Maryland Workers’ Compensation Educational

Association

Annual Conference

Maryland Workers’ Compensation Educational

Association

Annual Conference 9/22/039/22/03

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?

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 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

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

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

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

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

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?

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

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

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

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

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

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

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

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

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

WCRI CompScope™ Benchmarking Studies

WCRI CompScope™ Benchmarking Studies

www.wcrinet.orgwww.wcrinet.orgAnn Clayton

617-661-9274 ext. 224

aclayton@wcrinet.org