2018 Network Report Card Demonstrates Improved System Performance

The Texas Workers’ Compensation Network Report Card was released by the Research and Oversight Group on October 1, 2018. Texas HCNs improved cost performance relative to Non-HCNs. Networks’ average medical cost fell by 19 percent, from $2,917.00 in report year 2010 to $2,356.00 in report year 2018.

Opioid prescriptions for Networks have been lower than Non-network since 2016. Networks’ average number of prescriptions for opioids fell from 2.57 per claim in 2011 to 2.00 in 2018, down by 22 percent.

The percentage of Network injured employees who went back to work after their injury increased by seven percentage points, from 87 percent in 2011 to 94 percent in 2018. The return-to-work rate for Non-network injured employees has remained relatively steady at 88 percent for the same timeframe.

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

• health care costs;
• utilization;
• satisfaction with care;
• access to care;
• return to work; and
• health outcomes.

In March 2006, TDI began certifying workers’ compensation networks. There are 29 networks covering 254 Texas counties that are certified to provide workers’ compensation healthcare services to insurance carriers as of June 1, 2018. Among the certified networks, 19 were treating injured employees as of May 31, 2017. Since the formation of the first network, a total of 918,681 injured employees have been treated in workers’ compensation networks.

Past years’ network report cards can be found at this link.