These are wild times for the workers comp managed care industry. With Aetna’s recent announcement that they are expanding their workers comp network into additional states, it appears the big health plan is becoming a serious competitor for network business. Sources indicate that the Hartford will be announcing expansion of their relationship with Aetna in the near future, with the business moving from First Health.
Liberty Mutual, the comp industry’s 800 pound gorilla, has yet to announce the results of their network selection process, an event that has many in the industry on the proverbial edge of their chair.
CorVel, which has been laying low, keeping under the radar after the adverse publicity from the Broward County School Board debacle is set to announce a major new business relationship; sources indicate it will pertain to provider networks. This announcement may come too late for one of their larger business relationships; the State of Florida is likely to go to bid for their managed care program in the near future.
Gallagher-Bassett has been revisiting their managed care vendor contracts, apparently (at least in part) to eliminate the referral, administrative, commission, and other fees that they have been receiving from the managed care vendors they work with.
First Health is still seeking a head for their workers comp unit; Aetna is as well. Meanwhile, Concentra’s takeover of Beech Street and Occupational Health and Rehab has made the company a more formidable competitor in the network and occ health clinic markets.
Changes to the Texas workers comp laws go into effect (realistically) on the first of the year, and national and regional players are scrambling to prepare. If California and Florida are any indicators, the first entities into the new programs will resemble pioneers – the settlers with the arrows in their backs. Kudos to them for their initiative, and credit to the “fast followers” for waiting a bit to watch how things shake out.
Meanwhile the private equity/venture capital world continues to buzz around managed care companies like bees around honey. There is a lot of attention being paid to these service providers; workers comp managed care is hot now among the investment community.
This is all playing out amidst the ongoing Spitzer/Blumenthal investigations into the insurance industry, sham bids, anti-competitive behavior, and outright fraud.
It all makes for a highly entertaining season.
What does this mean for you?
Significant change brings significant opportunity, along with big risks. Stay tuned; more changes are likely soon.
Oct
7
