Texas Increase in Workers’ Comp Claims Cost Due to Rise in Med Prices

March 25, 2014

Payments per claim for the medical care of injured workers in Texas grew nearly 8 percent in 2011, largely the effect of price increases from earlier reforms, according to a 16-state study by the Workers Compensation Research Institute (WCRI).

The WCRI study, CompScope Medical Benchmarks for Texas 14th Edition, said the growth in medical payments per workers’ compensation claim in Texas was faster than in prior years and more rapid than in most other states in the study.

The study continues to monitor the impact of the series of reforms on medical costs, particularly House Bill (HB) 7, enacted in 2005, on prices and utilization of medical care for injured workers.

“Prior to the reforms in 2001 and 2005, Texas medical payments per claim were the highest of the study states. In recent years, however, they were lower than the typical state in the study,” said Ramona Tanabe, WCRI’s deputy director and counsel.

The study found fee schedule increases following Medicare updates as required under HB 7, and the 2011 ban on informal networks drove an increase in prices for medical services, fueling the recent growth in medical payments. A decrease in utilization of nonhospital care slightly offset the increases in prices.

Medical payments per claim were lower than the typical study state following the series of reforms, according to the study. That finding resulted from lower-than-typical prices paid for some medical care and large decreases in utilization of medical care.

To purchase a copy of this study, paste this link in your browser: http://www.wcrinet.org/result/csmed14_TX_result.html.

Source: WCRI

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