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N.H. Workers’ Compensation Care Is Costly

Monday, May 26, 2014
New Hampshire medical providers charge significantly more — in some cases twice as much — for workers’ compensation care than their counterparts across New England and the country, according to a new report from the state Insurance Department.

New Hampshire is the ninth-most expensive state for workers’ compensation insurance, and almost three-quarters of those costs go toward paying medical providers, said Deb Stone, actuary and director of market regulation at the Insurance Department.

New Hampshire is also one of six states in the country without a fee schedule, or a cap on how much providers can charge for workers’ compensation care.

On average, workers’ compensation surgical procedures in New Hampshire are 83 percent more expensive than in other New England states, and more than twice as expensive as the rest of the nation, according to data from the National Council on Compensation Insurance.

∎ Radiology: 35 percent more expensive than New England and 66 percent more expensive than nationally.

∎Physical and occupational therapies: 95 percent more than the rest of New England and 64 percent more expensive than nationally.

∎ Doctors’ visits: 36 percent more expensive than New England and 47 percent more expensive than nationally.

Stone delivered the report last week to the Workers’ Compensation Advisory Council. Representatives for the New Hampshire Hospital Association and the New Hampshire Medical Society at the meeting objected to the fee schedule being proposed as a solution, based on the data shown.

“While we have agreed to be part of the work group so we can provide input and be part of the solution, what we cannot support is mandated rate setting. Others states, such as Massachusetts, have imposed rates that are so strict that they are now having difficulty with worker’s compensation patients getting access to care,” Paula Minnehan, vice president for finance and rural hospitals with the hospitals association, said in a statement after the meeting.

The hospitals and doctors would like to examine data that takes quality into account — for example, data for costs by diagnosis and statistics showing how quickly a patient was able to return to work.

New Hampshire providers might be giving care that is expensive but eliminates the need for follow-up care later, said Gary Woods, the medical society’s representative and a hand surgeon at Concord Orthopaedics.

“A fee schedule is the easiest, most visible way to control costs. But if we look at global dollars, you can either pay me now, or pay me later,” Woods said.

There have been several attempts by legislators over the past decade to pass a fee schedule, but each was defeated. The current Legislature recently failed to reach a compromise on a bill that would have created a commission to examine workers’ compensation insurance.

Gov. Maggie Hassan said in a statement yesterday that instead of waiting until the next session to try again with a new bill, she will appoint a task force “of workers, businesses, insurers and members of the health care community to make recommendations” for reducing costs.

Rates for workers’ compensation insurance in the state decreased in 2014, and the industry is “not in crisis,” Stone said.

But “as somebody that works with consumers, we get calls all the time from employers struggling to pay their workers’ comp costs and they don’t understand why we’re so much higher than Massachusetts,” said Assistant Actuary Sally MacFadden. “It feels like a crisis, I know it does, to some of our small-business people.”

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