May Day catch-up

It’s a big day for we commie socialists; hope your International Workers’ Day is filled with tributes to the proletariat…

Workers’ comp

While the world was at RIMS, I was otherwise engaged. Heard from several folks that the MedRisk event was just incredible; a terrific party followed by a police-escorted parade thru the French Quarter complete with bands, jugglers, and all manner of entertainment. Kudos to MedRisk Marketing VP Rommy Blum and her stellar team; by all reports this was THE event at RIMS {and yes, MedRisk is a consulting client].

And thanks to Bob Wilson, Jonathan Mast, and Jen Jordan for the shout-out from RIMS; I know, I’m a loser for not coming…

Another research study indicates “Persons with non–cancer-related pain have an increased risk of fatal and nonfatal drug overdose related to treatment with opioid analgesics.”  [emphasis added] A great piece in Business Insurance by Sheena Harrison and Bill Keneally explains why this study should cause prescribers – and payers – to think even more carefully before prescribing/approving opioids for long-term users.

Coincidentally, CMS has released a huge database of prescriber information; accessible to anyone, the database provides:

For each prescriber and drug, the dataset includes the total number of prescriptions that were dispensed, which include original prescriptions and any refills, and the total drug cost.  The total drug cost includes the ingredient cost of the medication, dispensing fees, sales tax, and any applicable administration fees and is based on the amount paid by the Part D plan, Medicare beneficiary, government subsidies, and any other third-party payors.

For work comp payors, I could see analysts looking to see if physician prescribing patterns for Medicare are consistent – or inconsistent – with work comp prescribing patterns.

Found this item in WorkCompWire; according to an Align Networks exec, the “top challenge” Align is working on this year is education of nurse case managers and adjusters.  I guess the whole 59 modifier thing isn’t that big a deal…

Lockton’s Keith Rosenblum is referenced in another WorkCompWire story about mis-diagnoses and bad medical treatment.  Why mis-diagnosis occurs and the consequences thereof is laid out in a white paper available here.

I neglected to inform you, dear reader, of a brief-and-excellent take on ProPublica’s recent “reporting” on work comp by the estimable Mark Walls.  Next time someone confronts you with PP’s “reporting”, send them to Mark’s column.

Implementing health reform

In what is an amazingly timely follow on to my post earlier this week about the snake-bitten Florida Legislature, turns out hospitals in states that expanded Medicaid are doing a LOT better than facilities in states that haven’t.  If you’re wondering why Florida’s hospitals are screaming so loudly, there’s this:

Hospitals in non-expansion states actually saw a 9.4 percent decline in Medicaid revenue…

That’s a shipload of dollars.

Unsurprisingly, new research indicates the PPACA non-insurance penalty may be too low to drive much more enrollment.

Oops, gotta run! time to don my red kerchief and head down to the gathering area for today’s celebration of the working wo/man.  Hope to see you there!