Waltham, MA, October 24, 2024 – A recent study from the Workers Compensation Research Institute (WCRI) found that medical payments per claim for the treatment of workers injured in Indiana were higher than typical for all claims with experience through March 2023. This was driven mostly by high prices paid for professional (nonhospital) services and ambulatory surgery centers (ASCs).

“Indiana has no fee schedule for professional services like it does for hospitals, which means the state does not regulate prices for professional services or ASCs,” said Sebastian Negrusa, WCRI’s vice president of research. “The state did recently implement a fee schedule for ASCs, effective January 2023. Time will tell what effect that will have.”

The study, CompScope™ Medical Benchmarks for Indiana, 25th Edition, is meant to examine medical payments, prices, and utilization in Indiana compared with 16 other states. The report also examines how these metrics have changed over time. Some sample findings include the following:

• Prices paid for professional services remained stable in contrast to most other non-fee schedule study states and were largely in the middle of that group (Indiana, Iowa, New Hampshire, New Jersey, Missouri, and Wisconsin).
• While the share of physician payments in networks decreased in most study states, there was little change in Indiana.
• From 2005 to 2022, Indiana had a long-term decrease in the share of hospital outpatient claims. This was a 4 percent decrease in utilization from 2005 to 2019, and a 6 percent decrease from 2019 to 2023. During this time, however, payments per claim for those services increased.

The study is based on claims data from 2017 through 2022, with claims experience through March 2023. It therefore provides insights into how the pandemic impacted non-COVID-19 workers’ compensation claims during the first three years (March 2020–September 2022). The report, authored by Evelina Radeva, can be downloaded from WCRI’s website at www.wcrinet.org.

ABOUT WCRI

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Waltham, MA. Organized in late 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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