Maryland Workers Compensation Educational Association Annual Conference 92203

Maryland Workers’ Compensation Educational Association Annual Conference 9/22/03

Today’s Presentation: n. What wc system outcomes can we monitor? n. What are we learning and how can it help improve wc systems?

WCRI Benchmarking Series Comp. Scope™ Multistate Benchmark Comparison Studies Anatomy of Workers’ Compensation Costs and Utilization Studies Injured Workers’ Survey Studies

WCRI Comp. Scope™ and Anatomy Benchmarking Measures n. Benefit amounts n. Timeliness n. Medical costs n. Disability duration n. Defense attorney involvement n. Vocational rehab use n. Benefit delivery expenses n. Medical costs by service/provider type n. Medical prices n. Utilization of services n. Utilization by provider

Average Benefit Costs per Claim in TX Is Twice That of IN and WI

What % of Claims Have More Than 7 Days Lost Time?

Average Ind/Med/Exp Costs per Claim > 7 Days Lost Time

What is WCRI? n. Non-partisan, not-for-profit resource for public officials and stakeholders n. Diverse membership and funding n. Published over 100 studies n. Studies regularly used in public policy debates www. wcrinet. org

WCRI – What Do We Study? n. Public policy research on workers’ compensation issues: § How are workers' compensation systems performing? § How do various systems compare? § How can systems better meet workers' needs? § What factors are driving costs? § What is the impact of legislative changes on system outcomes?

Average Cost per Claim > 7 Days Lost Time CT TN TX 3412 4583 2905 5431 6177 6494 Med 4084 2762 5328 6147 7218 8048 Exp 816 1323 1298 Ind MA WI 1366 689 GA 1549 8312 8711 8922 13127 14718 15840

Indemnity Costs and Duration Texas and Wisconsin at 36 months % of LT Claims/All TX WI 25% 19% Compensation Rate – TD Max $491/$508 Duration of TD Disability % PPD Claims/Ind Average PPD paid/PPD claim $509 3. 9 wks 1. 6 wks 52% 29% $6516 $7752

Average Cost per Claim > 7 Days Lost Time CT TN TX 3412 4583 2905 5431 6177 6494 Med 4084 2762 5328 6147 7218 8048 Exp 816 1323 1298 Ind MA WI 1366 689 GA 1549 8312 8711 8922 13127 14718 15840

Average Medical Cost/Claim Varies Widely Claims With >7 Days Lost Time Injury/Industry Mix Adjusted 1997/2000

Drill Down On Costs – Anatomy Study Average Cost / Claim Average Cost by Provider / Service Price per Service # of Visits # of Services per Visit Provider / Service Mix (% claims; % payments)

Providers Treat More in Texas Costs per Service Higher in Wisconsin WI TX % Diff Avg. # of services 40. 3 101. 5 60% Avg. # visits per claim 14. 7 28. 4 48% Avg. # services per visit 2. 7 3. 6 25% $127 $74 -41% Avg. payment per service All providers on claims with > 7 days lost time for 1998/1999 claims

Average Cost per Claim > 7 Days Lost Time CT TN TX 3412 4583 2905 5431 6177 6494 Med 4084 2762 5328 6147 7218 8048 Exp 816 1323 1298 Ind MA WI 1366 689 GA 1549 8312 8711 8922 13127 14718 15840

Georgia Has More Litigation and More Medical Cost Containment Expenses % Claims with Def. Atty Ave. Defense Atty Payment WI GA 8% 28% $1951 $2675 % Claims with Med/Leg 12% 4% Ave. Med/Leg Payment $1083 $598 Ave. Med. Cost Cont. Exp. $640 $1147 Claims > 7 Days Lost Time, 1997/2000

Value of Comp. Scope™ Multistate Comparisons n. Makes comparisons meaningful § Large database – nearly 15 million claims § Subset claims for waiting period § Adjusts for differences in wages, industry and injury mix per state § Representative of all claims n. Provides publicly available documentation and statistics n. Uses an advisory committee to focus measures and discuss results

WCRI Comp. Scope™ Benchmarking Studies www. wcrinet. org Ann Clayton 617 -661 -9274 ext. 224 aclayton@wcrinet. org