CompScope™ Medical Benchmarks for California, 17th Edition

By Rebecca (Rui) Yang, Karen Rothkin

October 1, 2016 Related Topics: Medical Costs, Utilization, Annual State Medical CompScope™ Benchmarks

This study examines medical payments, prices, and utilization in California compared with 17 other states (Arkansas, Florida, Georgia, Illinois, Indiana, Iowa, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, New Jersey, North Carolina, Pennsylvania, Texas, Virginia, and Wisconsin). 

Senate Bill (SB) 863 became effective on January 1, 2013. This report can help policymakers and stakeholders in the California workers’ compensation system monitor the impact of this reform legislation. The data covered in this study reflect up to 27 months of experience post-reform.

The report can help identify changes over time in the provision of workers’ compensation medical care; detect areas where medical payments per claim, prices, or utilization may be higher or lower compared with other study states for a set of similar claims; or reveal areas where legislative changes or state system features and processes may be impacting the costs or delivery of medical services.

This study covers 2009 to 2014, with claims experience through March 2015. Where relevant, findings from other Workers Compensation Research Institute (WCRI) studies are added to provide a more complete picture of the system. 

CompScope™ Medical Benchmarks for California, 17th Edition. Rui Yang and Karen Rothkin. October 2016. WC-16-53.

Copyright: WCRI

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Research Questions:

  1. How are workers' compensation medical payments distributed across providers and services? 

  2. How do medical payments, prices and utilization per claim differ across states for similar injures and workers? 

  3. How have medical payments, prices and utilization per claim changed over time within a state, and what are the major drivers of those changes?

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