Thursday, March 29, 2012

TX DWC: A Missed Opportunity

Readers of this blog know that, in general, I'm a fan of the way Texas has begun to attack the issue of over-utilization of prescription narcotics.  In the past, I've written that the (relatively) new Texas Closed Formulary Rules represent "a rare example of effective formulation and implementation of public policy to begin addressing a major issue in the work comp space." 

But alas, Texas has missed a major opportunity to signal to the physician community that it's serious about fixing the opioid issue.  DWC has rejected the idea of including opioid prescriptions as part of the 2013 report card for physicians who treat injured workers in Texas.  It's not entirely clear why this is.  The measure had the support of the Insurance Council of Texas (which would be expected) but also had the support of the Texas Medical Association.  Insurers and doctors were both supportive, so it surpasses understanding why the DWC wouldn't take the logical step of measuring opioid prescriptions.

So what does the DWC measure on the "report card"?  Three metrics:
1) Timely filing and completeness of the return to work form (DWC-073)
2) Timely filing of the medical evaluation form (DWC-069)
3) Use of MRI in low-back injury cases

If my kids' report cards looked like this, I would likely only be able to tell that they made it to class on time and, perhaps, used a protractor correctly in geometry.  That's it.  Timeliness and the use of a single modality for a single diagnosis.  This offers very little insight into the quality of the actual care being rendered.

Until we start getting serious about measuring the quality of care being delivered in work comp, you can expect medical costs to continue the upward climb toward absurdity. 

On Twitter @PRIUM1

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