Overview of the 2019 NCCI Medical Data Report KRISTINE EDIGER NOVEMBER 2019
“M “Med edical Ben Benefits r resu esulting f g from a a work- re related i injury or or disease a are re t the he le leading cos cost d dri rivers f for w or wor orkers com compensation claims o ms on a countrywide ba e basi sis”( ”(NCCI) Page 2
• Med Medical al ac accounts f for 6 r 68% o % of t f total tal b ben enefit it costs ts in in Mo Monta tana • The a average c cost o of m medical pe per l lost-time e claim aim in in Mo Montan ana is is $35,000 • 59% o % of m f med edic ical is is paid aid d duri ring the the fir irst f fiv ive year ears fr from the ac the accident Page 3
Chart 4: Distribution of Medical Payments DMEPO EPOS – DME, Supplies, and Implants Page 4 Other er – includes home health, transportation, vision, and dental services
Chart 6: Distribution of Physician Payments Page 5
NCCI CCI c conducted a a re review o of p physician c cost sts in in work comp c compa pared ed to group h p healt lth • Work c comp p physician c n costs a are 7 77% high gher t r than n grou oup h heal alth th i in general al • The difference is is costs is is due ue t to b both p pri rices and and util ilizat ization ion of s servic ices • Phys ysical m l medi edicine s services es i in work c comp a are e almost t three ee t times es t the c e costs o of phys ysical m l medi edicine e services i in group h healt lth, l largely d ly due t e to t the n e number er of s servic ices p s provid ided • i.e physical therapy, occupational therapy, and chiropractic care (Lipton, B B. [Channel N NCCI]. ]. ( (2019, M May 2 23). ). Wor ork C Comp v omp vs. G Grou oup H p Health – The Pr Price ce W We Pa Pay ) Page 6
Payme ments ts f for: • anes anesthes esia in ia in Mont ntana in ana in line ine wit ith t the r e regio egion n and and count untrywid ide ( e (cw cw) • sur urger gery and and rad adio iology q quit uite a e a bit it lower er t than an the e reg egio ion and n and cw cw • almost two months until major surgery in Montana vs a little over a month • Ph Physical al and and gener general al m med edic icine and ine and eval aluat uatio ion n and and manag anagem ement ent s slig ightly high igher er t than an the e reg egio ion and n and cw cw Page 7
Chart 29: Top 10 DRG by Amount Paid for Hospital Inpatient Services Page 8
Chart 38: Top 10 Diagnosis by Amount Paid for Hospital Outpatient Services Page 9
Chart 49: Top 10 Diagnosis by Amount Paid for ASC Services Page 10
Source: 2019 NCCI Me Medical dat ata c cal all Page 11
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