PPO To MPN: Impact Of Physician Networks In California WC (06/15) [PDF]

A research report that examines the changes in the use of physician networks in California workers’ compensation as they evolved from Preferred Provider Organizations (PPOs) to Medical Provider Networks (MPNs) and measures their impact on medical costs associated with work-related injuries. Using data compiled from more than 1.8 million claims from accident year (AY) 2000 through June of AY 2011, the report compares the average medical benefit payments at 24 months post injury for claims where treatment was delivered by network providers to claims where treatment was delivered by non-network providers. In addition, the study documents changes in network utilization over the 11.5 year span of the study, and compares the changing nature and characteristics of claims where treatment was managed inside and outside of networks.

(Research Note, 06/15)