North Carolina Pays High Price for Medical Treatment of Workers

Nearly every employee in North and South Carolina is covered by the workers’ compensation system. In industries and jobs where the rate of accidents and injuries is higher, employers may have greater workers’ compensation claims and costs. According to a new study by the Workers Compensation Research Institute (WCRI), hospitals in North Carolina pay higher costs for work-related injuries than in most states. The report, titled “CompScore Medical Benchmarks for North Carolina,” assessed medical costs between 2007 and 2012 and compared the data to 15 other states. The report concluded that overall, medical payments were higher in North Carolina than in other states.


In addition to the overall costs, there were also varying medical payments depending on the provider. According to the analysis, North Carolina had the highest cost per claim among the states evaluated in the WCRI study. Despite the higher cost of hospital care, the state had lower “nonhospital” costs related to workers’ compensation. Public health officials, legislators, and hospital officials have worked to tackle the issue of rising health care costs in North Carolina and nationwide. In 2009, the state made significant headway in reducing the hospital outpatient reimbursement rate. For most hospitals this rate fell from 95 percent to 79 percent of charges.

North Carolina has a charge based schedule, a system that has historically resulted in higher hospital outpatient costs per surgery than in states where fees remain fixed. According to the report, North Carolina began to freeze charges for in an outpatient services in 2013, then cut rates another 10 to 50 percent. Additional legislation required hospital reimbursements to be paid in accordance with pre-existing Medicare methods, but the changes have not yet been implemented.

Rising costs related to health care are a problem not just for hospitals and employers who pay into the workers’ compensation system, but to injured workers as well. In the event of a work-related injury, victims should file an immediate claim and consult with an experienced advocate who can help to ensure full coverage for past, current, and future medical expenses. Our Asheville workers’ compensation attorneys understand the pressures faced by injured workers and their families and will take a comprehensive and thorough approach to maximize benefits. It is important to properly file your claim at the outset to ensure that you collect the full compensation you are entitled to.

According to researchers, there has been an increase in prices paid for return doctor’s visits as well as medicine services. Claim costs in North Carolina were higher than in most states and now advocates are working towards policy changes to improve health care costs and coverage. In the event of a workplace accident, victims are entitled to coverage for all medical expenses and lost wages. Additional coverage for pain and suffering and other personal losses may be available through third-party personal injury claims against other entities, including property owners, manufacturing companies, or contractors. The average payout was $10,498 per workers’ compensation claim in North Carolina, where the median was around $8,617.

If you have been injured at work, contact the Lee Law Offices at 800-887-19

More Blog Entries:

Poole v. University of North Carolina – Vocational Rehabilitation Often Mandated, Aug. 11, 2014, Greenville Workers’ Compensation Lawyer Blog

Graven v. N.C. Dept. of Public Safety – Injuries From Holiday Lunch Accident Not Compensable, Aug. 15, 2014, Charlotte Work Injury Lawyer Blog

Contact Information