Big Drop in California Workers’ Comp Hospital Stays Since 2010
Attorneys at Cantrell Green, a prominent Orange County law firm specializing in California workers comp, have studied with interest recent statistics relating to hospitalizations with respect to workers comp cases. As such, they have noted the recent report issued by the California Workers Compensation Institute (CWCI), and how its findings affects their clients. This article highlights some of CWCI’s findings in the report.
CWCI Issued Report on Inpatient Hospital Trends
Oakland-based California Workers’ Compensation Institute reported in its California Workers Compensation Inpatient Hospital Trends 2010-2018 that hospitalization stays under the workers comp system declined from 0.6% in 2010 to 0.4% in 2018, which represents a 31% decline. This is in sharp contrast to the 19.6% drop in hospitalizations paid for under private health plans.
To measure use of inpatient services and procedures in the different systems, CWCI analyzed discharge data compiled by California’s Office of Statewide Health Planning and Development, which included data on more than 32 million inpatient hospitalizations from 2008-2016. Workers comp cases represented the smallest segment of the total number of hospitalizations that were included in the study.
Factors in Shorter Hospital Stays for Workers Comp Patients
According to CWCI, there were a number of factors contributing to the decline. One such factor is that 3.7 million Californians were added to Medi-Cal when the Affordable Care Act became available. Another factor is the upsurge in the use of ambulatory surgery centers. The adoption of utilization review and independent medical review programs that ensure that treatment meets evidence-based standards has further held inpatient hospitalization stays in check. Further, there was a 46% reduction in the number of spinal fusions during that period. (Even so, spinal fusions are still the top inpatient service performed in workers’ comp, a number that equated to more than 1 in 6 hospitalizations last year.) And finally, technological and procedural advances allow for more procedures to be performed in an outpatient setting.
Other Trends & Factors Relating to Workers Comp
In addition to analyzing inpatient trends relating to workers’ comp, Medicare, Medi-Cal and the various private plans during the study, the CWCI also reviewed and analyzed several other factors and provided detailed results and exhibits that showed a variety of other developments.
- Inpatient hospital stays for workers’ comp patients are allocated among five major diagnostic categories delineated by the CWCI.
- The report further breaks down the number of surgical vis-à-vis non-surgical, or “medical” hospitalizations according to payer group (workers’ comp, Medicare, Medi-Cal and private insurance plans).
- It compares the top five workers’ comp surgical and medical inpatient discharges according to diagnostic-related group (MS-DRGS), and further analyzes the top ten workers comp MS-DRGS according to payer groups for the year 2018.
- The report gives considerable focus to the volume and frequency of spinal fusion surgeries by payer group, specifically for the years 2010 through 2018.
- It further delineates the top ten hospitals, based on criteria setting forth the percentage of inpatient discharges covered by workers’ comp, and the proportion of California workers’ comp medical and surgical hospitalizations performed at those facilities.
CWCI has released its study as a Research Update report, “California Workers’ Compensation Inpatient Hospital Trends, 2010-2018.” The report itself is available for purchase through their website at www.cwci.org.
CA Workers Comp Attorneys
While these statistics may seem a bit dry, rest assured that they are not so to the workers comp attorneys at Cantrell Green. We study these reports diligently to see how we can better serve our clients. Being on top of the latest studies, statistics and reports is one way we can assure that our clients get the best workers comp coverage, care and benefits available. If you have sustained an injury on the job, please call us today to make an appointment for a free consultation, to see what we can do to assist you.