Last week’s Diabolical Discounts revealed that the City of Long Beach paid a doctor just over $32 to treat an injured municipal employee. The article provoked outrage–and comparisons to other trades that earn far more than physicians.

Long Beach slashed the orthopedist’s pay using a tangle of Preferred Provider Organization (PPO) discounts, prompting one reader to note:

“Even plumber charges 400/-$ for only evaluation in 15 minutes in Bay Area. We should start plumbing company and not [have] to pay malpractice insurance.”

While daisyNews can’t confirm Bay Area plumbing rates, we can confirm that Long Beach pays interpreters significantly more than doctors. As another reader put it:  (emphasis ours):

“I find it appalling that a doctor is paid only $32.08 for a medical visit. Yet if an interpreter was present the interpreter would be paid $180.00. Maybe we should tell our children to grow up to be an interpreter rather than a doctor.”

This comment is not hypothetical. In two real cases, Long Beach paid an interpreter more than four times what it paid a treating physician.

California allows private equity-backed Third-Party Administrators, bill review companies, PPOs, and other middleperson entities to make treating injured workers the worst financial option for a California doctor.

Long Beach Pays CA Interpreter Over 4X Doctor’s Rate

The screenshot below from daisyBill displays Long Beach's payments to a California interpreter who provided language translation for an injured employee.

For four dates of service, Long Beach paid the interpreter a total of $1,500, which averages out to $375 for each visit.

For comparison, see the screenshot below for a different injury, this time displaying Long Beach’s payments to the treating physician.

Long Beach paid the doctor $733.14 for this injury over nine office visits.

This averages out to $81.46—less than 25% of what Long Beach paid the interpreter per visit in the previous example.

According to California’s Official Medical Fee Schedule (OMFS), Long Beach should have reimbursed the physician $1,889.29. Instead, the city paid just 39% of what was owed, citing the following eight PPO contracts to justify the drastic cuts:

• Anthem
• CareWorks
• CorCare (CorVel)
• Coventry
• HealthSmart
• MultiPlan
• Networks by Design
• Prime Health Services

This kind of PPO discount stacking renders the OMFS meaningless and lets Long Beach slash payments to doctors with impunity.

At these rates, suggesting kids grow up to be interpreters—or plumbers—instead of physicians doesn’t seem all that far-fetched.

Why Doctors Ditch Comp

Interpreters deserve every cent of the correct fee schedule rates for making injured workers’ treatment possible (and we encourage them to fight for it). However, something is wrong when orthopedists earn far less than interpreters for their respective roles.

As more and more practices close their doors to injured workers, California has to address the fact that a perfect storm of financial threats is making it financially untenable for providers to take on workers’ comp patients:

• Rampant claims administrator non-compliance with payment laws and regulations
• PPO and other network discount structures fund private equity profits
• Complete and utter inaction by the California Division of Workers’ Compensation to protect providers

While these doctors may not switch to interpreting or plumbing, they can treat private insurance and Medicare patients instead.

With the CA DWC permanently out to lunch, California will need an extraordinarily talented plumber to address the “doctor drain” currently pulling providers out of this broken system.

Know exactly what your practice should be paid for treating injured workers. Get the daisyWizard’s Fee Schedule Calculator for just $49/month. Click below to try it free.

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