Waltham, MA, Nov. 7, 2024 – A recent study from the Workers Compensation Research Institute (WCRI) found that medical payments per claim for the treatment of injured workers under workers’ compensation in North Carolina decreased in 2022. In contrast, medical payments grew in many study states in that year.

“North Carolina has lower payments for hospital and nonhospital services than the typical study state, and payments have been largely stable since 2017,” said Sebastian Negrusa, WCRI’s vice president of research. “However, those findings mask offsetting trends, including a 4 percent decrease in payments from 2021 to 2022.”

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

• Utilization of nonhospital and hospital services declined from 2021 to 2022 in North Carolina, contributing to the decrease in medical payments per claim.
• North Carolina saw a 5 percent decrease in the use of networks from 2017 to 2022, as measured by the share of claims with payments for care in networks; however, changes varied within the period and by provider.
• Payments per inpatient episode in North Carolina were found to be 21 percent lower than in the typical study state.

This report analyzes claims data through March 2023, providing insights into the pandemic's impact on non-COVID-19 workers’ compensation claims over its first three years. The interstate comparison data cover states that account for 60 percent of all workers’ compensation benefits paid nationwide.

Click here for more information or to download a copy of the report. The report was authored by Carol Telles.

ABOUT WCRI

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