This study can help policymakers and other stakeholders identify current cost drivers and emerging trends in payments, prices, and utilization of medical services provided for treating workers with injuries in the Minnesota workers’ compensation system. It examines medical payments, prices, and utilization for various types of services by nonhospital and hospital providers in Minnesota and compares them with 17 other states. The study also examines how these metrics of medical payments and care have changed, mainly from 2013 to 2018. Claims with experience through 2019 for injuries up to and including 2018 were analyzed. In some cases, a longer period was used to supply historical context for key metrics.  

Minnesota implemented multiple policy changes in recent years. Effective January 1, 2016, Minnesota adopted a Medicare diagnosis-related group (DRG)-based fee schedule for hospital inpatient care. This study discusses the impact of this policy change using data with up to 39 months of experience under the new fee schedule. Effective October 1, 2018, Minnesota adopted Medicare ambulatory payment classification (APC)-based fee schedules for hospital outpatient and ambulatory surgery center services, as provided in House File 3873. This study includes up to six months of data following the adoption of these new fee schedules; therefore, the results primarily reflect experience prior to these policy changes. Future editions will monitor the impact of these 2018 fee schedule changes.

CompScope™ Medical Benchmarks for Minnesota, 21st Edition. Rui Yang. October 2020. WC-20-35.

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