States once again show the way to management and reform of public systems by having affected interests sit down together to work out a plan. In Wisconsin, the nation’s oldest workers’ compensation program historically has been maintained through negotiated revisions to coverage, benefits and procedures by labor and employer representatives. Earlier this week, the Wisconsin Workers’ Compensation Advisory Council issued a report embracing current research and recommendations for maintaining the system where cost containment was the imperative.
Medical costs in Wisconsin’s workers’ comp system generally are unlimited, which is why the Wisconsin Insurance Alliance reported earlier this year that neighboring states had maximum medical cost allowances for workplace injuries that were only about half of those faced by Wisconsin employers. The Wisconsin Compensation Rating Bureau calculated last year that the median rate paid for the 25 most commonly-performed procedures in their state was almost five times the Medicare reimbursement rate.
Since there is no certainty whatsoever in the national health care landscape, it makes perfect sense for a state to protect its system and its workers by developing an innovative fee schedule, which calculates an average of local reimbursement rates in different regions of the state and then adds in 10 percent to allow a modest benefit increase for worker injuries.
As the National Conference of Insurance Legislators has developed information on problems arising for patients in the cost of physicians dispensing drugs in their offices outside pharmacy plans, there is also a model section to curb some abuses and thereby provide consumer protection to patients for which their employers have bargained.
This is both a commendable process and a set of recommendations that should be considered carefully by the Legislature in the New Year.