Research
California Workers' Compensation Prescription Drug Trends.
A CWCI Research Update Report provides new data on prescription drug utilization and reimbursement trends, based on 5.85 million prescriptions dispensed to California injured workers from 2011 through June 2020. The report looks at changes in the distribution of prescriptions and payments by therapeutic drug group; details opioid utilization trends for AY 2007 -2018 claims at 24 months post injury using four different metrics; and measures pre- and post-formulary shifts in the mix of prescription drugs and payments among the formularys drug categories.
IMR Decisions: January 2014 Through December 2020.
A CWCI Research Update report documents the sharp decline in IMR volume in 2019 and 2020, fueled by the reduction in prescription drug IMRs and the economic slowdown brought on by the COVID-19 pandemic in 2020. The report also looks at the distribution of IMRs and IMR outcomes by medical service category, regional distributions, IMR response times, and examines the distribution of pharmaceutical IMRs among therapeutic drug groups.
Trends in the Use of Opioids in California WC
CWCI research based on 10.8 million California workers' comp prescriptions filled between 2005 and 2014 identifies trends in the volume, cost, potency and types of opioids used to treat injured workers over the past decade.
Impact of the Calif. WC OMFS New Geographic Adjustment Factor
Impact of the OMFS's New Geographic Adjustment Factor: CWCI Research compares E&M service and payment data before and after the switch from a statewide to an MSA-based geographic adjustment factor within the OMFS. The study compares 2018 and 2019 data to identify changes in the distribution of E&M services and payments among MSA-assigned counties; average amounts paid within MSA-assigned counties; the overall mix of E&M services used within the state; and the proportion of E&M services that were paid below the amount allowed by the fee schedule and the change in the average discount.
Integrating COVID-19 Presumptions into California Workers' Compensation
A CWCI Report examines the historic role of WC presumptions, the current and proposed COVID-19 presumptions, and results of a survey detailing characteristics and outcomes of initial COVID-19 claims.
Post-Reform Medical Service Approval Rates in California WC
A new CWCI study on California workers comp medical care approval rates shows 94% of all treatment services performed or requested for injured workers in the first 10 months of 2018 were either approved or approved with modifications, though outcomes varied by type of service.
