The California Workers’ Compensation Insurance Rating Bureau (WCIRB) released its 2024 State of the System report, highlighting key metrics of the workers’ comp system, including trends in medical care.

The report found that average medical costs are increasing due to longer claim durations post-pandemic and inflationary updates to medical fee schedules, with projected modest increases through 2026.

Pharmaceutical costs decreased 88% since 2012, with a slight increase in 2020, but they are returning to pre-pandemic levels and have continued to decline in 2022 and 2023.

HCPCS service costs per claim have been stable since 2012, but they increased due to the pandemic and inflation, particularly for DME, home health, and interpreter services.

Average medical cost per indemnity claim remains 30% above the median state.

In 2023, out of the $4.6 billion paid for medical benefits, 27% went to physicians, 6% to medical supplies and equipment, 1% to pharmaceuticals, and 11% to inpatient and outpatient services.

Medical service transactions per claim decreased by 34% since 2012, due to SB 863, fewer hospitalizations, and reduced pharmaceutical use.