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Access to Medical Treatment for Injured Workers in California

Year 3 Annual Report

by Kandice A. Kapinos, Cheryl K. Montemayor

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Research Question

  1. What is the state of access to medical care among injured workers in California?

The California workers' compensation program provides medical care and indemnity benefits to workers who suffer on-the-job injuries or illnesses. California law mandates an annual assessment of whether injured workers in the state have adequate access to quality care, and the RAND Corporation was asked to help answer that question over three years.

The key objective of this Year 3 report is to describe access to medical care among injured workers in California using medical billing data from Version 2.0 of the Workers' Compensation Information System. Overall, the estimates using such data suggest stability or slight improvements in most measures analyzed when compared with the Year 2 estimates.

Key Findings

Year 3 estimates suggest stability or slight improvements in most measures when compared with the Year 2 estimates

  • Overall, the estimates using the Version 2.0 data for 2016 were relatively similar to those presented in the Year 2 report, although the authors did not test for statistical differences resulting from differences in the samples used.
  • There were 76,950 unique providers serving injured workers in 2016, and the most common specialties were internal medicine, physical therapist, physician assistant/nurse practitioner, emergency medicine, and family medicine/general practice.
  • Across all specialties, providers had, on average, 29.4 claims each during 2016 and delivered 208.1 medical services per claim. The total annual payment per provider was $24,440, and the payment per claim was $1,306.
  • There was significant variation by region and county across all measures.
  • The median time between injury and first evaluation and management visit was 2 days. The median time between injury and first evaluation and management visit with a primary care provider in a non–emergency department setting was 6 days.

Table of Contents

  • Chapter One

    Background and Key Objectives

  • Chapter Two

    Analytic Approach

  • Chapter Three

    Results

  • Chapter Four

    Discussion and Summary

  • Appendix

    SAS Code for Type of Service

Research conducted by

The research described in this report was sponsored by the California Department of Industrial Relations and conducted by the Justice Policy Program within RAND Social and Economic Well-Being.

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