The future of networks (WC edition)
I met with quite a few managed care execs at RIMS, as well as several network vendors. There’s a disconnect between the two groups.
Read More...Insight, analysis & opinion from Joe Paduda
I met with quite a few managed care execs at RIMS, as well as several network vendors. There’s a disconnect between the two groups.
Read More...I’ve been following Bob Laszewski’s views on Medicare Advantage with some interest. My take is the program is about to embark on a financial bread-and-water diet, a regimen prescribed by the Democratic Congress seeking funds to offset physician reimbursement increases … Continue reading Those heartless Democrats
Read More...Big changes are coming to Medicare, changes that are going to dramatically effect health plans, providers, PBMs, and pharma. Medicare Advantage’s “bonus” payments are going to be cut significantly, Part D sponsors will likely see reductions in their payments from … Continue reading The stock market’s take on health care reform
Read More...Controversy over treatment types, overly generous payments to physicians to endorse a product, lawsuits alleging faulty research, the FDA under fire for inadequate evaluation, fights over reimbursement for a new procedure, and confusion over the usefulness of a common and … Continue reading my aching back
Read More...Elected officials considering health care reform would do well to adopt the “first, do no harm” rule. So far, they haven’t. Health care reform proposals circulating among the States run from the broad and all-encompassing (California) to the very narrow … Continue reading Misguided reform
Read More...Medicare Advantage subsidies will be cut, while Medicare will gain the ability to negotiate drug prices, albeit on a limited basis. Those are my predictions for legislation that will be passed early in January by Congress. The trick will be … Continue reading January on the Hill
Read More...A panel at the WCRI conference discussed the TX workers comp reform initiatives aka House Bill 7; here are my impressions in chronological order. The (relatively) new WC fee schedule, (new as of 8/2003), set reimbursement at Medicare +25%, and … Continue reading Texas’ WC reforms – predictions for the future
Read More...According to several providers in Florida, Aetna is recruiting physicians for its workers comp network while requesting discounts that are quite aggressive. I’m attending the Florida Workers Compensation Institute annual conference in Orlando, and spent much of Sunday moderating a … Continue reading Aetna’s Florida WC network
Read More...There’s been so much activity on the national health care scene involving managed care, medicare, provider reimbursement, consumer-directed health plans and Part D, I’ve neglected another loyal readership, the brave souls who toil in the workers comp managed care business. … Continue reading The latest on the work comp managed care world…
Read More...Physicians choose surgical implants and devices, hospitals order and pay for them, patients get whatever the docs choose, device manufacturers make lots of profits, and payers foot the bill. A process that is seemingly designed to completely avoid any price … Continue reading Surgical implants – who’s paying?
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