CRAIN'S
Chicago Business, Senior Reporter, Thomas Corfman ( http://bit.ly/1MtlVdW ) recently reported that under the 2011 IL workers comp reforms, medical costs
per claim have now dropped by 15%. Citing a report from the Workers Compensation
Research Institute ( http://bit.ly/1Q7kgve ), CRAIN"S Chicago Business reported that Illinois Workers Comp medical payments fell by over
15%, down to an average of $14,513 per claim, during the 12-month period
ending Sept. 30, 2013, which was over15% down from $17,140 per claim incurred in 2010-11.
I expect that when the final numbers roll in from 2014 and 2015 we should see some substantial medical savings documented for Illinois employers from the major workers comp reforms put in place in 2011.
According to the WCRI report, Illinois' medical payments per claim are down lower than Indiana ($18,863), Wisconsin ($17,787) and Iowa ($16,051) for the same review period. JUST AMAZING.
This is great news for all Illinois employers who have been waiting patiently (or not so patiently) for lower workers comp premiums based upon the lowered Illinois medical fee schedule rates and UR reforms.
Some of the medical savings incurred are likely due and directly attributable to the 30% slashing of the IL Workers Comp Medical Fee Schedule reimbursement rates from 2011 and some of the savings are likely attributable to new utilization review enforcement which challenges what medical care is actually being approved by Illinois workers comp insurance carriers as being both "reasonable and necessary".
Widespread utilization review is now often leading to great difficulty for injured Illinois workers seeking recommended medical treatment. Out-of-state UR doctors in a "medical records review only" are often utilized to deny medical treatment recommended by Illinois physicians including lumbar fusions, length of PT, objective testing or common surgical procedures.
Perhaps this review process needs to be brought back into our state to compare apples to apples on what is considered both reasonable or necessary.
Injured Illinois employees are typically forced to seek out representation by an experienced Chicago workers compensation attorney for medical treatment which has been recommended but denied and for pursuing UR appeals. Trial may often prove necessary to contest the initial UR denial of medical care but, for better or worse, the overall reform package of 2011 is working to cut medical costs for Illinois employers.
