- On Oct. 20, 2021, DWC issued the Workers’ Compensation Network Data Call to produce the 2021 Network Report Card, which will cover data from June 1, 2020 to May 31, 2021. The report card is typically published in September and ICT will update members as soon as the results are released.
- As of June 1, 2021, there are 30 networks covering 254 Texas counties that are certified to provide workers’ compensation health care services to insurance carriers.
- 24 networks actively treated injured employees as of May 31, 2020.
- Since 2006, about 1.2 million injured employees have been treated in workers’ compensation networks.
- The percentage of new claims treated in networks has not changed significantly since 2015. 49% of all new claims were in network in 2021; 51% were non-network (up 1% from 2020)
Medical Costs
- Networks generally have lower medical costs per claim than non-networks, especially at 18 months maturity.
- Since 2017, non-network average medical costs per claim at six-months post-injury had been approximately 4% higher on average than network claims. The difference expanded to 7.5% in 2021.
- Average medical costs at six-months post-injury for non-network – $2,721
- Average medical costs at six-months post-injury for network – $2,531
- Network medical costs were about 11% lower per claim at 18-months post-injury with non-network claims.
- Average medical costs at 18-months post-injury for non-network– $3,881
- Average medical costs at 18-months post-injury for network– $3,485
- A higher percentage of network injured employees received evaluation and management, physical medicine, and pharmacy services than non-network claims. A higher percentage of non-network injured employees received hospital services.
Return to Work
- Since 2012, network claims consistently report higher return-to-work rates than non-network claims.
- 94% of injured employees in network returned to work compared to 84% non-network.
- There was a 36% increase in lost workday claims from 2019-2020 (99,880 from 73,632). Lost workday claims only involve work-related injuries reported by employers with workers’ compensation insurance that resulted in: the employee’s absence from work for more than one (1) day; an occupational disease or illness (even if the employee was never absent from work); or the employee’s death.
- The most claims came from the Transportation, Warehousing industry (5,656); followed by the Retail industry (4,985) – this is consistent with previous years.
Claims from TDI Systems Data Report
