Monitoring Trends in the New York Workers’ Compensation System, 2021 Edition

By Carol A. Telles, William Monnin-Browder

October 21, 2021 Related Topics: CompScope™ Medical Benchmarks

Originally established to monitor changes in the New York workers’ compensation system following substantial legislative reforms in March of 2007, the report has evolved into a tool for tracking key metrics of system performance on an ongoing basis, as further legislative reforms and administrative changes continue to shape the system.

In recent years, New York has implemented several policy changes regarding medical treatment, including medical fee schedule changes, the implementation of a drug formulary for new prescriptions, and the Expanded Provider Law. The regular monitoring provided in this report helps focus attention on policy objectives that are being met, objectives that are not being met, and unintended consequences that have emerged.

The analysis in this edition focuses primarily on trends in indemnity benefits, medical payments, and benefit delivery expenses from 2014 to 2019 for claims at different maturities. Claims with experience through 2020 are analyzed, and in some cases, trends before 2007 are shown to establish a baseline prior to the 2007 reforms. In addition, various interstate comparisons from other WCRI studies are provided to help put the performance of the New York system into perspective, such as prices paid for medical services and the frequency and amount of opioids dispensed to workers.

Monitoring Trends in the New York Workers' Compensation System, 2021 Edition. William Monnin-Browder and Carol A. Telles. October 2021. WC-21-42.

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Research Questions:

  • How have indemnity benefits, medical payments, and benefit delivery expenses per claim changed over time in New York, and what factors may have contributed to those changes?
  • How did payments per claim for nonhospital services change following the implementation of a new fee schedule in 2019?
  • Given recent policies to address the overuse of opioids, as well as the implementation of a drug formulary for new prescriptions, what have been the recent trends in prescription payments?
  • Following increases after the 2007 reforms, how have indemnity benefits per claim changed in recent years? 
  • Have attorney involvement and defense attorney payments changed since the 2007 reforms?

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