Workers Compensation Costs Out of Control According to New Data

Today’s post was shared by Gelman on Workplace Injuries and comes from www.maciverinstitute.com

Median Workers Comp Payments Nearly 5 Times the Medicare Rates for Same Procedures

The Workers Compensation Advisory Council (WCAC) is worried that medical costs are out of control and has spent the past few months formalizing a plan to keep them in check. Documents recently obtained by the MacIver Institute show there is reason to worry.

The documents, prepared by Wisconsin Compensation Rating Bureau (WCRB), compare the median payments from Workers Compensation to Medicare reimbursement rates in 2012. WCAC is currently considering a plan to tie Workers Comp payments to 175 percent of the Medicare reimbursement rate, which is similar to what other states have done.

Unfortunately, the 2012 data shows that the median amount paid by Workers Comp was nearly five times the Medicare reimbursement rate for the top 25 procedures performed in 2012. That is 177 percent greater than what is being proposed by the Council.

Arthroscopic shoulder surgeries, which doctors perform to inspect, diagnose, and repair problems within a person’s shoulder joint, had the largest differentiation in cost at 1,680 percent of the Medicare rate. The next highest was arthroscopic knee surgeries at 796 percent.

None of the Workers Comp median payments for the top 25 procedures were within 175 percent of the Medicare reimbursement rate.

The lowest differentials were for office or outpatient visits. Workers Comp median payments were between 199 percent and 232 percent of the Medicare rate for office…

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