Medical Care Provided California's Injured Workers

An Overview of the Issues

by Barbara O. Wynn, Giacomo Bergamo, Rebecca Shaw, Soeren Mattke, Allard E. Dembe

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California’s workers’ compensation system has been the center of intense debate and legislative activity over the past several years. The California Commission on Health and Safety and Workers’ Compensation and the California Division of Workers’ Compensation asked RAND to examine the cost and quality issues affecting medical care provided to California’s injured workers and to assess strategies to improve the quality and efficiency of that care. The study involved several interrelated tasks, the first of which was to identify the most important utilization and cost drivers and quality-related issues. This paper discusses the findings from this task, which are based on a review of the literature and interviews with stakeholders regarding their perceptions of the program and the likely impact of recent legislative changes on the access, cost, and quality of medical care. The paper also contains the product of a second task, which was to develop a conceptual framework for an ongoing monitoring system.

Table of Contents

  • Chapter One


  • Chapter Two

    Key Features of the California Workers’ Compensation System

  • Chapter Three

    Medical Treatment Costs and Utilization

  • Chapter Four

    Medical Care for Injured Workers: Access, Quality, and Outcome Issues

  • Chapter Five

    Conceptual Framework for an Ongoing Monitoring System

  • Chapter Six

    Summary of Issues and Topics That Need Attention

  • Appendix A

    Medical Treatment Study Interview Protocol

The research described in this report was prepared for the Commission on Health and Safety and Workers’ Compensation and Division of Workers’ Compensation, California Department of Industrial Relations and was conducted by the RAND Institute for Civil Justice (ICJ) and RAND Health.

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