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Employers, insurers, and policymakers in California have been searching for options to the current California workers’ compensation benefits system, which has both the highest and the fastest-growing insurance premium costs in the country. Proponents of a type of insurance program called 24-hour care believe that such a program could yield substantial workers’ compensation savings. A 24-hour care plan would consolidate employers’ health care benefits, and possibly disability benefits, for both work-related and non-work-related claims, and services could be delivered by the same group of providers under a coordinated insurance package. (The name “24-hour care” derives from the premise that a single benefit mechanism can cover health care needs following an injury wherever it occurs during the day, either at work or at home.) In this monograph, the authors present the results of their assessment of the value of 24-hour care as a mechanism for reducing workers’ compensation costs, while maintaining or improving the quality of care. The authors discuss possible options for 24-hour care models, including one that consolidates only medical care services and one that consolidates both services and health insurance.

Table of Contents

  • Chapter One

    Introduction

  • Chapter Two

    Medical Treatment and Workers’ Compensation in California

  • Chapter Three

    24-Hour Care Models and Mechanisms

  • Chapter Four

    Lessons from Previous Work with 24-Hour Care

  • Chapter Five

    Legal Considerations for 24-Hour Care

  • Chapter Six

    Operational Issues for Implementation of 24-Hour Care

  • Chapter Seven

    Alternative Models of 24-Hour Care

  • Chapter Eight

    Synthesis of Findings and Recommendations

The research described in this report was conducted by the RAND Institute for Civil Justice, a unit of the RAND Corporation. This research was sponsored by the California Commission on Health and Safety and Workers’ Compensation.

This report is part of the RAND Corporation monograph series. RAND monographs present major research findings that address the challenges facing the public and private sectors. All RAND monographs undergo rigorous peer review to ensure high standards for research quality and objectivity.

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