California’s comp medical costs stable, comparable to rest of U.S.

Long the national leader in medical costs for injured workers, California’s medical costs per claim were “typical of other states” for 2016 claims with experience through 2019, according to new data released Thursday by the Workers Compensation Research Institute.

Researchers with the Cambridge, Massachusetts-based institute said the trend is likely the effect of “comprehensive reform legislation,” with the decrease in medical payments per claim following the 2013 passage of S.B. 863 ranging from 2% to 7% per year, depending on the claim maturity.

WCRI’s annual study examines medical payments, prices and utilization for various types of services by nonhospital and hospital providers, and compares California with 17 other states. California typically outpaces other states when it comes to medical costs, according to reports from years past.

The 2020 report pegged a number of policy changes in recent years, including a drug formulary put in place in 2018 and fraud-fighting measures, as the catalyst for lower costs.

“In addition, during the analysis period of this study, California went through multiple medical fee schedule updates for hospital outpatient department and ambulatory surgery center services, and nonhospital professional services,” the report states.