Insight, analysis & opinion from Joe Paduda
For we policy types, one of the most important provisions in the stimulus bill, aka the American Recovery and Reinvestment Act, addressed comparative effectiveness research. Alas, the $1.1 billion+ invested in transforming medicine from art to science has been fed … Continue reading Comparative effectiveness – what’s left after the sausage-making process
Read More...Because they allowed workers comp and national accounts to dictate provider contracting strategies, a decision that drove up the core group business’ medical loss ratio. Here’s how. The beginning of the tough times for Coventry came last spring. Up till … Continue reading Why did Coventry’s medical loss ratio increase?
Read More...Horrors! Those big-government Democrats are at it already, actually trying to get taxpayers to fund medical effectiveness research! How dare the government actually fund research. The nerve! The gall! The (sputter sputter) utter brazenosity! (I know it’s not a word … Continue reading The horrors of effectiveness research
Read More...South Carolina* is a great example of what happens when hospitals are financially incentivized to treat workers comp claimants. Costs go up dramatically, and – surprise! premiums quickly follow. That hasn’t stopped Florida from merrily marching off the cliff. But … Continue reading Why is Minnesota increasing work comp hospital costs?
Read More...FierceHealthcare reported last week that Aetna paid $20 million to settle charges related to its use of the Ingenix UCR database (their term is MDR). There will likely be announcements from other health plans of their settlement amounts; expect them … Continue reading The Ingenix settlement and physician income
Read More...Much against my better judgment, here are my predictions – in no particular order – for the work comp managed care world in 2009. 1. Coventry will be acquired. Currently trading just under $15 per share, Coventry Health looks to … Continue reading Predictions for Comp managed care in 2009
Read More...As the options on the table become somewhat more clear, it appears all but inevitable that any national health reform program will include a public insurance option, sometimes labled as “Medicare for All”. The plans offered by Pres. Elect Obama … Continue reading What are health insurers afraid of?
Read More...I’ve been rather negative about the chances we’ll see major health care reform next year. That doesn’t mean the new Congress and President won’t address significant issues – expect major efforts to change physician reimbursement, enable HHS Sec-to-be Daschle to … Continue reading Health reform – Pollyannas v Reality
Read More...While I and a few thousand other industry folks have been conferring in Las Vegas, the world (most inconveniently I would add) has been marching forward without us. In Florida, it looks their progress is headed right for the edge … Continue reading Florida – the end of the happy times
Read More...Once again the fall is here, which means it is time for the Workers Compensation Research Institute’s annual meeting (today and tomorrow in Boston) and the National Workers Comp and Disability meeting (next week in Las Vegas). Today’s kickoff began … Continue reading WCRI – Practice pattern variations in workers comp
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