TX Study Analyzes Access to Medical Care

17 Oct, 2018 F.J. Thomas


Austin, TX (WorkersCompensation.com) - A recent study released by the Workers’ Compensation Division of the Texas Department of Insurance shows that the number of providers treating workers’ compensation patients has remained steady. This has resulted in a slight improvement for access to medical care. The focus of the study was provider participation, continuation of care, and timeline for access to care.

Overall, the study showed that patients received non-emergent care sooner for 2016 injuries in comparison to 2005 injuries. In 2017, 84 percent of injured workers received care within seven days or less. This is up from 81 percent in 2005, and 83 percent in the subsequent years.

According to the study, part of the improvement may be due in part to a 20 percent decrease in workers’ comp claims during that time period, which resulted in a 24 percent drop in the number of patients per provider.

Physician participation decreased for primary care, but this was partially balanced by the increase in emergency specialists and physicians’ assistants.

The study also looked at the ramifications of delayed medical care, which resulted in higher overall medical costs. In 2016 data, patients with delayed access to care for more than seven days resulted in a 39 percent increase in cost for the first six months.

Extremity injuries received initial care sooner than orthopedic problems for neck, shoulder, and low back. Network participation also played a factor, as the percentage of patients that received care within seven days or less was higher for networks than those under regular comp coverage. 

The overall retention rate for providers remained steady when taking into consideration the flux of claims at 81 percent in 2006 and 79 percent in 2017. Retention rates for orthopedic, emergency medicine, radiology and pathology has remained at 90 percent and above since 2006. For primary care, there was a slight drop from 79 percent in 2006 to 71 percent in 2017.

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    About The Author

    • F.J. Thomas

      F.J. Thomas has worked in healthcare business for more than fifteen years in Tennessee. Her experience as a contract appeals analyst has given her an intimate grasp of the inner workings of both the provider and insurance world. Knowing first hand that the industry is constantly changing, she strives to find resources and information you can use.

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