Here in no particular order is a list of concerns/issues/problems that have recently come up in conversations with work comp insurers large and small.
1. Repackaging and physician dispensing of drugs – I’m still getting calls from payers (first came right after my post a couple weeks back); about this issue. Physician dispensing in itself isn’t so much the problem as the potential for much higher prices when a repackaged bunch of pills is billed at some multiple over the cost for a similar non-repackaged drug.
2. Too much utilization review and not enough utilization control – there’s a growing awareness that much if not most of the precert and concurrent review is little more than a rubber stamp followed quickly by a bill. UR has to – absolutely has to – deliver more value.
3. Claim counts are increasing ever so slightly. The trend has been up for a few months; it’s not yet a trend but if it keeps up for a couple more months we may be out of the proverbial woods.
4. The competition appears to be a little less brutal than a few months back. (An unscientific sample set of) agents report more consistency in rates across the board. While there are still some of those ‘they quoted what?’ incidents, they are fewer and further between.
Sep
17
