Cost of Medical Claims Paid by Workers Comp Drops

Cost of Medical Claims Paid by Workers Comp Drops


What impact did the reduction in the medical fee schedule for workers’ compensation in Illinois have on actual prices paid?

The new fee schedule, with rates reduced 30 percent from the previous schedule, was imposed by law in 2011. A study published today (Monday) says the 30 percent reduction resulted in a 24 percent reduction in prices.

“We observed the price decrease actually being smaller than the 30 percent reduction in the fee schedule, and the main reason was changes in network penetration and changes in the negotiated prices,” said Rebecca Yang, co-author of the study for the Workers Compensation Research Institute in Massachusetts.

The results were uneven, though: Regular office visits are compensated at lower rates than group health and Medicare rates, which might hinder access to care, and surgery is paid at higher rates, raising the question of whether fees could have been cut further.

Prior to the reduction, the Illinois fee schedule was one of the highest in the nation.

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