Today’s post was shared by Workers Compensation and comes from www.businessinsurance.com.
As headlines like this one appear across the country we are simultaneously noting a significant increase in surgery denials from claims managers. Coincidence? – kc
 The number of inpatient hospitalizations among injured workers in California has declined, in part because of a reduction in the number of implant-eligible spinal surgeries in recent years, according the California Workers’ Compensation Institute. From 2008 to 2014, workers comp inpatient hospitalizations declined 22.8%, according to an updated report, “Inpatient Hospital Utilization in California Workers’ Compensation,” released by CWCI on Thursday. Payers of workers comp claims saw fewer hospital stays than Medicare, Medi-Cal and private coverage between 2013 and 2014, with the number of inpatient discharges for comp dropping 8.6%, the report states. It also found that the number of workers comp implant-eligible spinal surgeries declined 8.4% in 2013 and 13.6% in 2014. The decline “coincided with continued development of evidence-based medicine, utilization review, and independent medical review, fee schedule changes, and the phase out and ultimate repeal of duplicate ‘pass-through’ payments for hardware used in workers compensation spinal surgeries,” CWCI said in a statement. However, since 2008, implant-eligible spinal surgeries have ranged between 21% and 23.2% of all workers comp inpatient discharges, according to the report. They accounted for 21.2% in 2014, the most recent year included. The report notes that spinal fusions and back/neck procedures are the highest-volume inpatient hospital discharges among injured workers… |
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