Paduda: WCRI's New Studies

Thursday, June 5, 2025 | 0

The Workers Compensation Research Institute is on the ball.

Joe Paduda

A webinar on heat-related illnesses in the workplace is scheduled for June 26; register here. Space is limited, so don’t get left out in the blazing sun.

Topics covered will include:

• What is the effect of excessive heat on heat-related illnesses versus broader heat-related accidents?
• What role does geographic region play in the frequency of HRI claims?
• Are certain age groups, genders or industries more at risk?
• How does job tenure, particularly two or fewer months on the job, influence the likelihood of HRIs?

This is especially timely, as the new head of the Federal Emergency Management Agency, who has no disaster response experience, is wholly unprepared for the job.

Hospital fee schedules and your medical spend

WCRI released its report on hospital fee schedules, outpatient surgical costs and changes thereto from 2011 to 2023 last week. Takeaways:

• As always, results varied a lot among states. The average payment for outpatient hospital surgical episodes in Alabama, the costliest state, was more than eight times the payments in Nevada.
• Nevada’s costs were 40% below Medicare.
• Alabama’s were almost five times above Medicare.
• States without fee schedules — Arizona, Missouri, New Jersey and Wisconsin — had higher payments than states with fee schedules.
• But fee schedules are no panacea. Florida, Louisiana and Alabama all have “fee schedules,” but all seem to have been constructed to hoover the most money out of employers’ and taxpayers’ wallets.

Payments for outpatient surgery in Pennsylvania jumped 130% from 2011 to 2023 and dropped 23% in Indiana.

What does this mean for you?

With pending big cuts to Medicaid, expect costs to zoom in states that are already costly.

Joseph Paduda is the principal of Health Strategy Associates, a consulting firm focused on improving medical management programs in workers’ compensation. This column is republished with his permission from his Managed Care Matters blog.