Cambridge, Mass.-based WCRI said in its "CompScope Benchmarks"report for Texas that, "In 2001, prior to the reforms, medicalcosts per claim in Texas were highest among the study states."Later in the decade, the report said, medical costs per claim inTexas were lower than the typical state for claims with more thanseven days of lost time, which WCRI called "a dramatic shift."

After several years of decreases due to the legislative reforms,medical costs per workers' compensation claim in Texas were stablein 2007, WCRI said.

HB 2600, passed in 2001, instituted reforms in Texas such as acertification system of doctors to be included on an approved listto provide health care under the workers' compensation system; thecreation of fee-for-service regional health care delivery networksto deliver care under the workers' compensation system; andpre-authorization requirements for certain procedures.

HB 7, passed in 2005, established certified workers'compensation health-care networks and adopted evidence-basedtreatment guidelines.

Medical costs per claim fell 19 percent from 2002 to 2006, thereport said, "largely due to fee schedule decreases under HB 2600combined with an increased management of medical care by payersthrough utilization review and other means."

But WCRI noted that an increase in the 2008 medical fee scheduleconversion factors -- to reflect increases in practice expensessince 2002 -- and a separate conversion factor established forsurgery may result in a one-time increase between 16 percent and 41percent in prices paid for services by non-hospital providers.

The report said, "We estimate that even if surgical prices paidincreased by 41 percent on average, Texas would still havelower-than-typical prices paid for surgery services."

Medical cost containment expenses per claim have also continuedto "grow rapidly," WCRI said. In fact, the report noted that, at anaverage of $2,818, Texas had the highest medical cost containmentexpenses per claim among study states in 2007-2008.

The report commented, "One might wonder if this merely reflectsa transfer of dollars from one type of cost to another. However,the combination of the medical cost containment expenses andmedical costs per claim resulted in a decline in medical-relatedcosts per claim from 2002 to 2007."