North Carolina Workers’ Compensation Survey Reveals That the State Has Exceptionally High Payment Per Claim Costs

July 31, 2009, by Michael A. DeMayo

According to a study conducted by the non-partisan Workers’ Compensation Research Institute (WCRI), North Carolina’s workers’ compensation payment per claim costs are significantly higher than average when compared to similar costs in other states. The study, CompScope TM Medical Benchmarks, revealed that North Carolina workers’ compensation payments per claim exceeded the average of a group of 13 states by 13%. State lawmakers have already reacted to the problem by imposing fee schedule changes; these began taking effect in July 2009. Various policy groups have also proposed initiatives to reduce payouts for certain hospital costs, physical medicine, and outpatient services. The Office of State Budget and Management has calculated that the fee schedule changes for 2009 should save the state over $35 million.

What was driving the abnormally high payments per claim in the state?

The CompScope survey points to many culprits. For one, the state has a higher surgery rate than other states surveyed. In addition, both outpatient and inpatient payments per claim and payments to providers are much higher than the median for the states studied. Bear in mind that these figures don’t mean that North Carolina workers’ compensation claimants are necessarily getting more money or a better deal on their medical services. The costs have gone up for almost every party within the healthcare system across the board.

Workers` Compensation Payments Per Claim to North Carolina Hospitals Higher Than Typical of 14 States and Growing, Says WCRI Study, Reuters, Fri Jul 10, 2009

North Carolina: Study finds payments per claim growing rapidly, Risk and Insurance.com, July 30, 2009

More Web Resources

CompScope

Workers’ Compensation Research Institute