Closing out MCM’s coverage of WCRI’s annual meeting, here’s a few final observations.
In general, this was one of the better WCRI meetings I’ve attended over the past fifteen years. The material was more current, the focus was on issues near and dear to my heart (lots of research on drugs, pricing, and utilization of medical services), and attendance was robust. WCRI’s also recognized the influence of press and social media, and worked diligently to accommodate both.
One of the sessions addressed the oft-asked question “Do work comp fee schedules affect the actual prices paid for medical services?”
The answer? Yes.
But not consistently.
According to data provided by WCRI, states with the highest prices for medical services are generally those that do not have few schedules. The non-FS states also exhibited higher growth in costs than those jurisdictions with fee schedules.
However, my home state of Conn. was one of the states in the ‘high price’ group but it has a fee schedule, albeit a particularly high one. Illinois was even pricier but there’s a lot more to that, namely the IL FS was a pretty loose one (and was one of the reasons reform was passed earlier this year).
Interestingly, there was a BIG variation in medical prices paid with the highest prices 2.5 times greater than the lowest. There’s been much discussion and research into this in the past, and the correlation isn’t very strong.
Note that this research addressed price – and not cost. While price is one component of cost, its influence is often overshadowed by utilization. Moreover, price is not directly linked with cost. For example let’s look once again at Connecticut. While we have high prices, we don’t have high costs. In fact, CT’s costs are consistently about average among WCRI’s study states.
Finally, I’d vote for WCRI to move their conference to the first quarter instead of the same month as National WC. The two conferences compete for a similar target market, and moving to a different date may increase attendance as heading to Las Vegas one week only to pack up and travel to Boston the next is tough. (National WC can’t move as they have a 5 year facility contract.)

Employment.
After much discussion and debate, WCRI Executive Director Rick Victor informed WCRI meeting attendees that one of the more significant issues facing work comp is the gap between jobs needed to return to pre-recession levels of employment and current employment.
Specifically, Rick noted there are now 25 million potential workers and 3.5 million current job openings. This will – and undoubtedly is – dramatically affecting claimants looking to return to work in a new position.
If those jobs aren’t there;
– disability durations will increase
– medical costs may well escalate
– overall claim costs will rise
– older workers may find it particularly hard to get hired
– states with older populations and declining industries may be particularly hard hit
Combine Rick’s elephant with rapidly rising hospital and pharmacy expenses (the ‘elephant’ CWCI research guru Alex Swedlow and I discussed at length over dinner last week) and things aren’t looking so bright.
Quite the opposite.

The fall conference schedule comes to a close with this week’s annual WCRI meeting in Boston. I’ll be posting from my iPhone as the wifi access fee is $100(!) so watch out for typos…
Peter Barth began with a history of work comp, with particular emphasis on the societal issues that helped give rise to Wisconsin’s first in the nation state comp laws. (more accurately the first WC law that survived legal challenges) Barth noted that one county in PA had more than five hundred workplace fatalities one year in the early nineteen-hundreds.
The National Commission on WC and the impact thereof was discussed in some detail. For the non-work comp folks out there, the Commission led to rather remarkable changes in many state work comp systems by shining a very bright light on the differences among and between the various states. By developing and promulgating universal objectives, the Commission helped accelerate the pace of change and modernization in those states that had long lagged more progressive jurisdictions.
This being the anniversary of the passage of Wisconsin’s comp law, there have been many reviews of the history of comp; Barth’s presentation was one of the better ones. Perhaps the most revealing takeaway was the drastic change in medical benefits from the early days.
Barth reported that several states allowed claimants a maximum of fourteen days to obtain medical care, two states had rather brief medical benefits periods (Massachusetts with 14 days) as late as1940.
Next up for public consumption is a discussion of pharmacy costs – which is a subject near and dear indeed.
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