Report: California Workers’ Comp Medical Payment Trends Fell in 2018

Medical payments in California’s workers’ compensation system continued to decline in 2018 as the medical payments per claim decreased, according to a report from the Workers’ Compensation Insurance Rating Bureau of California.

The WCIRB released its California Workers’ Compensation Aggregate Medical Payment Trends report comparing medical payment information from 2016 to 2018.

The report also includes an analysis on utilization and cost of opioid prescriptions over time and by region.

Other findings in the report include:

  • The medical payments for pharmaceuticals and to pharmaceutical providers declined sharply.
  • Physical therapy services experienced the largest increase in the share of medical payments driven by increases in both service utilization and paid per service.
  • Physical medicine and rehabilitation procedures continued to grow the fastest within all physician services and use of anticonvulsants increased more significantly than any other therapeutic groups.
  • Opioid prescriptions and costs declined significantly, mostly driven by fewer claims involving opioid prescriptions. In addition, average doses of opioids prescribed dropped sharply as did the concurrent use of opioids and sedatives.
  • Fresno, Bakersfield and Tulare areas had the highest share of claims involving opioid prescriptions, while the Silicon Valley area and the Los Angeles Basin had the lowest share.

Another WCIRB report issued this week showed a new drug formulary put into effect by the California Division of Workers’ Compensation over a year ago may be working as intended.

This article was first published by Insurance Journal.

Leave a Reply