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

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

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

WCRI CompScope™ and Anatomy Benchmarking Measures Benefit amounts Benefit amounts Timeliness Timeliness Medical costs Medical costs Disability duration Disability duration Defense attorney involvement Defense attorney involvement Vocational rehab use Vocational rehab use Benefit delivery expenses Benefit delivery expenses Medical costs by service/provider type Medical costs by service/provider type Medical prices Medical prices Utilization of services Utilization of services Utilization by provider 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? Non-partisan, not-for-profit resource for public officials and stakeholders Non-partisan, not-for-profit resource for public officials and stakeholders Diverse membership and funding Diverse membership and funding Published over 100 studies Published over 100 studies Studies regularly used in public policy debates Studies regularly used in public policy debates

WCRI – What Do We Study? Public policy research on workers’ Public policy research on workers’ compensation issues: 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 CTMAWIGATNTX Ind Med Exp

Indemnity Costs and Duration Texas and Wisconsin at 36 months TXWI % of LT Claims/All 25%19% Compensation Rate – TD Max $491/$508$509 Duration of TD Disability 3.9 wks 1.6 wks % PPD Claims/Ind 52%29% Average PPD paid/PPD claim $6516$7752

Average Cost per Claim > 7 Days Lost Time CTMAWIGATNTX Ind Med Exp

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 Services # of VisitsServices per Visit Provider / Service Mix (% claims; % payments)

Providers Treat More in Texas Costs per Service Higher in Wisconsin WITX % Diff Avg. # of services % 60% Avg. # visits per claim % Avg. # services per visit % Avg. payment per service $127$74 -41% -41% All providers on claims with > 7 days lost time for 1998/1999 claims

Average Cost per Claim > 7 Days Lost Time CTMAWIGATNTX Ind Med Exp

Georgia Has More Litigation and More Medical Cost Containment Expenses WIGA % Claims with Def. Atty 8%28% Ave. Defense Atty Payment $1951 $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 CompScope™ Multistate Comparisons Makes comparisons meaningful 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 Provides publicly available documentation and statistics Provides publicly available documentation and statistics Uses an advisory committee to focus measures and discuss results Uses an advisory committee to focus measures and discuss results

WCRI CompScope™ Benchmarking Studies Ann Clayton ext. 224