Texas Workers’ Comp Study Finds Worker Access to Medical Care Improved

September 26, 2018

The Texas Department of Insurance, Division of Workers’ Compensation reported in a newly released study that access to medical care for injured workers has improved slightly and that a high rate of doctors who treat workers’ comp patients has remained steady.

A September 2018 study from the division’s Research and Evaluation Group measures access to care by mainly looking at doctor participation and retention, and timeliness of care. It focuses on the injured employees’ initial access to medical care, excluding emergency medical services. The principal measurements are participation and retention rates of health care providers, and timeliness of care.

The study found that about 84 percent of injured employees received initial care within seven days or less in 2017, up from 81 percent in 2005. The rate has remained above 83 percent since 2009.

The study also found that 80 percent of doctors who treat workers’ compensation patients return the following year. Additionally, the number of workers’ comp claims fell by 20 percent from 2005 to 2017, causing a 24 percent decrease in the number of patients per doctor in Texas.

The total number of physicians actively practicing in Texas increased at an annual rate of 3.2 percent between 2005 and 2017.

Most active workers’ comp physicians — 78 percent — practiced in the five largest metro areas in the state in 2017, the study found. In addition, 73 percent of workers’ compensation claimants resided in the state’s large metro areas.

Because of the higher number of workers’ comp doctors practicing in large metro areas, the physician to patient ratio is generally lower than in smaller metro areas. The study found that some smaller metro areas and border regions had a relatively higher number of workers’ comp patients per physician. Tyler, San Angelo, and Bryan Hospital Referral Regions (HRRs) had relatively more physicians than claims. Harlingen and El Paso areas had relatively less physicians than claim.

The share of claims that received their initial treatment within seven days after injury was higher among workers’ comp networks than non-networks.

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