Overview of the 2019 NCCI Medical Data Report KRISTINE EDIGER - - PowerPoint PPT Presentation

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

• r disease a

are re t the he le leading cos cost d dri rivers f for w

• r wor
• rkers com

compensation claims o ms on a countrywide ba e basi sis”( ”(NCCI)

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• 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

• f 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

Chart 4: Distribution of Medical Payments

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DMEPO EPOS – DME, Supplies, and Implants Other er – includes home health, transportation, vision, and dental services

Chart 6: Distribution of Physician Payments

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NCCI CCI c conducted a a re review o

• f 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

• up 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

• f 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

• f 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

• rk C

Comp v

• mp vs. G

Grou

• up H

p Health – The Pr Price ce W We Pa Pay)

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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

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Chart 29: Top 10 DRG by Amount Paid for Hospital Inpatient Services

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Chart 38: Top 10 Diagnosis by Amount Paid for Hospital Outpatient Services

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Chart 49: Top 10 Diagnosis by Amount Paid for ASC Services

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Source: 2019 NCCI Me Medical dat ata c cal all

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