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Wednesday, November 18, 2015

NJ Medical Payments Stabilize - But Why?

A recent study by an insurance based data organization has reported that NJ is experiencing a leveling of medical costs. The real question is "why?" Are declining medical benefits caused by fewer claims based on a shift of challenging employment status in the shared economy or a shift of medical costs under Obamacare to the private sector? 
Medical payments per workers’ compensation claim in New Jersey were stable from 2010 to 2013, in contrast to rapid growth in the 2008 to 2010 period, according to a recent study by the Workers Compensation Research Institute (WCRI).
The report, CompScope™ Medical Benchmarks for New Jersey, 16th Edition, indicates results for New Jersey differed from those of other states WCRI studied, many of which experienced moderate to rapid growth in medical payments per claim.
The study found the following to be contributing factors: 
  • Increased use of networks, which may be linked to a decrease in prices paid for non hospital care. In recent years, two-thirds of total medical payments came from non hospital services.
  • Flat or decreasing trends in utilization of many non hospital services.
  • Slower growth in hospital outpatient payments per service.
  • A continued decrease in the percentage of claims that had hospital inpatient care.
“From 2010 to 2013, medical payments per claim with more than seven days of lost time rose less than 2 percent per year in New Jersey,” said Ramona Tanabe, executive vice president and counsel for WCRI. “From 2008 to 2010, payments rose nearly 10 percent per year.”
WCRI studied medical payments, prices, and utilization in 17 states, including New Jersey, looking at claim experience through 2014 on injuries that occurred in 2013 or earlier. WCRI’s CompScope™ Medical Benchmark studies compare metrics of medical costs and care from state to state and across time.