Updated Interactive Tools

CWCI has completed updates to our four interactive data applications (the Claims Monitoring, Regional Scorecard, Prescription Drug, and Inpatient Hospital Claim tools). Members who log on to our website (www.cwci.org) with their user name and password can access each of these updated applications from the drop down menu under the Research tab on our home page. The applications provide you and your staff online access to detailed data to examine and compare industry data on key metrics as noted below.  In addition, there are on-line tutorials available for each application.

The Claims Monitoring Application: This tool allows users to examine industrywide trends in average paid medical (with MCC), average paid indemnity, and combined medical and indemnity payments for AY  2008-2018 claims at development periods from 3 to 72 months for all claims or indemnity claims alone. Users can also choose to view the percent change in each of these average payments compared to the prior accident year; drill down to obtain specific data for a region or an industry; and access results on heat maps highlighting regional differences. The medical payment data can be segmented to show the average paid for Treatment, DME/Pharmacy, Medical Cost Containment and Med-Legal expense. This version of the application contains data valued through June 2019 (IRIS 21A). Among the recent findings:  

• First-year paid medical losses (including MCC) averaged $9,317 for AY 2018 indemnity claims, down 1.0% from $9,413 in AY 2017. The distribution of first-year medical loss components shows medical treatment accounted for 80.6% of the payments, pharmacy/DME accounted for 2.0%, med-legal expense comprised 3.3%, and medical cost containment represented 14.0%.
• First-year paid indemnity on AY 2018 lost-time claims averaged $8,426, up 2.5% from AY 2017, while at 72 months post-injury, indemnity payments on AY 2013 claims averaged $22,285.
• Since AY 2015, average total paid loss trends for indemnity claims have varied significantly by development period, ranging from a 4.6% decrease at 36 months to a 13% increase at 3 months.  

The Regional Scorecard Application: This tool, an extension of the CWCI Regional Scorecard series, has been updated to include AY 2008-2019 data valued through June 2019. Users can view regional and statewide data on 19 key metrics, compare results from 8 different regions, and identify regional and statewide trends that have developed. The app includes data on average medical, indemnity and other payments (including breakdowns showing average paid TD and PD, allocated loss adjustment expense, and data on demographics, claim status, and claim volume. Users may also drill down to view results by injury year and industry. Examples of findings from Regional Scorecard application:  

• The L.A. region continues to lead the state in average medical and indemnity payments, attorney involvement rates, time to employer and carrier notice, and percentage of claims with PD.
• The average number of TD days on AY 2018 indemnity claims statewide was 50, but results ranged from 46 TD days in San Diego and the Central Valley to 62 days in the North Counties.
• Among AY 2018 indemnity claimants, average job tenure was 6.0 years statewide, but in L.A. County the average was 8.3 years — the highest in the state. A. County also had the highest level of attorney involvement (42.2% of AY 2018 indemnity claimants from L.A. were represented vs. 25.2% of the Bay Area claimants and 34.0% of indemnity claimants statewide). 
• For AY 2015–AY 2018, allocated loss expense payments for all claims (M-O and indemnity) statewide averaged $1,056, but there was significant regional variation, with average expenses per claim ranging from a low of $608 in the Sierras to $1,488 in L.A. County.   

The Prescription Drug Application: This app can be used to examine and compare industrywide data on prescription drugs dispensed between January 2007 and June 2019. The app includes claim level results so users can measure and compare prescription drug utilization by accident year at various levels of development and service-level data based on prescriptions filled within a given calendar year. The app features a series of dashboards that can generate statewide or regional prescription drug data either for all claims or for just indemnity claims. Global selection settings and drop down menus allow users to view results for different levels of development; for open and/or closed claims; for specific drug groups; by opioid drug name; for generic and/or brand drugs; for specific industries; and for specific accident years or service years. As with our other online applications, once the user selects the specific metrics they are interested in, results automatically display in the tables and graphics, with regional data displayed in color-coded heat maps. An Interactive Research Report also provides a guide to help users through the app, reviewing the data in each dashboard, and demonstrating options for generating customized views and screenshots of the data and exhibits available. Examples of recent findings: 

• Anti-inflammatories are now the #1 drug category in California workers’ comp, accounting for more than 27% of the prescriptions given to injured workers in the first half of 2019, more than twice the proportion noted for opioids, which still rank second, but have declined from a record 31.6% of the workers’ comp prescriptions in 2009 to 13.5% in the first 6 months of last year.
• Opioids are most prevalent in claims from the Central Valley, where they were used in 18.5% of the AY 2015-2019 claims at 24 months. In contrast, opioids were least prevalent in Bay Area claims, dispensed in 12.5% of the claims over that same period. Among individual counties, Kings County had the highest rate of opioid use in the state, with more than a quarter of all claims from that county involving opioids.
• Over the past five years, average payments for dermatologicals have been higher than for any other class of drugs, averaging $288 per prescription. During this period, diclofenac sodium topicals have accounted for an increasing share of the dermatologicals dispensed to injured workers, climbing from less than 20% of all dermatologicals in 2015 to nearly 50% in 2019.

The Inpatient Hospitalization Claim Application: This tool offers detailed data on utilization trends, costs and characteristics of inpatient hospitalization claims, with comparative data on back surgery rates, average lengths of stay, and hospital charges for spinal fusions paid under Medicare, Medi-Cal and private coverage, regional variations, and hospital-specific data for 2010-2018 spinal fusion discharges. Among the recent results:

• The number of California workers’ comp inpatient discharges fell 1.9% between 2017 and 2018, for a net decline of nearly 31% since 2010.
• Spinal surgeries accounted for 18% of the workers’ comp inpatient discharges in 2018, compared to 1% or less of the inpatient discharges paid by Medicare, Medi-Cal and private coverage. However, the number of spinal fusions in workers’ comp has declined 46.3% since 2010.
• The hospital-specific data identify 8 hospitals where back surgeries accounted for more than 50% of their 2017-2018 workers’ comp inpatient discharges – and at 3 of those, back surgeries represented more than 70% of the workers’ comp discharges over that 2-year span.

How to Access the Applications

To access the updated interactive data apps, log on to our website (www.cwci.org) with your user name and password.  (If you haven’t set up a member account, select “Your Account” at the top of the home page, click “Add me as a Member User” from the pull-down menu, complete the form, then use that information to log in). Once you are logged on, use the drop-down menu under the Research tab and click Interactive Research Tools, then scroll down and click on the app you want to open. As new data becomes available, CWCI automatically updates the apps to provide the most current data available.

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