Cambridge, MA, December 7, 2023 – A recently released study from the Workers Compensation Research Institute (WCRI) found that medical payments per claim in Wisconsin remained stable between 2019 and 2021 after prior years saw moderate growth. Wisconsin, however, sees some of the highest prices and payments per claim out of any of the study states.

“Both higher prices for professional services and higher payments to hospitals for common outpatient surgical episodes were drivers of higher than typical medical payments per claim in Wisconsin,” said Ramona Tanabe, president and CEO of WCRI.

The study, CompScope™ Medical Benchmarks for Wisconsin, 24th Edition, focuses on the payments, prices, and utilization of workers’ compensation medical care. It examines medical services in Wisconsin compared with 16 other states overall, by type of provider, and by type of medical service. The study also analyzes how various system performance metrics have changed over time from 2016 to 2021, with claims evaluated as of 2022. In some cases, we use a longer time frame to supply historical context.

The following are examples of other findings from the study:

• Nonhospital utilization per claim was lower in Wisconsin than most states.
• The percentage of claims with many nonhospital or hospital outpatient services decreased mostly due to the pandemic.

The results reflect experience on claims through March 2022, including non-COVID-19 claims from the first and second years of the pandemic period (March 2020–September 2021). The study, therefore, provides a look at how the pandemic impacted non-COVID-19 workers’ compensation claims in the first two years of the pandemic. For more information about this report or to download a copy, visit https://www.wcrinet.org/reports/compscope-medical-benchmarks-for-wisconsin-24th-edition. The report was authored by Evelina Radeva.

ABOUT WCRI

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Cambridge, 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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