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California sees steady decline in medical costs per comp claim: Study

California sees steady decline in medical costs per comp claim: Study

Medical payments per workers compensation claim with more than seven days lost time in California have decreased steadily since the enactment of reform legislation in 2013, according to a study released Thursday by the Cambridge, Massachusetts-based Workers Compensation Research Institute.

For claims with 12 months of experience, the average medical payment per claim decreased 3% per year from 2012 to 2016, the study found. For more mature claims with 36 months of experience, this measure decreased 4% per year in this same time frame, according to the study.

The study examined medical payments, prices, and utilization in California and compared them with 17 other states over a period from 2010 through 2015 — with California seeing the largest drop in payments per claim. In that time frame, California lawmakers passed S.B. 863, which reduced the fee schedule rates for services provided in ASCs to 80% of the Medicare hospital outpatient rate from 120%, starting in 2013.

While California saw reductions, most of the other study states experienced growth in this measure during the same period, the study found.

“We continue to monitor the impact of California reform legislation on medical payments, prices and utilization,” said Ramona Tanabe, the WCRI’s executive vice president and counsel in a statement. “The decrease in medical payments per claim in California likely reflects the impact of S.B. 863 provisions.”



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