Insight, analysis & opinion from Joe Paduda
So-called “specialty hospitals“, facilities typically owned by for-profit firms and/or practicing physicians, have been the subject of much debate by the Centers for Medicare and Medicaid Services (CMS). Now, it looks like CMS will continue their ban on new facilities … Continue reading Ambulatory Surgical Centers’ future
Read More...Gary Schwitzer has posted a quick item in his blog providing more detail about the financial benefits to physicians of “leasing” imaging services. For those who missed the article in the Wall Street Journal, Schwitzer’s blog has a link and … Continue reading More on cheating docs
Read More...The journal “Health Affairs” reports that medical inflation in 2003 was 7.7%, significantly less than the prior year’s 9.3% rate. However, the bad news is that the 7.7% was significantly higher than the rate of overall inflation, and the medical … Continue reading Health care spending stats
Read More...Three things. First, healthcare is a very complicated and complex business, nothing like Walmart’s core business Walmart’s culture, ethos, business practices, priorities, and people built a multi-gazillion dollar consumer business by TBH, beating the crap out of vendors to deliver really … Continue reading Walmart is shutting down its healthcare centers…which means…what?
Read More...A pending CMS rule may lead to major changes in the use of Prior Authorization, changes that would reverberate across all payers – Medicare, Medicaid, group health, Exchange plans and workers’ comp. Remember work comp is the flea on the … Continue reading Prior auth – are you flying blind?
Read More...RAND’s long-awaited research paper on Alternative Payment Models for California Workers’ Comp is out. It is…underwhelming, incomplete, doesn’t focus on key metrics, did not include actual examples of APMs in WC (of which there are many), makes inappropriate comparisons, and…I could … Continue reading RAND’s report on Alternative payment models in work comp…oh my…
Read More...Proving I never learn, we return to score how I did on my 2022 predictions for workers’ comp… a sneak peek inside Health Strategy Associates’ intergalactic HQ as the analytical team finalizes its prediction algorithm today we’ll look at the … Continue reading 2022 Predictions for workers’ comp – How’d I do?
Read More...After 15 years working with private equity firms looking to invest in workers’ comp service companies, I’ve learned a couple of things. Work comp is attractive primarily because it is viewed (accurately) as horribly inefficient, with admin expenses that are … Continue reading Private equity and work comp services…lessons learned
Read More...Two seemingly-unrelated new items hit my news feed – Kaiser Permanente lost over a billion dollars last quarter, and Amazon paid $3.9 billion to buy One Medical, a primary care company. Amazon is betting it can make primary care “work”, yet … Continue reading Amazon, Kaiser, and primary care
Read More...In addition to my focus on work comp medical management I’m deeply involved in governmental programs (Medicare/Medicaid/dual eligibles) and related businesses. Here’s a few things work comp would do well to understand/explore/pursue. Auto-adjudication of medical bills – the standard target … Continue reading Things work comp can/should learn
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