In June of this year the Workers Compensation Research Institute (WCRI) completed a 22 state study taking a closer look at the prices paid for common non hospital surgeries. The study compared the cost of these prices to those paid by various group health insurers. Not surprisingly the prices paid by workers’ compensation insurers tended to be higher than those paid by the group health insurers in nearly every one of the states involved in the study.
The states included in the study were:
- Arizona
- Arkansas
- California
- Connecticut
- Florida
- Georgia
- Illinois
- Indiana
- Iowa
- Louisiana
- Maryland
- Massachusetts
- Michigan
- New Jersey
- New York
- North Carolina
- Oklahoma
- Pennsylvania
- Tennessee
- Texas
- Virginia
- Wisconsin
The median prices paid for 4 common patient office visits and five common nonhospital related surgeries both paid out in 2009 were the focus of this study. The CPT (Current Procedural Terminology) code was used to identify the billed services and their respective costs.
In some of the cases these increased prices were up to two-four times as high. A New Benchmark for Workers’ Compensation Fee Schedules: Prices Paid by Commercial Insurers?, the WCRI study, also found that office visits paid out under workers’ compensation policies tended to fall within a thirty percent or less variance of those paid out by non-workers’ comp insurers. The WCRI study found that states that lack fee schedules or have poorly crafted ones could be the major cause of this disparity. States that lacked fee schedules or had higher ones in place tended to pay higher prices with the converse being true for those with lower fee schedules.
According to Richard Victor, the executive director of the WCRI, many states revisit the topic of new fee schedules about every five to ten years. Either they look into creating new ones altogether or revising the existing schedules in order to better regulate prices. It is the hope of the WCRI that the results of this study will help those stakeholders and policymakers to find common ground and reach a meaningful resolution.
What does this mean for you, the Workers’ Compensation insurance consumer? As more issue such as this are identified they can be dealt with as well. Reduced prices being paid out can then be passed on to you the consumer in the form of lower insurance premiums and overall costs. When it comes to the cost of doing business, any cost savings are certainly a bonus. As an insurance broker, The Hoffman Agency has the ability to take a closer look at the various Workers’ Compensation insurance providers and help to identify the one that best suits your needs. This includes the ability to identify those whose premiums fit your budget.
We also work to stay on top of Workers’ Comp and other related news so that we can offer you the best information, experience et al possible. Never settle for some straight out of the box policy that other insurers may offer you with a smile and without a bit of information. Come see us and let’s sit down and take a look at what may work best!
