Snapshot: 2019 Network Report Card

Workers’ Compensation Research and Evaluation Group

In 2005, the 79th Texas Legislature passed House Bill (HB) 7, authorizing the use of workers’ compensation health care networks certified by the Texas Department of Insurance (TDI). This legislation also directed the Workers’ Compensation Research and Evaluation Group (REG) to publish an annual report card comparing the performance of these networks with each other, as well as with non-network claims, on a variety of measures.

Key findings

Percent of new claims treated in networks holding steady

48 percent of all new workers’ compensation claims in 2019 have been treated in networks, up from 20 percent in 2010.

Percentage of New Claims in Workers’ Compensation Networks 2010-2019

Network medical costs at 18 months still decreasing

Overall, medical costs in networks still outperform those in non-network and are down 15 percent since 2010. Over the same time, non-network average medical costs increased by 11 percent.

The overall average medical cost for network injured employees at 18 months was lower than non-network injured employees prior to the 2015 report card. This supports measures which show networks provide higher utilization of services than non-network in the first six months of injury, but less during the following 12 months.

Average Medical Costs at 18 Months Maturity 2010-2019

Return to work rates better among networks

The percentage of network injured employees who went back to work after their injury increased to 94 percent in 2019, an increase of seven percentage points since 2011. The return-to-work rate for non-network injured employees has remained relatively steady at 90 percent for the same timeframe.

Percent of Injured Employees Who Went Back to Work 2011-2019

Mental and physical health outcomes trending higher

Physical functioning measures a person’s ability to do everyday tasks. Mental functioning measures a person’s ability to think and reason. All networks had higher physical functioning scores among their injured employees than non-network. Most network patients had better or equal mental functioning scores as well. Both of these scores among network injured employees have consistently been higher than those of non-network injured employees and the U.S. population since 2012.

About this report

Measures presented in this report card were created using data gathered from a variety of sources:

Medical cost, utilization of care, and administrative access to care measures were calculated using the DWC medical billing and payment database, a collection of about 100 medical data elements, including charges, payments, and Current Procedural Terminology (CPT) and diagnosis codes for each injured employee.
Access to care, satisfaction with care, return-to-work, and health outcomes measures were calculated using the results of an injured employee survey conducted by the Public Policy Research Institute at Texas A&M University on behalf of REG.