New Hampshire Workers’ Comp: Docs Love It!
When workers' comp gets a mention in the State of the State address, you know there is a problem. NH Governor Maggie Hassan pointed to the high cost of comp as an obstacle to business growth in the state. New Hampshire has an unusual problem: the dollars are not flowing primarily toward injured workers or toward attorneys. They are flowing into the pockets of doctors and hospitals, with a whopping 73 percent of total expenditures going into medical care. The national average for comp medical expenditure is 59 percent. Massachusetts, with its somewhat Draconian fee schedule, is only spending around 41 percent on medical bills. The high cost of medicine in NH comp has resulted in a national ranking of #9 overall for the cost of workers comp, second only to Connecticut (#2) among the New England states.
New Hampshire needs an effective and aggressive medical fee schedule. Easier said than done. Given the hyper-sensitivity of the medical community to any cuts in reimbursement rates, the governor has taken the safe path and opted for a study committee (outlined in HB-255, passed last month in the New Hampshire House). In addition to members of the medical community, the committee will include members from the legislature, the Insurance Department, the insurance industry, labor and business.
We can only hope that the commission is more effective than a similar effort to implement a medical fee schedule in the neighboring state of Maine. Work began in 1991 and finally concluded twenty years later with the implementation of a modest fee schedule. Why so slow? Because medical providers and their allies, prominent on the study committee, objected to virtually any proposed cut in rates for medical reimbursement.
New Hampshire will encounter similar opposition from their medical community. But if the Granite state is to successfully control the cost of comp, they will have to put the squeeze on medical rates. Doctors won't love it, but if the experience in other states holds, they will learn to live with it.