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Maryland Workers’ Compensation Educational
Association
Annual Conference
Maryland Workers’ Compensation Educational
Association
Annual Conference 9/22/039/22/03
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Today’s Presentation:
What wc system outcomes can we What wc system outcomes can we monitor?monitor?
What are we learning and how can it What are we learning and how can it help improve wc systems? help improve wc systems?
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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
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WCRI CompScope™ and Anatomy Benchmarking Measures
Benefit amountsBenefit amountsTimelinessTimelinessMedical costsMedical costsDisability durationDisability durationDefense attorney Defense attorney
involvementinvolvementVocational rehab Vocational rehab
useuseBenefit delivery Benefit delivery
expensesexpenses
Medical costs by Medical costs by service/provider service/provider typetype
Medical pricesMedical pricesUtilization of Utilization of
servicesservicesUtilization by Utilization by
providerprovider
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Average Benefit Costs per Claim in TX Is Twice That of IN and WI
$0
$1,000
$2,000
$3,000
$4,000
$5,000
IN WI GA NC CT PA MA TN FL IL CA TXAverage Cost per All Paid Claims, 1999/ 2000 Claims
Adjusted for Injury, Industry Mix and Wages
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What % of Claims Have More Than 7 Days Lost Time?
0%
5%
10%
15%
20%
25%
30%
IN GA TN NC PA WI FL IL CA CT TX MA
Claims > 7 Days Lost Time as Percentage of All Paid Claims, 1999/ 2000
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Average Ind/Med/Exp Costs per Claim > 7 Days Lost Time
$0
$5,000
$10,000
$15,000
$20,000
CT WI IL IN PA MA NC CA FL GA TN TX
EXPMEDIND
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What is WCRI?
Non-partisan, not-for-profit resource Non-partisan, not-for-profit resource for public officials and stakeholdersfor public officials and stakeholders
Diverse membership and fundingDiverse membership and fundingPublished over 100 studiesPublished over 100 studiesStudies regularly used in public Studies regularly used in public
policy debatespolicy debates
www.wcrinet.orgwww.wcrinet.org
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WCRI – What Do We Study?
Public policy research on workers’ Public policy research on workers’ compensation issues:compensation issues:How are workers' compensation systems How are workers' compensation systems
performing? performing? How do various systems compare? How do various systems compare? How can systems better meet workers' How can systems better meet workers'
needs? needs? What factors are driving costs? What factors are driving costs? What is the impact of legislative changes on What is the impact of legislative changes on
system outcomes? system outcomes?
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Average Cost per Claim > 7 Days Lost Time
CTCT MAMA WIWI GAGA TNTN TXTX
IndInd 34134122
45845833
29029055
54315431 61776177 64946494
MeMedd
40840844
27627622
53253288
61476147 72187218 80488048
ExpExp 816816 13613666
689689 15491549 13231323 12981298
83183122
87187111
89289222
1312131277
1471147188
1584015840
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Indemnity Costs and DurationTexas and Wisconsin at 36 months
TXTX WIWI
% of LT Claims/All% of LT Claims/All 25%25% 19%19%
Compensation Rate – TD Compensation Rate – TD MaxMax
$491/$50$491/$5088
$509$509
Duration of TD DisabilityDuration of TD Disability 3.9 wks3.9 wks 1.6 wks1.6 wks
% PPD Claims/Ind% PPD Claims/Ind 52%52% 29%29%
Average PPD paid/PPD Average PPD paid/PPD claimclaim
$6516$6516 $7752$7752
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Average Cost per Claim > 7 Days Lost Time
CTCT MAMA WIWI GAGA TNTN TXTX
IndInd 34134122
45845833
29029055
54315431 61776177 64946494
MeMedd
40840844
27627622
53253288
61476147 72187218 80488048
ExpExp 816816 13613666
689689 15491549 13231323 12981298
83183122
87187111
89289222
1312131277
1471147188
1584015840
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Average Medical Cost/Claim Varies Widely
$0
$2,000
$4,000
$6,000
$8,000
$10,000
MA CT PA WI CA FL GA IN IL TN TXClaims With >7 Days Lost Time
Injury/Industry Mix Adjusted 1997/2000
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Drill Down On Costs – Anatomy Study
Average Cost / Claim
Average Cost by Provider / ServiceProvider / Service Mix
(% claims; % payments)
Price per Service # of Services
# of Visits Services per Visit
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Providers Treat More in TexasCosts per Service Higher in Wisconsin
WIWI TXTX % Diff% Diff
Avg. # of servicesAvg. # of services 40.340.3 101.5101.5 60%60%
Avg. # visits per claimAvg. # visits per claim 14.714.7 28.428.4 48%48%
Avg. # services per Avg. # services per visitvisit
2.72.7 3.63.6 25%25%
Avg. payment per Avg. payment per serviceservice
$127$127 $74$74 -41%-41%
All providers on claims with > 7 days lost time for All providers on claims with > 7 days lost time for 1998/1999 claims1998/1999 claims
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Average Cost per Claim > 7 Days Lost Time
CTCT MAMA WIWI GAGA TNTN TXTX
IndInd 34134122
45845833
29029055
54315431 61776177 64946494
MeMedd
40840844
27627622
53253288
61476147 72187218 80488048
ExpExp 816816 13613666
689689 15491549 13231323 12981298
83183122
87187111
89289222
1312131277
1471147188
1584015840
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Georgia Has More Litigation and More Medical Cost Containment Expenses
WIWI GAGA
% Claims with Def. Atty% Claims with Def. Atty 8%8% 28%28%
Ave. Defense Atty Ave. Defense Atty PaymentPayment
$1951$1951 $2675$2675
% Claims with Med/Leg% Claims with Med/Leg 12%12% 4%4%
Ave. Med/Leg PaymentAve. Med/Leg Payment $1083$1083 $598$598
Ave. Med. Cost Cont. Exp.Ave. Med. Cost Cont. Exp. $640$640 $1147$1147
Claims > 7 Days Lost Time, 1997/2000
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Value of CompScope™ Multistate ComparisonsMakes comparisons meaningfulMakes comparisons meaningful
Large database – nearly 15 million Large database – nearly 15 million claimsclaims
Subset claims for waiting periodSubset claims for waiting periodAdjusts for differences in wages, Adjusts for differences in wages,
industry and injury mix per stateindustry and injury mix per stateRepresentative of all claimsRepresentative of all claims
Provides publicly available Provides publicly available documentation and statistics documentation and statistics
Uses an advisory committee to focus Uses an advisory committee to focus measures and discuss resultsmeasures and discuss results
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WCRI CompScope™ Benchmarking Studies
WCRI CompScope™ Benchmarking Studies
www.wcrinet.orgwww.wcrinet.orgAnn Clayton
617-661-9274 ext. 224