CompScope™ Medical Benchmarks for California, 19th Edition

By Rebecca (Rui) Yang

October 15, 2018 Related Topics:

This study continues to monitor how medical payments, prices, and utilization in the California workers’ compensation system have changed following the comprehensive reform legislation Senate Bill (SB) 863 (effective January 1, 2013).

It also compares California with 17 other states (Arkansas, Florida, Georgia, Illinois, Indiana, Iowa, Louisiana, Massachusetts, Michigan, Minnesota, New Jersey, North Carolina, Pennsylvania, Tennessee, Texas, Virginia, and Wisconsin) before and after SB 863.

The policy goals of SB 863 were to increase permanent disability benefits for injured workers and to create cost savings and improve the efficiency of the workers’ compensation process where possible. SB 863 includes various provisions with different effective dates that affect medical payments, indemnity benefits, and benefit delivery expenses in the California workers’ compensation system. 

The analyses in this study primarily focus on the period from 2011 to 2016 and include claims at various claim maturities. In some cases, a longer time frame was used to supply historical context for key metrics. Claims with experience through March 2017 for injuries up to and including 2016 were analyzed; these data reflect up to 51 months of experience post-SB 863. 

CompScope™ Medical Benchmarks for California, 19th Edition. Rui Yang. October 2018. WC-18-24.

Copyright: WCRI

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Research Questions:

Questions Addressed:

  1. How are workers' compensation medical payments distributed across providers and services?
  2. How do medical payments per claim, prices, and utilization differ across study states?
  3. How have medical payments per claim, prices, and utilization changed over time within a state, and what are the major drivers of those changes?

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