Value of care review.
Existing law establishes a workers’ compensation system, administered by the Administrative Director of the Division of Workers’ Compensation, that generally requires employers to secure the payment of workers’ compensation for injuries incurred by their employees that arise out of, and in the course of, employment. Existing law requires every employer to establish a utilization review process, as described, and establishes an independent medical review process to resolve disputes over a utilization review decision, as specified.
This bill would require the department to conduct a study on the viability of and regulatory steps that would be required to be taken to link health care reimbursement in workers’ compensation claims to the value of care provided to injured workers. The bill would require that study to include a discussion of the viability of developing and adopting an accountable care organization model to manage workers’ compensation claims. The bill would require the department to hold 5 stakeholder workshops to discuss the findings of the study and to post the findings of the study on its internet website.