A recently released report comparing prices paid for medical professional services across 36 states from 2008 to 2023 found that states with no fee schedules for professional services had higher prices paid compared with states with fee schedules—36 to 169 percent higher than the median of the study states with fee schedules in 2023.
The report, released by the Workers Compensation Research Institute (WCRI), found that prices paid for professional services varied significantly across states, ranging from 33 percent below the 36-state median in Florida to 162 percent above the 36-state median in Wisconsin in 2023.
“Unlike other indices measuring how prices for professional services change, this index is a more relevant benchmark of medical inflation in workers’ compensation as it focuses on those services commonly provided to workers with injuries,” said Ramona Tanabe, WCRI’s president and CEO. “Since workers’ compensation price regulations are set at the state level, this study provides a state-level price index to help policymakers and stakeholders conduct meaningful comparisons of prices paid across states and to monitor price trends in relation to changes in fee schedules.”
The study, “WCRI Medical Price Index for Workers’ Compensation, 16th Edition (MPI-WC),” focuses on professional services (evaluation and management, physical medicine, surgery, major and minor radiology, neurological testing, pain management injections, and emergency care) billed by physicians, physical therapists and chiropractors.
Most states with no fee schedules experienced faster growth in prices paid for professional services compared with states with fee schedules—the median growth rate of states with and without fee schedules was 13 percent and 36 percent, respectively, from 2008 to 2023.
The findings are in line with information provided by the National Council on Compensation Insurance during its State of the Line report. Currently, 23 states have fee schedules in place which have been found to be a key cost containment measure.
The study also provides details on price changes, overall and by service type, following major fee schedule changes.
This edition covers 36 states that represent 88 percent of the workers compensation benefits paid in the United States.
The states are Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia and Wisconsin.
The authors of this study are Dr. Rebecca Yang and Dr. Olesya Fomenko.