Workers' Comp Grades Physicians

If you treat workers' compensation patients, you may soon get a letter telling you that you have been selected for the workers' compensation system's Performance-Based Oversight Regulatory System. Physicians reviewed by the program will be designated as high, average, or poor performers. The ratings will be made public on the Texas Department of Insurance Division of Workers' Compensation (TDI-DWC) website.

TMA and the Texas Osteopathic Medical Association (TOMA) have serious concerns about the survey.

A TDI-DWC notice  [PDF] explains the program and includes Attachment A, which lists the names of the physicians selected for the survey.

In a letter to physicians, TMA and TOMA point out that in the 2009 survey almost 80 percent of providers were rated as poor performers based on criteria established by TDI-DWC. The letter says TMA and TOMA believe the results from the 2009 assessment "did not accurately and fairly reflect the true performance of Texas physicians even though the measurement was based only on administrative criteria. Therefore, while both TMA and TOMA have actively worked with DWC to create 2011 assessment criteria that would more fairly and accurately reflect the true performance of Texas physicians, you should note that for the first time a clinical performance measure will be used as one of the criteria."

For more information, call the TDI-DWC staff at (512) 804-4770 or (512) 804-4712, or e-mail You may also contact Warren Cooper, TMA's director of health care delivery systems, at (800) 880-1300, ext. 1409, or (512) 370-1409, or e-mail  Warren Cooper.


Action , July 1, 2010