Calif. comp system sees drop in inpatient care

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The number of California workers compensation inpatient hospital stays fell 31.2% from 2008 to 2016, according to a study released Thursday by the California Workers Compensation Institute.

The Oakland, California-based institute compared the workers comp figures to those of other payer systems and found that comp outpaced programs such as Medicare and Medi-Cal in declines in inpatient care.

During the eight-year period, it found a 19.6% drop in hospital stays paid under private plans, a 2.4% increase in Medicare inpatient stays and a 19.6% increase in inpatient stays paid by low-income-eligible Medi-Cal, which saw a huge jump in enrollment with the rollout of Affordable Care Act plans, according to the data.

To measure and compare the use of inpatient services and procedures in the different systems, researchers analyzed discharge data compiled by the state Office of Statewide Health Planning and Development on more than 32 million inpatient hospital stays from 2008 to 2016, according to a press release.

Workers compensation is the smallest of the four medical delivery systems reviewed, accounting for just 0.5% of all inpatient stays in 2016, which the study notes is down from 0.7% in 2008, primarily due to a surge in Medi-Cal hospitalizations after 3.7 million adult Californians were added to the Medi-Cal rolls once the ACA plans became available in 2014, the release stated.

The study examined the comp system’s decline in hospital stays, finding a number of factors responsible: claim volume declined; use of ambulatory surgery centers increased; utilization review and independent medical review programs required that treatment requests meet evidence-based medicine standards; technological and procedural advances allowed more services to be provided in outpatient settings; and the number of spinal fusions fell by 36% after duplicate payments for spinal implant hardware were eliminated from the workers compensation inpatient fee schedule.

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