California’s SB 863 – Unintended Consequences?
Did California’s SB 863 increase the Workers Comp medical costs for the state?
Workers Compensation Research Institute WCRI recently published a study that showed that California’s medical cost growth had slowed from 8% growth per year to 3% just before SB 863 was enacted. When looking over WCRI’s CompScope™ Medical Benchmarks for California, 14th Edition, the impact of the RBRVS adoption was noticeable.

According to WCRI – “The moderating trend stemmed from the stabilization in utilization of nonhospital services and little change in prices paid for professional services. Hospital payments per inpatient episode continued to grow rapidly from 2006 to 2011.”
According to the study, the potential impact from the transition to a resource-based relative value scale (RBRVS) fee schedule would likely shift payments from specialty care to primary care, based on experiences from other states.
The study reported that in Maryland and Georgia, the prior transition to the RBRVS-based fee schedules led to increases in prices paid for office visits and physical medicine, and decreases in prices paid for surgical services.
One area that WCRI and other groups have documented is the very high level of medical-legal reviews on CA WC medical charges.
There will be many updates in the next few months on the effect of Californias SB 863 on overall WC costs.
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