Wisconsin was once considered a national leader when it came to workers’ compensation, being the first state in the nation to approve a workers’ compensation law in 1911. The Act established limits on awards that employees could recover, and in return employers were required to pay for workplace injuries, including medical care and lost wages.

Wisconsin’s workers’ compensation program still operates under this general premise, with workers having the right to a first and second choice of providers while employers (or their insurers) pay all reasonable and necessary medical expenses. While other states have taken steps to allow employers to direct care or establish fee schedules for workers’ comp, Wisconsin has done little in the past several years to address costs on the medical side.

Not surprisingly, Wisconsin has seen its average medical payment per claim increase sharply through the years, and today is among the most expensive states reporting data to the Workers Compensation Research Institute (WCRI). A WCRI study of 2008 claims finds that the cost of a procedure in Wisconsin is $11,221 when paid for by workers’ compensation compared to $9,990 when paid for by a group health plan. Illinois is not far behind.

If there is a small sliver of good news in this, it may that policy makers are getting serious about reforming workers’ compensation this session. Traditionally, changes to Wisconsin’s program are proposed by an advisory council made up of labor, management and insurance carriers. This session, it appears that both labor and management may agree to fixed rates for claims in Wisconsin, and have asked health provider organizations to propose a reasonable fee schedule by September.

If provider groups come up with an acceptable proposal, the council will recommend it to the legislature. If providers fail to come up with an acceptable proposal, the council may develop its own fee schedule, but the legislature always has the option to move forward to enact changes outside of the council process. A handful of legislators have made a commitment to addressing employers’ concerns about workers’ compensation through legislation in the next two years, and that may be where this debate ends up.

The Alliance Fights Workers’ Compensation Costs on Two Fronts

As an advocate for employers, The Alliance is playing a role in helping policy makers understand what may constitute an “acceptable” fee schedule for employers. The Alliance Health Policy Committee approved several pdf recommendations that have been shared with advisory council members. As this issue moves forward, we will continue to work with lawmakers and monitor the advisory council process to advocate for reforms that are in the best interests of employers.

The Alliance is not waiting for new legislation to address this problem. The Alliance already offers a workers’ compensation solution in Wisconsin and Illinois through our cost-effective network of providers. Using The Alliance’s comprehensive, cost-efficient network, participants save an average of 35 percent on compensable billed charges. Learn more about our workers’ compensation solution here.

The Alliance solution reduces workers’ compensation costs by providing cost savings for work-related medical expenses. We work with your workers’ compensation insurance carrier to redirect your claims to The Alliance network.