Anne Searcy, MD
Assoc. Exec. Medical Dir.
IMC releases results of workers' comp studies
SAN FRANCISCO - Two groundbreaking studies released by the Industrial Medical Council (IMC) reveal that in California, physician work and practice expenses for evaluation and management (E/M) services are higher for injured workers than for non-workers' compensation patients.
Reasons cited include determining causation, managing disability, facilitating return to work and meeting the workers' compensation reporting requirements.
The IMC studies were undertaken following the administrative director's proposal to adopt a resource-based relative value scale, known as the RBRVS, for California's workers' compensation medical treatment fee schedule. Physician work and practice expenses are components of the RBRVS relative values that can be adjusted for study results.
These projects are the first to assess adapting RBRVS E/M relative values for workers' compensation. They were designed and conducted by the Lewin Group, a national health care consulting firm recognized for its expertise in medical reimbursement issues. Power point presentations of the study results are available from the IMC.
The IMC oversees the medical aspects of the state workers' compensation system and is the medical resource for the Labor and Workforce Development Agency. These studies help fulfill one of the IMC's mandates: to assist the administrative director on issues affecting medical benefit delivery to injured workers.
The IMC also oversees the process by which injured workers obtain
the medical-legal evaluations that determine their benefits under workers'
compensation law. The Council promulgates guidelines for the treatment of
common industrial injuries and protocols for the evaluation of disability
in California. It also appoints and educates qualified medical evaluators,
the physicians who perform medical-legal evaluations. Its monthly meetings
are open to the public and held alternately in northern and southern California.
Information on IMC activities, guidelines and protocols is available
on its home page at www.dir.ca.gov/imc.
The E/M studies may be obtained by writing to the IMC at P.O. Box 8888, San
Francisco CA 94128, or calling (650) 737-2000. They are entitled "Practice
Expense Study of Evaluation and Management Services" and "The Relative
Work Content of Evaluation and Management Codes: The Physician Work Study."
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