G2TT
来源类型Report
规范类型报告
DOIhttps://doi.org/10.7249/RR1406
来源IDRR-1406-DIR
Physician Reporting Requirements for Injured Workers in California: A Review of Reporting Processes and Payment Policies
Denise D. Quigley; Molly Waymouth; Barbara O. Wynn
发表日期2017-12-19
出版年2017
页码105
语种英语
结论

There Are Several Opportunities to Streamline WC-Required Reports

  • There is a general consensus that the report should be required from the first physician who examines the patient following a work-related incident.
  • The elimination of the redundancies between the Primary Treating Physician's Progress Report (PR-2) and the Request for Authorization (RFA) represents another opportunity to reduce physicians' reporting burden.
  • Program efficiency could be increased through electronic reporting of all WC-required reports and documentation.
  • While electronic reporting has distinct advantages over the current system, it is important to recognize that physician practices providing services to WC patients have different levels of health information technology capabilities.

Intense Care Coordination Is Required Between the Primary Treating Physician and Any Secondary Physicians in Treating an Injured Worker and in Efficiently Gaining Needed Treatment

  • Requiring the primary treating physician to submit the reports facilitates care coordination, but there are downsides to this.
  • Primary treating physicians indicated that obtaining and compiling reports from secondary physicians was time consuming and can create delays in filing progress reports.
  • Requiring a secondary treating physician to submit the RFA raises an issue of whether the secondary physician should also file a PR-2.

The Fee Schedule Should Account for Reporting Burden Not Otherwise Incorporated into the Allowance for the Related Medical Care

  • Findings are mixed about the lack of an allowance for the Doctor's First Report of Occupational Injury or Illness (DFR).
  • PR-2 is undervalued relative to other services for comparable activities.
摘要

California's workers' compensation (WC) program provides medical care and wage-replacement benefits to workers who suffer on-the-job injuries and illnesses. Individuals who are injured on the job are entitled to receive the medical care they need to relieve the effects of their injury with no deductibles or copayments. Physicians who treat and provide care to injured workers are required to file reports with the WC payer that address the worker's treatment, medical progress, and work-related issues. California's Division of Workers' Compensation (DWC) asked the RAND Corporation to review the reporting process and pricing structure of the WC-required reports to ensure that the policies are consistent with efficient program administration. This report provides a framework for understanding the current processes for filing WC-required reports in California and establishes a baseline for comparison with other state systems. The objective of this report is to provide an assessment of WC-required reports, including the structure and content, level of effort, and allowances, and to compare the elements and processes with other systems to inform potential improvements and further refinements to California's reporting requirements and policies. The report should be of general interest to stakeholders in California's WC system and in other WC programs.

目录
  • Chapter One

    Introduction

  • Chapter Two

    Doctor's First Report of Occupational Injury or Illness

  • Chapter Three

    Primary Treating Physician Progress Report and Request for Authorization

  • Chapter Four

    Permanent and Stationary Report and Return-to-Work and Voucher Report

  • Chapter Five

    Allowances for Workers' Compensation–Required Reports Within the Resource-Based Relative Value System Context

  • Chapter Six

    Summary of Findings, Discussion, and Recommendations

  • Appendix A

    Methods

  • Appendix B

    Interview Protocol Guide for Stakeholder Interviews

  • Appendix C

    Interview Questions for Division of Workers' Compensation Staff for Environmental Scan

  • Appendix D

    Summary of Domains and Data Elements for California's Workers' Compensation–Required Reports

  • Appendix E

    Reporting Characteristics for California and the 20 Most Populous States, by Report

主题California ; Occupational Safety and Health ; Physicians ; Program Evaluation ; Return-to-Work Programs and Policies ; Workers' Compensation
URLhttps://www.rand.org/pubs/research_reports/RR1406.html
来源智库RAND Corporation (United States)
引用统计
资源类型智库出版物
条目标识符http://119.78.100.153/handle/2XGU8XDN/523461
推荐引用方式
GB/T 7714
Denise D. Quigley,Molly Waymouth,Barbara O. Wynn. Physician Reporting Requirements for Injured Workers in California: A Review of Reporting Processes and Payment Policies. 2017.
条目包含的文件
文件名称/大小 资源类型 版本类型 开放类型 使用许可
RAND_RR1406.pdf(743KB)智库出版物 限制开放CC BY-NC-SA浏览
1600181362668.jpg(5KB)智库出版物 限制开放CC BY-NC-SA缩略图
浏览
个性服务
推荐该条目
保存到收藏夹
导出为Endnote文件
谷歌学术
谷歌学术中相似的文章
[Denise D. Quigley]的文章
[Molly Waymouth]的文章
[Barbara O. Wynn]的文章
百度学术
百度学术中相似的文章
[Denise D. Quigley]的文章
[Molly Waymouth]的文章
[Barbara O. Wynn]的文章
必应学术
必应学术中相似的文章
[Denise D. Quigley]的文章
[Molly Waymouth]的文章
[Barbara O. Wynn]的文章
相关权益政策
暂无数据
收藏/分享
文件名: RAND_RR1406.pdf
格式: Adobe PDF
文件名: 1600181362668.jpg
格式: JPEG

除非特别说明,本系统中所有内容都受版权保护,并保留所有权利。