10 Promising Trends in California Workers’ Compensation Insurance

Thanks to recent reforms and new strategies, positive things are happening in California workers’ compensation insurance. Below are 10 trends on our “good news” list:

1. Lower premiums. Last year California employers paid an average of 10 percent less in workers’ compensation premiums according to the 2018 State of the System report by the Workers’ Compensation Insurance Rating Bureau (WCIRB) of California.
2. Better treatment environment for injured workers. The environment for injured workers is improving, thanks to the use of evidence-based medicine to guide treatment decisions; improved access to network physicians; and the Independent Medical Review (IMR) process to determine the necessity of treatment and settle disputes.
3. Claims settled faster. That same IMR process is leading to quicker resolution of medical treatment and quicker claims settlements.
4. A new prescription drug formulary. The state’s new prescription drug formulary is helping to ensure that the drugs injured workers are getting meet evidence-based medicine standards. The new formulary is expected to streamline the process, improve efficiency, and reduce pharmacy costs by roughly 10 percent.
5. Progress on anti-fraud efforts. Lien filings have dropped by roughly 40 percent, 227 medical providers have been barred from treating California’s injured workers, and 292,000 illegitimate liens with claims valued at more than $2.5 billion have been dismissed.
6. Self-reporting shows promise. Some employers have improved results through self-reporting policies. For example, in 2015 Starbucks implemented a self-reporting system that allows employees to self-report claims rather than going through a manager. The program provides an integrated work comp call center, a dedicated telephonic medical case management team, direct deposit of time-loss pay, and other perks. The result? Starbucks has boosted efficiency, slashed work comp loss reserves by more than $50 million, increased the percentage of claims achieving maximal medical improvement and release to work from 51 percent to 86 percent, and cut claims litigation by 50 percent.
7. Early intervention works. According to the Bureau of Labor Statistics, musculoskeletal disorders (MSDs) – carpal tunnel, tendinitis, muscle strain, and low back injuries – account for 33 percent of all worker injury and illness cases. Early intervention helps control MSD treatment costs. That’s why Schenker Logistics (Essen, Germany) implemented early intervention programs in their U.S. operations. The program assesses injured workers on the spot and educates them on how to perform tasks more safely. The result? Schenker slashed their previous $2 million in MSD claims to under $500.
8. Onsite triage reduces lost time. In 2017 California discount retailer 99 Cents Only implemented an onsite triage program in two of their stores with high occurrences of injuries. Clinicians triaged injuries immediately, and the company used a ride-hailing service to quickly transport injured workers for treatment. The company reported a 41 percent reduction in lost time claims in the first 12 months of the program.
9. Advances in telehealth. Telemedicine is evolving into telehealth, encompassing more comprehensive services such as physical therapy, behavioral health, and pain management. And technology is driving much of the change, with video, artificial intelligence, smartphone apps, and other technology all playing a role. These interactive formats make the process more convenient and transparent for injured workers, boost efficiency, and reduce costs.
10. Robotics. Everything from physical therapy to repetitive motion assistance to medication dispensing systems to clerical work in claims handling are using robotics. Increased efficiency, fewer errors, more transparency, and lower costs are resulting.

Want more good news out of your workers’ compensation insurance program? Contact the California workers’ compensation insurance professionals at Heffernan Insurance Brokers.