Study: Medical Payments to Treat Injured Workers in Texas Stable Over Five-Year Period

November 17, 2023

Medical payments to treat injured workers in Texas were stable from 2016 to 2021, according to a new study from the Workers’ Compensation Research Institute (WCRI).

The study, CompScope Medical Benchmarks for Texas, 24th Edition, found that stability in medical payments masked offsetting changes, “including a decline in utilization of medical care coupled with increases in outpatient and inpatient hospital payments,” said Ramona Tanabe, president and CEO of WCRI.

A decline in payments per claim mainly occurred between 2019 and 2021, which WCRI said was largely affected by the Covid-19 pandemic.

Other findings from the study include:

  • Utilization of nonhospital services decreased by 11 percent from 2020 to 2021, mainly because of fewer visits per claim.
  • Hospital outpatient payments per workers’ compensation claim increased from 2019 to 2021 mostly due to growth in payments per service.
  • Payments per workers’ compensation claim were lower in Texas than typical for both nonhospital and hospital care.

The study examined medical services in Texas compared with 16 other states overall, by type of provider, and by type of medical service.