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Medical Payments per Workers’ Compensation Claim Grew About 3 Percent Each Year in Illinois

Recent public policy discussions in Illinois have focused on reducing workers’ compensation costs and making the state more attractive to businesses. Among the areas of interest are causation of the injury, medical fee schedules, insurance premiums, and permanent partial disability benefits.

Medical payments per workers’ compensation claim in Illinois grew 3.1 percent per year on average from 2012 through 2015, according to a recent study by the Workers Compensation Research Institute (WCRI).

In all, medical payments per workers’ compensation claim were higher in Illinois than the median for the states included in the study.

The study, CompScope™ Medical Benchmarks for Illinois, 18th Edition, examined medical payments, prices, and utilization in Illinois compared with 17 other states.

“Recent public policy discussions in Illinois have focused on reducing workers’ compensation costs and making the state more attractive to businesses,” said Ramona Tanabe, WCRI’s executive vice president and counsel. “Among the areas of interest are causation of the injury, medical fee schedules, insurance premiums, and permanent partial disability benefits.”

The following are among the study’s other findings:

  • Physical medicine was a key driver of higher-than-typical medical utilization, accounting for more visits per claim and services per visit in Illinois than in other states studied.
  • Payments per claim for surgery (professional services) and facility payments to ambulatory surgery centers were higher in Illinois than in other study states.
  • Prices paid for professional (nonhospital) services were lower than typical for evaluation and management (office visits), but higher for other services. These results were…

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