Jon Coppelman at Workers Comp Insider has written a thoughtful and incisive piece on the new WC market in West Virginia. The state had been (actually, until the middle of this year it still is) a monopolisitic state – employers had to buy their WC insurance from the state.
That’s changing to an open competitive market. The state WC fund, now known as Brickstreet, is going to be the largest carrier in WV for some time, but will inevitably lose market share as competition enters. Jon points out that managing that transition, while adequately serving the needs of existing policyholders, is going to be an incredibly complex and difficult job. Their customer base will shrink, making one of the first tasks of Brickstreet’s execs the management of staff reduction. While building a new agent service infrastructure, upgrading systems, and figuring out how to effectively compete – something they never had to worry about before.
Yikes.

If anyone can get workers comp reform addressed in New York, it’s new Goc. Eliot Spitzer (D). In a wide-ranging interview conducted yesterday by the Journal-News, Spitzer noted that work comp reform is at or near the top of his list of priorities.
Likely changes will include a cap on the duration of benefits for injured workers.

One of the potential side effects of the Concentra-First Health deal relates to Aetna’s workers comp network. Concentra is one of, if not the, largest customers for AWCA (Aetna acronym for their network). Concentra re-sells the Aetna network to its bill review customers; these deals may now be at risk.

Continue reading FirstHealth and Concentra – the impact on Aetna

Timing is everything; Coventry’s fourth quarter financials release came on the heels of the Concentra acquisition announcement, allowing the observer to compare results to prognostications.

Continue reading The Concentra – First Health deal: Coventry’s views

It looks like the Concentra workers comp deal is coming none too soon. In today’s earnings release, Coventry disclosed that subsidiary First Health’s revenues dropped for the second straight quarter to a two-year low of $49,175k.
This marks the seventh consecutive quarter of flat revenues for the big WC managed care provider.

As part of the Concentra acquisition, First Health will own a large field case management force. From all indications, Coventry (FH’s parent company) has wanted to get into the case management business for some time – it generates steady fees, as opposed to the ups and downs of Coventry’s core HMO business.
Well, they’re certainly in the case management business now. Concentra has hundreds of nurses and vocational rehab specialists located around the country who spend hours each week driving to attend office visits with work comp claimants, meeting with employers, and discussing cases with adjusters.
At least FH hopes they’re getting lots of windshield time. If they aren’t, they will be sitting around doing nothing while getting paid.

Continue reading UPDATE – The monster in the basement – case managers at First Health