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Average medical payment in California since 2015



Average medical payments per claim with more than seven days lost time have been stable in California since 2015, according to a study by the Workers Compensation Research Institute.

Medical payments in California were 11% lower than the 18-state median for claims 2017 evaluated as of 2020.

"One area where California really stands out in this study is prescription drugs," said Ramona Tanabe, executive vice president. President and Adviser to WCRI. "Since 2013, California's prescription payments per prescription claim have declined very rapidly, more than any of the other study states, which is likely to reflect several factors."

WCRI reports that the average payment per hospital per claim has been fairly stable since 201

5, decreasing by 1% per year on average for injuries with 12 months of experience. Payments per claim for major non-hospital services were mostly stable after 2017.

The average prescription amount per prescription claim has decreased rapidly since 2013, according to WCRI.

The changes "may have to do with the introduction of independent medical review of SB 863, changes to the Medi-Cal fee schedule, application of treatment guidelines, the impact of the drug form, increased awareness of the use of opioids in labor compensation and practices of not allowing doctors to dispense. certain networks of physicians, "said WCRI.

WCRI also reports that payments per claim for hospital services increased moderately from 2015 to 2019, but the proportion of injuries with hospital care decreased.

"The results of this study include experience of injuries up to March 2020, at the beginning of the coronavirus pandemic," says Tanabe.

WorkCompCentral is a sister publication of Business Insurance. More stories here . [19659011]
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