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Study finds differences in workers' comp pricing procedures

North Carolina workers who have been hurt on the job may at times require surgery to recover from their workplace injury. A recent study that analyzed medical costs in various states between the years of 2003 and 2009 may shed light on why some states offer less expensive medical procedures than others.

According to the Workers Compensation Research Institute of Cambridge, Massachusetts, states that have implemented per-procedure fees for surgeries performed on workplace accident victims see a lower cost than those states that do not have these per-procedure schedules. The study included data from 17 states, including North Carolina, which together account for 60 percent of workers' compensation benefit claims.

The North Carolina Industrial Commission does have a medical fees schedule.

Common workplace injuries that require outpatient shoulder and knee surgeries were the focus of the study.

States that offered fee schedules based on procedures, or regulated reimbursement fees, had lower outpatient costs than those that did not.

In an interesting finding, the study compared the cost of a common procedure required for workplace injuries, an arthroscopic knee surgery, across states involved and found that the outpatient cost varied significantly. In some states, the cost was eight times higher than in others.

The rising costs of medical procedures have raised an alarm for policymakers as well and in order to bring about a reduction, more and more states have implemented a per-procedure fee system for workers' compensation claims.

The study has brought to light pricing procedures that may not have become transparent otherwise and for research purposes their findings are very interesting. Transparency in pricing has increased over the past few years in more than 40 states, which seems to be a constructive trend for consumers and the health care industry.

Source: Healthcare Finance News "Workers Comp surgery costs vary among states," Trevor Maxwell, March 5, 2012

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