The study also shows that the majority of injured workers are satisfied with their care and that levels of satisfaction appear unchanged from a similar study conducted in 1998.
“This study shows that, following the introduction of evidence-based medicine and treatment guidelines, most injured workers feel they are getting the care they need,” said DWC Executive Medical Director Dr. Anne Searcy. “It also points out where we need to improve, and gives us a baseline from which to measure the impact of changes we make going forward.”
Among the nearly 1,000 injured workers surveyed between May and October of 2006, the vast majority reported that they were able to see a doctor right away, did not have to travel far to see their doctor and were able to get specialty care, physical therapy and prescriptions they needed, according to California DWC.
According to the agency, the report also showed that the health and return-to-work outcomes of injured workers need further improvement, especially among those with high levels of utilization.
Some Doctors Perceived a Decline in Access
The 2003 workers’ compensation reforms added section 5307.2 to California's Labor Code, requiring DWC to contract with an independent firm to perform an annual study of access to medical treatment for injured workers. This first study was conducted by the University of California at Los Angeles (UCLA), Center for Health Policy Research.
While 82 percent of injured workers reported having access to quality medical care for their injury, some doctors surveyed for the study perceived a decline in access to quality care since the reforms.
“The fact that physicians report perceived declines in quality as a result of the 2003 and 2004 reforms isn’t surprising,” said Gerald Kominski, associate director of the UCLA Center for Health Policy Research and lead author of the study. “Some doctors are understandably dissatisfied because these reforms placed limits for the first time on the volume and type of services that can be used to treat injured workers. What’s important is that these negative perceptions of doctors regarding access and quality do not reflect the actual experience of most injured workers.”
The majority of physicians that perceived a decline in injured workers’ access to care – chiropractors, acupuncturists and orthopedic surgeons – also reported a decline in their workers’ compensation patient volume since 2004.
“Some decline in overall patient volume is expected because the actual number of claims in the system has decreased and caps were placed on physical medicine,” Searcy said. “But pending medical treatment regulations, which include guidelines for acupuncture, will address the decline in access to acupuncturists.”
Majority of Providers Intend to Continue Providing Treatment
Among the nearly 1,100 medical providers surveyed between April and October of 2006, the majority intend to continue providing treatment to workers’ compensation patients, according to DWC.
However, DWC noted that about one in five intend to decrease their volume of workers’ compensation patients in the future, and about 14 percent plan to quit entirely. In both cases, the physicians most frequently cited payment, paperwork and utilization review issues as their motivation.
“The division recently proposed regulations that will increase reimbursement to doctors for most office visits by an average of 23 percent,” Searcy said. “This, along with vigorous enforcement of our utilization review rules, should help alleviate the doctors’ main concerns. We’re also working to decrease paperwork through electronic billing and a better reporting form.”