In 2008, the State of Florida implemented a Medicare fee schedule to help control skyrocketing medical costs. Per procedure costs soon stabilized—still well above national benchmarks in areas but seemingly on the way to effective and fair cost management. 

Instead, over the next year the number of procedure units per claimant began a steady rise, all but eliminating the economic cost benefit of the fee schedule. Certain procedures allowing multiple units per encounter, like massage therapy, became an immediate staple in auto injury claims.

Insurance carriers, lacking substantive data to measure these changes and specifically identify the important cost drivers, were left with few options—other than increasing the size of their adjuster workforce inFloridato keep up with the claim handling workload. 

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