Massachusetts' workers comp problems
The state with one of the lowest fee schedules has been experiencing rapidly rising medical costs. The result of this trend has been that Massachusetts, long known for its draconian fee schedule, has seen total claims costs increase 10% from 2000-2002, after a period when costs were only going up 5.5% per year on average. The data come from the Workers' Comp Research Institute, one of the preeminent analytical bodies in the WC world.
According to "Insurance Journal",
"The major cost drivers of growth in the most recent year were continuing double-digit growth in medical costs per claim and very rapid growth in benefit delivery expenses per claim…The very rapid growth in benefit delivery expenses per claim - costs associated with managing claims - was driven by a rapid rise in medical cost containment expenses per claim and increases in litigation expenses per claim in the latest year."
This is yet another example of the fallacy of price controls. Low fee schedules encourage over-utilization, which encourages longer disability duration, which drives up total claims costs. Moreover, this higher utilization forces payers to use cost containment programs such as UR, peer review, and clinical guidelines (where possible) in an attempt to control the volume of treatments.
Perhaps an even more important question is:
Has the fee schedule and attendant over-management of physician decision making caused "good" doctors to abandon the WC system in Massachusetts, thereby depriving employers and injured workers of the best possible treatment?
What does this mean for you?
Why not find the right providers in Massachusetts and pay them above the fee schedule?