Snapshot: 2020 Network Report Card

Workers’ Compensation Research and Evaluation Group

In 2005, the 79th Texas Legislature passed House Bill 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 this annual report card comparing the performance of these networks with each other, as well as with non-network claims, on a variety of measures.

1.1 million employees treated in networks since 2006; New claims 52% network, 48% non-network; medical costs are 9% lower in networks; average weeks off work in network - 5, out of network - 10; employee satisfaction in network 87%, out of network 69%.

Key findings

% of new claims treated in networks holding steady

48 percent of all new workers’ compensation claims in 2020 have been treated in networks, up from 28 percent in 2010.

Percentage of New Claims in Workers’ Compensation Networks

Network medical costs lower than non-network at 6 and 18 months post-injury

Overall, medical costs in networks still outperform those in non-network. In 2020, network medical costs were about 9 percent lower per claim at 18 months post-injury compared with non-network claims.

Average Medical Costs (6-months maturity)

The medical cost gap widened between network and non-network claims at 18 months post-injury (using claims from the previous report card). Network medical costs were about 9 percent lower per claim at 18 months post-injury compared with non-network claims.

Average Medical Costs (18-months maturity)

Return to work rates better among networks

The percentage of network injured employees who went back to work after their injury increased to 95 percent in 2020, an eight percent increase since 2011. The return-to-work rate for non-network injured employees declined slightly to 89 percent for the same timeframe.

Percentage of Injured Employees Who Reported That They Went Back to Work

Network claims report better mental and physical health outcomes than non-network claims

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.