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Texas workers comp physician networks see declining medical costs

Posted On: Oct. 2, 2013 12:00 AM CST

Average medical costs for injured Texas workers treated in the state’s workers compensation physician networks fell 6% in the past three years, while average costs for comp claimants treated outside of networks climbed 19% in that time, according to the Texas Department of Insurance.

Texas has 28 state-approved workers comp doctor networks, 21 of which were treating injured workers as of February, according to the department’s “Workers’ Compensation Network Report Card,” released Tuesday. The report evaluated comp claims for injuries that occurred between June 2011 and May 2012, about 23% of which involved treatment from non-network doctors.

The average medical cost for claimants treated within networks was $2,753 in 2013, down from $2,915 in 2010. That’s compared with an average cost of $2,633 in 2013 for claimants treated by non-network doctors, up from $2,217 in 2010.

Networks tended to have higher utilization of professional and pharmacy services compared with non-network claims, the insurance department said. Networks also reported faster return-to-work times than claims treated by non-network doctors.

The report is available here.