Providers, business clash over fee schedule

November 08, 2017 1:28 PM | Anonymous

November 8, Wisconsin Health News 

Healthcare providers and the state’s business lobby sparred over a proposal that would establish a fee schedule for the workers’ compensation program at a Wisconsin Health News event Tuesday. 

Under the proposal, the Department of Workforce Development would build a fee schedule to approximate the average negotiated price of group health in the state. It would also provide an additional 2.5 percent to 10 percent increase to cover administrative costs. 

“Wisconsin’s costs have gone up pretty dramatically in the last 20 years,” said Chris Reader, director of health and human resources at Wisconsin Manufacturers and Commerce. “We’re now, if not the most expensive, we’re close to it in most areas.” 

Reader said that employers are seeing that they’re paying more for the same procedure compared to group health plans and other states. More than 40 other states have developed their own medical fee schedules. 

The Legislature didn’t enact a fee schedule four years ago. But this time is different because costs have gone up, according to Reader. 

Mark Grapentine, senior vice president of government relations for the Wisconsin Medical Society, called the proposal a “solution in search of a problem.” He said that Wisconsin provides wide access to high quality care, which helps workers get better quicker. 

Grapentine said there’s a lot of attention paid to individual codes for procedures as opposed to the cost per claim. Wisconsin’s cost for all workers’ compensation claims on the healthcare side is around the national average, he said. 

“When you look at the whole picture overall, the story is pretty good,” he said. “The rest of the country looks at Wisconsin workers’ comp. program as a national model.” 

But Charles Burhan, assistant vice president and senior public affairs officer for Liberty Mutual, said most employers cannot negotiate on workers’ compensation. 

“It’s a national model for high prices,” he said of Wisconsin’s current system. “Is there a need for a fee schedule? Yes." 

Joanne Alig, senior vice president of policy and research at the Wisconsin Hospital Association, said that group health has lower prices because of negotiations, such as prompt payment. 

She said that workers' compensation premiums in Wisconsin have declined the last two years too. “To say that costs are not coming down, we just disagree with that,” she said. 

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