WCRI: Chiros, Litigation, Boost Calif. Comp Cost

NU Online News Service, March 19, 12:42 p.m. EST?A not-for-profit group that has done six studies of California's workers' compensation claim costs said multiple chiropractor visits, more costly physician treatments and litigation expenses are among the factors impacting the system.

Cambridge, Mass.-based Workers' Compensation Research Institute, which did the research over the past 18 months,

announced its findings earlier this week.

Examining the medical costs, WCRI compared California with 12 other large states, and found that, for workers being treated outside of hospitals, the number of visits per claim was 40 to 100 percent higher in California than the median for other states.

California chiropractors used more visits per claim than chiropractors in any other state studied--an average of 34 visits per claim, WCRI said.

The researchers found that prices paid for physician's office visits were 3 to 10 percent lower than the median state, but doctors billed a much higher share of office visits at higher intensity codes for ailments diagnosed with greater severity.

"This is consistent with ?up-coding' by California physicians to enhance revenue," WCRI said.

According to the Institute, the average non-medical indemnity payment per claim (with more than seven days lost time) in California was 39 percent higher than other large states.

The expenses for delivering claim benefits to workers, WCRI said, were much higher than most states. The delivery cost, it was explained involved litigation, claims adjusting and medical cost containment services.

Benefit delivery expenses represent about 13 percent of total claim costs. The higher delivery expense was driven, in part, by higher litigation and claims adjusting expenses, WCRI said.

The researchers found that in determining permanency of benefits, the design and implementation of the California system has features that result in a greater need for attorney involvement and more hours spent resolving cases.

WCRI also noted higher bill review costs driven by more visits and services from medical providers, longer treatment, more disputes and more changes in medical providers.

Special Reports /

WCRI: Chiros, Litigation, Boost Calif. Comp Cost

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