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Monday, May 4, 2015

WCRI: Drop in Medical Costs May Reflect early Impact of SB 863

  • State: California
  • Topic: Top
  • - Popular with: Employer
  • -  0 shares
California defied national trends and logged a 5% decrease in medical payments per claim during 2013…

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Anonymous Nov 3, 2016 a 7:58 am PDT

So in essence we spend more money than every other state on everything except paying for the treatment that workers need. I do not see this as a success. I see this as a travesty. The spin needs to stop. Let's be honest.

Anonymous Nov 3, 2016 a 7:58 am PDT

Maybe, just maybe this is an indication that the there is less unauthorized lien driven treatment. Maybe this system is working like it is intended. Hey Lie Detector wouldn't rather see higher PD and the injured worker spending less time running after suspect unnecessary treatment. Why protect and promote shady providers? Travesty, hardly.

Deborah Halverson Nov 3, 2016 a 7:58 am PDT

Yes, the entire WC public policy community concurs. Reimbursement rates well BELOW the cost of care serves no one, especially the catastrophic injured worker. It is inhumane and non-sustainable. The WC system has become yet another subsidy and financial burden for California healthcare. It is based in misconstrued idealogy which defies logic and basic sound medical practice. Let us endeavor to repair the financial damage done to WC reimbursements before someone dies due to such restricted care.

Anonymous Nov 21, 2016 a 10:49 am PST

Hey "Billy Joel. Most injured workers care more about receiving proper medical treatment than PD, in fact I could care less about PD. PD would not be needed of the injured worker healed quicker and returned to work. This UR and IMR system is hurting injured workers. No one believes the 95% approval rates, in my case it is opposite. They are rigging these numbers and they inaccurately show what is occurring in the real world. While lawmakers pat themselves on the back, people are suffering often times without proper medical treatment. It is disgusting how injured workers are treated. I would gladly waive all claims for any PD, if they would just approve my doctors requests.

John Kamin Nov 3, 2016 a 7:58 am PDT

The 5% cut most likely stems from the recent string of indictments and plea deals. More great work done by the Orange County and LA County DA offices!

Lisa Italia Nov 3, 2016 a 7:58 am PDT

There is a growing amount of research supporting that higher volume of or spending on medical care does not produce better outcomes for patients. I agree that our current system does not focus enough on outcomes. We ought to be looking in this direction with outcome-based medical networks and provider reimbursements. Simply equating lower medical costs or denial of some treatment requests with poor outcomes is not accurate and does not help to improve the situation.

Anonymous Nov 21, 2016 a 10:49 am PST

What is considered a outcome? If the injured worker is too disabled to return to work, and is on some pain medications that relive the effects of his injury, is this counted as a good outcome? It should. Remember workers compensation is meant to not only cure but ALSO relieve the effects of an injury. If someone had cancer, would you stop their pain medications because the person was not improving and would not be able to return to work? I do not think so. Please enlighten me what is considered a positive outcome.

Lisa Italia Nov 3, 2016 a 7:58 am PDT

Interesting question. It is akin to asking "what is success?" It varies by person, system, and depending on who you ask. I doubt everyone would consider the ongoing use of narcotic pain medications as a positive outcome. I've seen the long-term effects, and it is not good. The point is that there is not one answer to the question. It varies by person, system, perspective. Measuring outcomes provides information and options so that doctors, insurers and patients can make better choices about treatment.

Robert Bicego Nov 3, 2016 a 7:58 am PDT

If we cut California school lunches in half by feeding kids less food we will have decreased CA school lunches by 50%!

If we make driving in CA illegal every other day, we would have increased use of public transportation by 50%!

All the people that ate a tomato during the Civil War are now dead!

Anonymous Nov 21, 2016 a 10:49 am PST

Exactly.

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