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Nearly 50% increase in Texas comp networks: Report – Business Insurance

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    Reprints

    Texas

    Three out of four injured employees reported that their work-related medical care was the same or better than the medical care they normally receive when injured or sick, according to a study released Wednesday on the state of medical networks in the Texas workers compensation system. 

    Texas comp reforms in 2005 called for an annual “report card” comparing the performance of certified networks with each other, as well as with non-network claims, on such measures as health care costs, utilization, satisfaction with care, and access to care. By law, the networks must be certified to provide workers compensation health care services to insurers, according to the report issued by the state Division of Workers’ Compensation.

    As reported in recent years, networks typically have lower medical costs per claim than non-network injured employees, especially at 18 months maturity, according to the study’s highlights. Since 2017, non-network average medical costs per claim at six months post-injury have been approximately 4% higher on average than network claims. Overall, six-month average medical costs increased slighted in 2019 when compared with 2018: from $2,560 to $2,710 for non-network treatment and from $2,472 to $2,609 for in-network care.

     

    Also stable are return-to-work figures: since 2012, network claims “consistently” report higher return-to-work rates than non-network claims. In 2020, 95% of injured workers reportedly went back to work after being treated in network while 89% of those treated non-network did so — all numbers in line with recent years. 

     

    Highlighted in the report was that three out of four injured employees reported that their work-related medical care was the same or better than the medical care they normally receive when injured or sick.

     

     

     

     

     

    Read Next


    • Texas finds most comp doctors in good standing


      The Texas Department of Insurance, Division of Workers’ Compensation in 2019 assessed 113 medical providers statewide, finding that 36 of them, or 32%, were poor performers when it came to filing work status reports for previously injured workers, according to data released Friday. 



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