Texas Workers’ Comp Report Card: Medical Costs Higher in Networks

But Return-to-Work Rates Higher, Too

In its annual report card on the performance of Workers’ Compensation Health Care Networks, the Texas Department of Insurance (TDI) Workers’ Compensation Research and Evaluation Group reported that, overall, networks had higher average medical costs than non-networks. They also tended to have higher utilization of professional services and pharmaceuticals than non-networks. However, networks generally had lower utilization of hospital services than non-networks.

The report card is the third to be published since the initial networks were certified by TDI in early 2006. It compares network and non-network claims on a variety of measures, including: health care costs; utilization of care; satisfaction with care; access to care; return-to-work outcomes; and health outcomes.

Data used to measure network performance includes: workers’ comp medical billing data collected by TDI; results of an injured worker survey conducted by the University of North Texas, Survey Research Center; and results from a February data call issued by TDI to 34 networks. Currently, certified networks offer services in 234 Texas counties.

Some of the findings of the survey include:

• Overall, with some exceptions, non-network injured workers reported higher levels of access to, and satisfaction with, care.
• Non-network injured workers reported quicker care and higher satisfaction with their treating doctors than did network injured workers.
• Network injured workers reported higher return-to-work rates than non-network injured workers.

The injured worker survey results are based on telephone interviews with 3,018 injured workers with new lost-time claims.

Topics Texas Workers' Compensation