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Research

Research

Changes in Inpatient Hospital Fee Schedule Allowances

This evaluation measured changes in the average amounts allowed under the California workers compensation inpatient hospital fee schedule for hospital stays for 2002, 2003 and 2004.

Effect of AB 749 TD Increases on 2/3 Wage Replacement

This analysis estimates the proportion of California injured workers who are paid temporary disability and receive at least 2/3 wage replacement, and how the proportion has changed since the AB 749 TD rate increases took effect in 2003, 2004, and 2005?

Impact of Physician-Dispensing of Repackaged Drugs on California Workers' Compensation

Physician-dispensed prescription drugs comprise a significant portion of all pharmaceutical prescriptions dispensed in California's workers' compensation system. Because of limits on the reach of statute and regulations adopted under Senate Bill (SB) 228, physician-dispensed pharmaceuticals are also much more expensive than the same drugs dispensed through a pharmacy. This report, prepared for the Commission for Health and Safety for Workers' Compensation, documents the extra costs placed on the workers' compensation system by physician-dispensed drugs. The report also reviews research on both the positive and negative impacts of physician dispensing.

Medical Care Reform & Access to Medical Care

This study considers the association between two managed care reforms -the adoption of the 1993 Medical Legal Fee Schedule and the 2004 Utilization Review Schedule – and changes in access to workers' compensation medical services. Using a sample of more than 900,000 claims from injured workers treated between 1993 and 2005 — before and after implementation of the medical reforms — the study measures the workers' proximity to a choice of three active providers who saw injured workers in each corresponding calendar year. The findings show that implementation of managed care controls was not associated with a material change in access to a choice of medical providers.

Medicare Reimbursement Models for Evaluation and Management Services

This study estimated the impact on California workers compensation medical payments in 2005 had the Official Medical Fee Schedule reimbursements for evaluation andmanagement (E&M) office visits been set at 2006 Medicare rates.

Medical Utilization & Reimbursement Outcomes

The goal of this study was to measure the associations between the California workers' compensation medical care reforms implemented in 2004 – most notably, mandatory utilization review, the ACOEM guidelines, and the 24-visit caps on physical therapy and chiropractic care – and changes in the amount of treatment provided to injured workers, and the associated medical reimbursements.

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