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Related Links Delivers superior claims administration services and support with the highest level of personalized attention for your workers' compensation or liability needs A national workers' compensation pharmacy benefit management (PBM) company focused on reducing pharmacy costs and improving pharmacy related claim outcomes Professional Dynamics Incorporated A Utilization Review partner who has the philosophy of proactively and collaboratively managing medical treatment for your workers' compensation claims A specialty Managed Care company providing cost containment and Medical Provider Network (MPN) services for California employers About Athens Administrators Athens Administrators is a TPA for workers’ compensation and liability claims. We have successfully administered claims for more than 30 years. Our clients include public agencies, regional businesses, insurance companies and Fortune 500 companies. We provide workers’ compensation and liability claim administration services. For more information Northern California • Established 1976 Follow us
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Closing out 2011 2011 was an active year in the Risk Management arena. Some states, such as California, continue to make legislation changes that affect the way claims are handled and how employers are assessed. We have also seen some industry institutions provide some very significant insights on what are the driving costs behind a workers' compensation claim.
Workers' Compensation Pharmacy Costs In a report issued by NCCI report August of 2011, it noted that up through 2009, the average medical cost on a medical only claim was $6000. For a lost time claim, it averaged around $25,000 with about 19% of those costs being tied to prescriptions drugs. While 19% is significant, it does appear that an employer can potentially manage these costs by aggressively handling and resolving their workers' compensation claims in a proactive manner. We say this since the study showed that prescription costs within the first 1-2 years of the claim comprised only 3% of the total medical costs, but when the claim remained opened for more than 11 years, the costs tied to prescriptions jumped to 40%! You can view the full report here Workers' Compensation Prescription Drug Study: 2011 Update (PDF)
The Cost of Medical Services NCCI also issued a report in November of 2011 which highlighted the cost-drivers of certain medical services on a workers' compensation program. Nine areas were evaluated in their report and found that that the two highest categories were:
These two categories, on lost time claims, accounted for almost 40% of medical costs. Many more significant details are noted in the report (PDF), and knowing what these cost-drivers are may help you re-evaluate what your focus will be for your 2012 managed care program.
2011 WCIRB Report In a very detailed report issued by the WCIRB, it was noted that claim frequency appears to be fairly consistent with the reporting levels of 2010 for the first 9 months of 2011. It also anticipates that the average cost of a 2010 indemnity claim will be approximately $65,000, which is about 40% more since the full implementation of the 2005 California workers' compensation reforms. Of this $65,000, approximately $42,250 or 65% represents medical costs. Click HERE to view the summary reports provided by the WCIRB.
Legislative Review for 2011 California
Other Changes for 2012
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