The continual increase in health care costs is front of mind for many Wisconsin families. It is an issue that will likely be at the forefront of state and national elections in the coming years. It is also not a matter that is likely to subside from our focus for the time being.
These rising costs don’t only crimp your budget – they are also posing problems for workers’ compensation systems across the country. A recent national study sought to evaluate how different states are trying to keep costs down by assessing 18 different states’ workers’ compensation systems, including Wisconsin’s.
Different states take different approaches when controlling costs
Health care costs vary significantly from state to state and from urban to rural areas. It makes sense, then, that the landscape for the different workers’ compensation systems would see some differences when it comes to planning for health care expenses.
Some states, such as Illinois, lowered the cap on medical fees, thereby reducing the maximum amount covered by workers’ compensation. During their last round of reforms in 2011, Illinois reduced the cap on medical expenses by 30% to bring their costs more in line with national averages.
Other states have specific caps on the number of visits that an injured worker can see a doctor. In other words, if you’ve used up your visits but still need care, you may need to pay for the remaining visits out of your own pocket.
Additional reforms that are designed to save money include anti-fraud legislation and adjusting the medical fee schedules. Fee schedules outline how much a state’s workers’ compensation system will reimburse a health care provider for a specific service.
What could this mean for your benefits?
As states, especially Wisconsin, look to rein in costs, the worry is that benefits could be reduced going forward. In the last year of the study, medical payments increased in the state. The growth was mostly the result of higher costs of nonhospital care, as well as higher inpatient and outpatient costs.
As of now, there are no immediate plans in the legislature to reform workers’ compensation in Wisconsin that may put injured workers at risk of lower benefits. However, the state has been working to implement a fee schedule that could rein in costs.
The reform received supported by Wisconsin’s labor-management advisory council. Because the membership of the council is so broad, spanning from business organizations to labor unions, it seems likely that this reform would not have any negative impact on workers.
What it would do is better preserve the current system and make it more financially sustainable in the likely scenario where medical expenses continue to increase in the years to come.