View this article online: https://www.claimsjournal.com/news/midwest/2014/01/14/242814.htm

WCRI Study Examines Impact of Reducing the Illinois Fee Schedule

A new study by the Workers Compensation Research Institute (WCRI) examines the impact of the 30 percent reduction in the Illinois 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, The Effect of Reducing the Illinois Fee Schedule, looks at how prices paid for medical services changed and whether there were any services for which the cuts may have been so large as to raise concerns about access to care for injured workers.

For example, the workers’ compensation prices paid for the most common office visit were 18 percent lower than the estimated group health prices and 15 percent lower than the Medicare rates in 2012.

“Given that the workers’ compensation prices were below the group health prices and Medicare rates, policymakers might need to consider whether the fee schedule decrease was too much for office visits and whether access to care for primary care may have been impaired,” said Richard Victor, WCRI’s executive director.

The study observed the following after the fee schedule reduction:

• On average, medical prices paid fell by 24 percent.
• Prices paid for common surgeries were 107–231 percent higher than prices paid by Illinois group health insurers and 237–455 percent higher than the Medicare rates in Illinois. This raises the question about whether the reductions could have been even larger without affecting access to care by surgeons.
• Prices for common office visits (primary care) were 12–18 percent lower than group health prices and up to 15 percent lower than the Illinois Medicare rates. This raises a concern about access to primary care for injured workers.

The study also found that the 30 percent reduction in the fee schedule in Illinois resulted in a smaller decrease of 24 percent in the average price paid for professional services. Furthermore, more frequent billing of more complex office visits with higher prices in Illinois was observed after the fee schedule cut.

To purchase a copy of this study, click on the following link: http://www.wcrinet.org/studies/public/books/il_fs_reduction_book.html.

Source: WCRI