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Indemnity claims
receiving treatment, number of visits, and the
average payments per claim are all down
following the changes made by the workers'
comp reforms to overall utilization, according
to research by the California Workers'
Compensation Institute. This includes fee
schedule changes and treatment guidelines.
CWCI did its study based on 303,000 open and
closed indemnity claims for injuries between
January 2001 and December 2004 across seven
medical service categories.
The biggest
decrease was in chiropractic manipulation
where the percentage of indemnity claims
receiving medical treatment was 21.4 percent
in 2003 dropping down to 13.9 percent in 2004.
Physical therapy declined from 67.4 percent in
2003 to 61.0 percent in 2004. Both
chiropractic and physical therapy treatments
were capped by the 2003 reforms. The Medicine
section and Injections categories were also
down, albeit slightly.
But some
treatments showed increases as well. Radiology
increased from 30.2 percent in 2003 to 37.7
percent in 2004. Evaluation and Management
(office visits) increased slightly as did the
Surgery category.
Overall,
visits declined across all seven categories at
nine months post injury. Chiropractic
manipulation and Physical Therapy showed the
largest decreases between 2003 and 2004.
Chiropractic averaged 32.6 visits in 2003 and
averaged 17.4 visits in 2004. The other five
categories also showed decreases although they
were smaller. Radiology averaged 4.6 visits in
2003 dropping to 4.3 visits in 2004.
The average
total cost per claim for six of the seven
medical categories was also down. In 2003 the
cost of chiropractic manipulation per claim
was $1,488. In 2004 it was $748. Only surgery
went up from $3,447 in 2003 to $4,086 in 2004.
Earlier CWCI research indicates that the
surgical trend is toward more expensive
procedures.
These early
returns offer a positive outlook on the
workers' comp reforms and their impact on the
California worker's comp market. But CWCI
cautions the industry that this research only
reflects medical care rendered during the
first nine months following the date of
injury. Workers' comp medical costs typically
develop over years and court challenges and
legislative rollbacks to the reforms could
impact future savings.
(Article
Taken from WC Executive)
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