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Snapshot: Setting the Standard - An Analysis of the Impact of the 2005 Legislative Reforms on the Texas Workers’ Compensation System

Workers’ Compensation Research and Evaluation Group

The Texas Department of Insurance (TDI) and the Workers’ Compensation Research and Evaluation Group (REG) are required to issue biennial reports to the Texas Legislature no later than December 1 of every even-numbered year on the impact of the 2005 House Bill 7 reforms on the workers’ compensation system. This report analyzes the affordability and availability of workers’ compensation insurance for Texas employers and the impact of workers’ compensation health care networks on return-to-work outcomes, medical costs, access and utilization of health care, injured employee satisfaction, health-related outcomes, complaints, and medical dispute resolution.

Read the full report.

Published: December 2020 by the Workers' Compensation Research & Evaluation Group.

Average premium per $100 of payroll down 73%. Private sector employees with workers' comp coverage up 81%. 65 percent of injured workers said they had no problem getting care needed. 83% of injured employees back at work in 6 months. Network claims average days to get non-emergency medical care = 4 days. Non-network claims average days to get non-emergency medical care = 4.9 days.
Since 2003, workers’ compensation insurance rates decreased nearly 72 percent for Texas employers. The average premium per $100 of payroll declined from $2.32 per $100 of payroll in policy year 2003 to $.63 per $100 of payroll in policy year 2018 – a 73 percent reduction.
Average Premium per $100 of Payroll by Policy Year
Employer subscription rates since 2016 remain some of the highest since the first employer survey in 1993. 71 percent of year-round private sector employers and 81 percent of private sector employees have workers’ compensation coverage in 2020.
Percentage of Texas Employers That Are Non-Subscribers and the Percentage of Texas Employees That Are Employed by Non-Subscribers
Texas’ cost per claim with 12 months maturity is about 24 percent less than the median cost of the 18 states analyzed. In 2001, Texas had the highest medical costs per claim among these states.
Texas Medical Payments Per Claim Lower Than Many Study States
In 2020, a majority of injured employees report that the medical care for their work-related injury was as good or better than their routine medical care.
Compared to the Medical Care You Usually Receive When You Are Injured or Sick, Would You Say the Care You Received for Your Work-Related Injury or Illness Was Better, Same, or Worse?

Today on average, injured employees are waiting half as long to get their first non-emergency medical visit as they did in 2011.

Average Number of Days from Date of Injury to Date of First Non-Emergency Treatment 2011-2020, Six Months Post-Injury

A higher percentage of injured employees receiving income benefits went back to work within six months in 2017 (83 percent), compared to those in 2007 (78 percent).

Percentage of Injured Employees Receiving TIBs Who Initially Returned to Work at Six Months and One Year Post‐Injury

Since 2005, medical fee disputes decreased about 65 percent, preauthorization and concurrent review disputes decreased about 20 percent, and retrospective medical necessity disputes have essentially disappeared in the system.

Total Number of Medical Disputes Received, 2005 and 2019

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Last updated: 9/30/2021