The California Division of Workers’ Compensation (DWC) released its 2013 study on access to medical care for injured workers, which finds that most workers have nearby access to providers and are satisfied with the medical care they receive.
The Labor Code requires that DWC complete annual studies to ensure workers have access to medical care. New to this year’s report are data from medical claims submitted to the Workers’ Compensation Information System (WCIS). The other source for the report, completed by the Berkeley Research Group, was a survey of workers injured in 2011 and 2012.
“We’re pleased to see that the majority of injured workers have access to needed care without barriers,” said DWC acting Administrative Director Destie Overpeck. “At the same time, this study does show that improvements are needed to increase rates of recovery and job modifications.”
This study marks DWC’s first effort to review medical claims data in order to gauge injured workers’ access issues. Previous studies conducted in 2006 and 2008 focused solely on survey data. All three studies included a survey of injured workers to measure their satisfaction with the care they received. Although survey methods differed, the findings for each survey were similar: 85 percent of the injured workers noted they were satisfied or very satisfied with their care.
WCIS uses electronic data to collect comprehensive information from claims administrators. The WCIS medical claims data indicated that the number of injured workers who obtain care from specialists rather than general practitioners is increasing, while the overall number of providers treating injured workers has not changed. Among the 500 randomly selected workers 84 percent expressed satisfaction with their main health care provider and 85 percent of those whose saw specialists were satisfied with the care they received. 7 percent of workers reported that they were denied care. 85 percent of injured workers saw a health care provider, most frequently a general practitioner, within three days of their injury. The distance traveled to the first provider visit was most frequently less than six miles (55 percent) and took less than 16 minutes (59 percent). Injured workers reported receiving care through a Medical Provider Network 85 percent of the time.