Health care costs in the workers compensation system in Texas decreased 30% from 2012 to 2022, with the largest drop in pharmacy benefits at 71%, according to a report released Tuesday by the Texas Workers’ Compensation Research and Evaluation Group.
The state also saw the number of claims decrease 20% and the average cost per claim drop 12% over those 10 years, according to the report.
Accounting for the largest decrease, the total cost of pharmacy services decreased from $136 million in 2012 to $39 million in 2022. The number of claims receiving pharmacy services dropped 54% and the average cost of pharmacy services fell 38%.
Other reductions were seen across the board, with the total cost of professional and hospital/institutional services in 2022 24% lower than in 2012, using current prices, and 41% lower if adjusted for inflation. Total professional costs decreased 26%, and the number of claims receiving professional services decreased 19%.
Analysts concluded that the trends “are most likely a result of a decrease in the total number of claims, as well as the implementation of evidence-based treatment guidelines, the pharmacy formulary, and the increased usage of certified health care networks.”