Waltham, MA, October 10, 2024 ― A new set of studies from the Workers Compensation Research Institute (WCRI) found that utilization of medical services by workers with injuries declined in the majority of the 17 study states. The studies address two aspects of utilization: the percentage of claims receiving a particular medical service, and the number of services provided.

“We continue to see the effects of the pandemic on 2022 claims with experience through March 2023,” said Sebastian Negrusa, vice president of research for WCRI. “Besides strained hospital capacity and avoided medical care by many people out of fear of COVID-19 in the early months of the pandemic, waves of increased COVID-19 cases and medical provider shortages may have also affected the delivery of medical care. Even in the few cases where utilization in certain states has begun to rebound, we do not see it reaching pre-pandemic levels yet.”

The studies, CompScope™ Medical Benchmarks, 25th Edition, examined medical payments, prices, and utilization overall and by provider and type of service across 17 states and how these metrics of medical payments have changed over time. The following are sample findings for some of the study states:

• California: Utilization of medical services decreased in 2022, particularly in the percentage of claims with inpatient care and facility services (both hospital outpatient departments and ambulatory surgery centers).
• Indiana: Utilization declined in 2022, particularly for major surgery and facility services.
• Minnesota: Unlike most study states, utilization of most services in Minnesota either stayed stable or began to increase in 2022.
• North Carolina: Decreasing utilization was a driver of the state’s decline in medical payments per claim in 2022, in contrast to many study states which experienced growth.
• Pennsylvania: The share of claims with facility services in the state declined more than most study states since 2019.

The analysis results reflect experience on claims through March 2023, including non-COVID-19 claims from the pandemic period (March 2020–September 2022). The studies, therefore, provide a look at how the pandemic impacted non-COVID-19 workers’ compensation claims. The 17 study states ― Arkansas, California, Florida, Illinois, Indiana, Iowa, Louisiana, Massachusetts, Michigan, Minnesota, New Jersey, North Carolina, Pennsylvania, Tennessee, Texas, Virginia, and Wisconsin ― represent about 60 percent of all workers’ compensation benefit payments nationwide. Individual reports are available for every state except Arkansas, Iowa, and Tennessee. 

Click here for more information on these studies.

About WCRI

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