In addition to California, the states analyzed in the WCRI study were Connecticut, Florida, Georgia, Massachusetts, Minnesota, Pennsylvania and Texas. Although California's fee schedule sets maximum fees at typical levels, the average payment per service is the lowest of the eight states surveyed. Because the number of services per visit is typical, the difference in the average payment is more likely a result of lower cost services being provided at a higher number of visits, rather than of billing practices. The study found that chiropractic costs per claim are higher than the median, resulting from significantly more visits per claim than is typical. Although it is possible that chiropractors in California treat more severe injuries than chiropractors in other states, the higher use of services probably is also a product of treatment practices because we find a similar pattern among lost-time claims of seven days duration or less.
Hospitals are less likely to provide treatment.
However, the study found that when California hospitals are involved in a claim, there are more emergency visits, more visits for physical therapy and greater use of supplies and equipment than in other states.