Comp medical payments, claims with opioids down in California

Workers compensation medical payments and claims with an opioid prescription in California continued to decline in 2019, according to a study released Thursday by the Workers Compensation Insurance Rating Bureau.

California’s workers comp system made $2 billion in medical payments in 2019, a 3.8% decline from 2018. The state reported 654,000 claims, up 1% over the prior year, but medical payments per claim declined 4.8% to $3,003 in 2019, according to the Oakland, California-based rating agency.

WCIRB analyzed medical payment and utilization trends by provider type, service locations and service type, finding that physical medicine and rehabilitation continued to be the fastest-growing sector by medical costs within all physician services, with physical therapy accounting for nearly a quarter of costs for all medical transactions in 2019.

Hospital-based providers received the largest share of medical payments in 2019 at 28%, in line with prior years, with physician office visits accounting for nearly 80% of all medical transactions.

Pharmaceutical medical payments continued to decline, comprising just 3.1% of workers comp medical payments, down from 4.1% in 2017, and only 4% of all claims had an opioid prescribed at the end of 2019, down 7% from the first quarter of 2017. Controlled substances payments also declined, representing less than a percent of total medical payments.