Tuesday, October 20, 2015

Learning The Lessons

The Berkeley Research Group and Rand Corp. presented results and findings from studies conducted to the California Commission on Health and Safety and Workers' Compensation on Friday with several glass half-empty, half-full conclusions.

BRG's findings:
  1. 85% of workers injured in 2013 reported being "satisfied" or "very satisfied" with access to treating physicians and the treatment they received.
  2. The number of injured workers in California increased 5% from 2012 to 2013; this compares to nationally, in which the number of injured workers increased just 1% in 2013.
  3. The number of providers increased 1.4% in 2013, following a cumulative 25.8% decrease from 2007 to 2012.
  4. The increase in providers coincides with an increase in the number of medical bills of 19.3% in 2013, again following a steady decline over the prior 5 years.
  5. The number of medical bills per injured worker also increased, atop five years of increases cumulatively 16.9%, by another 19.3% in 2013.
  6. But the average medical bill decreased 18.8% following years of increases.
  7. Not surprisingly, because of the study's time line, opioid prescription and use had increased, and drug testing also increased (the California Workers' Compensation Institute earlier this month reported urine drug testing grew from 10.2% of lab tests in 2007 to 59.1% in 2014).

Rand Corp. also presented to CHSWC more conflicting information:
  1. The average pharmacy spend per injured worker increased to more than $1,000 in 2012, up from $600 in 2007.
  2. The average number of days from injury to first non-emergency room visit decreased from 21 or 22 days in 2011 to about 20 days in 2012 for all categories of injury. 
  3. The average number of days before the first medical service is provided dropped to about 18 days for specific injuries in 2012 from 20 days in 2011. 
  4. The delay in treatment for occupational diseases and cumulative injuries remained at just under 45 days in 2011 and 2012. 
  5. Delay increased slightly for multiple injury claims to 30 days from 28 or 29 days in 2011.
  6. The median number of days between injury and first visit for all injuries remained stable at two.
  7. Medical-legal services have been increasing steadily, as has the amount paid.
  8. Return to work was better for those with low back pain, but otherwise unchanged for chronic pain reporters: only about 40% of people with chronic pain injuries remain employed two years after the accident for all years from 2007 through 2011.
The study period for both of these reports is problematic - SB 863 became law in 2012, so 2013 is a transition year where many of the elements of that reform attempt were still in the process of being rolled out, and the industry adapting.

In addition, the BRG study cohort was just one year from date of injury, so by study's construction by definition pretty much did not include chronic injury cases.

And, though there was an increase in physician participation in work comp, the net decline is still over 24% from 2007.

There's plenty of conflicting data.

Which is where the story telling becomes relevant.

The flip side to the data are the stories about the 15% that are not satisfied, or about the 24% of physicians who no longer take work comp cases, etc. 

The data has to be put into context to have meaning. The stories will either explain the data, or contrast the data.

There's a story in the 15% that are dissatisfied with work comp, and in the increase in frequency, or lackluster RTW stats - that's where we learn the lessons.

1 comment: