This study compares hospital outpatient payments across states and monitors the impact of fee schedule reforms from 2005 to 2019. It also includes an additional benchmark comparing workers’ compensation hospital outpatient payments and Medicare rates. While the impact of COVID-19 is outside of the time frame covered in this study, it will provide a useful baseline to monitor the effects of the pandemic on hospital outpatient payments.

Payments for services provided and billed by hospitals are captured in this study. Professional services billed by nonhospital medical providers (e.g., physicians, physical therapists, and chiropractors), transactions for durable medical equipment and pharmaceuticals billed by providers other than hospitals, and payments made to ambulatory surgery centers are excluded. The study also provides an analysis of major policy changes in states with recent fee schedule reforms.

The 36 states included in this study are Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Jersey, New Mexico, New York, North Carolina, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, West Virginia, and Wisconsin.

Hospital Outpatient Payment Index: Interstate Variations and Policy Analysis, 10th Edition. Olesya Fomenko and Rebecca Yang. May 2021. WC-21-19.

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