Research Reports

A study that uses 2016 – 2017 California workers’ compensation prescription data to determine the prevalence of polypharmacy in the system and to identify the types of drugs used in polypharmacy prescribing..

A CWCI Report examines the historic role of WC presumptions, the current and proposed COVID-19 presumptions, and results of a survey detailing characteristics and outcomes of initial COVID-19 claims.

The number of IMR determination letters in California workers comp fell 11.3% in 2019, led by a sharp decline in prescription drug disputes, with initial data from 2020 showing the decline is continuing.

CWCI’s analysis of changes in the volume and reimbursement of California workers comp professional medical services from 2013-2018, which includes the 4-year transition to the RBRVS fee schedule that began in 2014. The study reviews data from nearly 36 million medical services rendered to injured workers during that period to measure shifts in the mix of services and payments across and within 9 major services categories, and discusses the underlying changes to the fee schedule that affected those moves.

A 30-page CWCI Report to the Industry details CWCI research that quantifies the declining prevalence of opioids in workers comp lost-time claims, the impact on average benefit payments and average days away from work, and in light of the opioid trends, estimates projected costs for 2010-2017 claims at 10 years of development.

A new CWCI study on California workers comp medical care approval rates shows 94% of all treatment services performed or requested for injured workers in the first 10 months of 2018 were either approved or approved with modifications, though outcomes varied by type of service.

CWCI’s updated look at changes in the volume of inpatient hospitalizations in WC, Medicare, Medi-Cal and private plans from 2010-2018. The study shows the most common WC inpatient diagnosis-related group codes (MS-DRGs) and the top 5 Major Diagnostic Categories (MDCs); and provides detailed data on other workers compensation inpatient trends, including changes in the volume of implant-eligible spinal surgeries and a listing of the top 10 hospitals based on injured workers as a percent of their total inpatient discharges. CWCI members and subscribers can log in to view the summary Bulletin under the Communications tab, and the full report under the Research tab. Institute members can also log in to access the updated version of the Inpatient Hospital interactive tool from the Research section. CWCI members and subscribers who log in may read the full report, others may purchase a copy from the Store.

California WC Rx Drug Utilization & Reimbursement: Part 2 Emerging Outcomes Under the Formulary A CWCI Spotlight Report examines the impact that the Medical Treatment Utilization Schedule has had on the types of medications dispensed to injured workers and recent shifts in the total drug spend.

CWCI’s analysis of changes in the types of prescription drugs used in California workers’ compensation over the past decade. The report looks at the breakdown of prescriptions and payments by therapeutic drug group by service year, as well as the generic utilization rates for the different drug groups and how the average amounts paid for drugs within each group changed over the 10-year study period.

Independent Medical Review Volume and Outcomes Through Q2 2018. For further details see the news release in the Newsroom and CWCI members and subscribers may log in to view a summary Bulletin and the Research Update report.

Using data from 141,643 pharmaceutical requests and UR decisions from the first five months of 2017 and 2018, and 58,604 IMR decisions from the first four months of those same two years, CWCI takes a preliminary look at changes in pharmaceutical UR and IMR outcomes in the first few months after Californias WC Formulary took effect.

CWCI research measures and compares changes in the volume of inpatient hospitalizations in WC, Medicare, Medi-Cal and private plans from 2008-2016, notes the most common WC inpatient diagnosis-related group codes (MS-DRGs) and the top 5 Major Diagnostic Categories (MDCs); and provides detailed data on other workers compensation inpatient trends, including average length of stay and changes in the volume of implant-eligible spinal surgeries.

From Bob

A CWCI analysis of the prevalence, volume and strength of opioid prescriptions in California work injury lost-time claims that involve a mental health component.

A CWCI Spotlight Report uses 2015 and 2016 workers’ comp prescription drug data to measure the potential impact of DWC’s proposed Formulary.

CWCI Study Examines the Impact of the California Workers Comp FormularyClaims filed by workers living in the Sierras represent just 1.7% of California workers’ comp claims, but over the past decade average loss payments in the region have grown faster than in other parts of the state. CWCI’s final Regional Score Card takes a close look at key aspects of Sierra claims and compares the results to those from other regions.

CWCI’s analysis of the utilization trends, costs, and characteristics of spinal fusion claims in California workers’ compensation.