Research
Independent Medical Review Decisions – January Through December 2015
A detailed analysis on IMR outcomes, including decision counts and uphold rates, based on data gleaned from 2015 IMR determination letters
The Changing Nature and Cost of the Medical-Legal Process in California WC
A CWCI study reviews statutory, regulatory and judicial changes to the California workers’ comp medical-legal process over the past quarter century, provides updated data on the quantity, mix and cost of medical-legal services following the 2002-04 reforms, and generates benchmark data for future research on the impact of the 2012 reforms, which introduced IMR as the new means for resolving treatment disputes.
Medical Review and Medical Dispute Resolution in California WC
New CWCI research based on 2014 UR data and IMR determinations from the first half of 2015 shows an estimated 96 percent of medical services in California workers’ comp are approved.
Utilization and Cost of Urine Drug Testing in California WC
A new CWCI Report to the Industry examines the issue of Urine Drug Testing in California workers’ comp, which now accounts for nearly half of all lab services and more than half of all payments for lab services in the California system.
ICD-10s and the WC System
A new analysis examines the history, form and function of the ICD-10 classification system for healthcare delivery, which takes effect October 1 for all health care systems in the U.S. – including California workers’ comp.
Medical & Indemnity Benefit Trends, AY 2002 – 2014
Initial data on AY 2014 lost-time claims indicate that average medical payments at 3 and 6 months post injury declined following implementation of SB 863, though the 12- and 24-month data on claims from prior years still show average losses trending up, led by ongoing increases in payments for prescription drugs and DME.
