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Texas comp claim costs close gap between in-, out-of-network care


Medical costs for injured workers treated by Texas workers compensation health care networks have declined 7% over the last five years while costs for workers treated by non-network providers have increased 21% in that time, according to the Texas Department of Insurance.

However, medical costs for in-network claims remain slightly higher than costs for claims from non-network providers, the department said in an Oct. 2 report.

Texas has 29 workers comp provider networks that have treated a total of 416,551 injured workers since March 2006, when the insurance department began certifying such networks, the department said. The Texas legislature approved a bill in 2005 authorizing the use of workers comp networks.

According to the department, average medical costs for claims treated by network physicians fell from $2,915 in 2010 to $2,700 in 2014. Average medical costs for workers treated outside of networks rose from $2,217 in 2010 to $2,681 in 2014.

Texas comp claimants who were treated by networks also saw higher return-to-work rates and fewer weeks off from work than injured workers treated outside of networks, the insurance department said.

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