This study can help policymakers and other stakeholders in the Texas workers’ compensation system identify current cost drivers and emerging trends in payments, prices, and utilization of medical services among nonhospital and hospital providers. 

The study shows how medical payments per claim and their cost components in Texas compare with 17 other states and how key metrics have changed from 2013 to 2018. Claims with experience through 2019 for injuries up to and including 2018 were analyzed. In some cases, a longer period was used to supply historical context, given the series of reforms in the state. The data in this report likely reflect all effects from House Bill 7 provisions enacted beginning in 2006, including certified medical networks, the required use of treatment guidelines and utilization review, and adoption of a drug formulary. Information from other WCRI studies was added to provide a more complete picture of the system in Texas. 

CompScope™ Medical Benchmarks for Texas, 21st Edition. Carol A. Telles. October 2020. WC-20-39.