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Provider participation

• Fewer providers provided care to California WC patients in 2014 than in 2010.
• The specialties with the largest declines from 2010 to 2014 in WC-participating providers were family medicine/general practice, chiropractic medicine, and pharmacy providers. Most other specialties were relatively stable.
• Over the same period, there was an increase in the number of WC injuries.

Utilization and payments per provider

• The average number of claims per provider increased from 2010 to 2014.
• Payments per provider increased by $8,813, on average, from 2010 to 2014.
• The observed increases in average claims per provider, bill lines per provider, and payments per provider were likely driven by changes in very large practices or health systems treating many injured workers.

Utilization and payments per injury

• For most service categories, utilization within 12 months of injury declined from 2010 to 2014.
• Payments for many service categories changed from 2010 to 2014. Payments for drugs, medicine services, and outpatient-facility services decreased, while payments for evaluation and management services increased.

Timeliness of care

• There was a small increase in the median wait time between injury and any evaluation and management visit.
• The pattern is similar between Northern and Southern California, but there were differences in timeliness of care between types of injury.

Monitoring provider churn

• Provider churn — switching from one primary care provider to another — decreased from 2010 to 2014.

Pathways of care

• Having the first visit in an emergency room occurred in only about 10 percent of injuries, with most of those injuries not resulting in an inpatient admission.
• Injured workers starting with an evaluation and management visit were typically able to be seen within one day of injury, with the second visit typically occurring four to five days later (when it was to see a nonspecialist) and about ten to 13 days later (when it was to see a specialist); that number increased somewhat over time.
• The average number of bill lines in a 12-month period following injury varied considerably across these different pathways, as well as over time.