Workers’ Comp Study Looks at California’s Reforms

When California Senate Bill 863 took effect Jan. 1, 2013, it created several fee schedule changes in the California workers’ compensation system.

The Workers Compensation Research Institute has released a study looking at the possible effect of these changes on prices and payments in California relative to other states, as well as their potential impact on behavior and access to care.

The study, “Estimating the Effect of California’s Fee Schedule Changes: Lessons from WCRI Studies,” focuses on the transition to a resource-based-relative-value-scale fee schedule for professional services and the decrease in fee schedule rates for ambulatory surgery center services.

Workers Compensation Research Institute logoFindings from the study include:

“Although it’s still too early to see the full impact of SB 863, lessons can be derived from other WCRI studies to help us predict what could happen,” Ramona Tanabe, WCRI deputy director and counsel, said in a statement.

California Department of Industrial Relations Director Christine Baker offered thoughts on how fee schedules are playing out following the reforms.

“The fee schedules that are tied to Medicare offer the opportunity to have updated schedules with updated DRGs for payment. They provide consistent, predictable fees for payment,” Baker said. “Because the reforms went to RBRVS for physicians, the incentives have now shifted to the treating physician who can facilitate return to work and direct to the appropriate specialist if needed.”

WCRI is an independent, not-for-profit research organization based in Cambridge, Mass.