years of stable medical payments since 2018, California saw a 5% increase in medical paym
ents per claim, with increases in payments per claim for several no
n-hospital services, including physical medicine services, contributing to that growth, according to the report.
Medical payments per claim grew 7% per year between 2021 and 2023 in Delaware, driven by price increases in
professional and hospital outpatient services. These trends align
with Delaware’s fee schedule, which is adjusted based on the Consumer Price Index for All Urban Consumers (CPI-U).
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In Pennsylvania, medical payments per claim for care provided to injured workers rose 14% in 2023 after years o
f decreases, reflecting, in part, larger recent annual updates to the st
ate’s medical fee schedule, which is tied to the statewide average weekly wage.
Medical payments per claim grew 6% per year in Wisconsin from
2021 to 2023 after years of small changes. The state, which has ha
d some of the highest medical payments per claim among the study states, recently passed legislation introducin
g a medical fee schedule for hospital services, according to the WCRI report.
The report reflects the experience of non-COVID-19 claims through March 2024. The 18 states in the study–Arka
nsas, California, Delaware, Florida, Illinois, Indiana, Iowa, Kentucky, Louisiana, Massachusetts
, Michigan, Minnesota, New Jersey, North Carolina, Pennsylvania, Texas, Virginia, and Wiscons
in–represent about 60% of all workers’ compensation benefit payments nationwide.