Fixed amount fee schedules keep hospital costs down: WCRI study

Outpatient procedures tended to cost less in states that follow a fixed amount fee schedule for hospital reimbursements, says workers’ compensation report

Workers Comp

By Allie Sanchez

Fixed amount fee schedules tend to keep hospital costs down for outpatient hospital services, a new study found.

The Workers Compensation Research Institute (WCRI) recently released a new study, Hospital Outpatient Payment Index: Interstate Variations and Policy Analysis, 5th Edition, which compares hospital outpatient payments across states and monitors the impact of fee schedule reforms.

“This report found that hospital outpatient payments per surgical episode varied significantly across states, ranging from 69 percent below the study-state median in New York to 142 percent above the study-state median in Alabama in 2014,” Dr. Olesya Fomenko, co-author of the study and economist at WCR, observed.
 
According to the study, fixed amount fees tend to anchor down procedure costs. It found that states with no workers’ compensation fee schedules for hospital outpatient reimbursement shelled out more for payments per episode compared with states that had fixed amount fee schedules.  Pay outs in the former states ranged from 63% to 150% higher than the median of the study states with fixed amount fee schedules.
 
WCRI examined the workers’ compensation structure of 33 states which represent 87% of the benefits paid in the United States in the study.
 

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