Author: Joe Paduda

Oct
31

Complacency and arrogance – part 2

Posted by Joe Paduda on Monday, October 31st, 2022 | Comments

Last week’s post on Complacency and arrogance struck a chord with quite a few readers; some commented on on the post and/or LinkedIn while more chose instead to email me directly.

One question was raised by several of you; how does one guard against complacency and arrogance?

a few thoughts…

  1. survey your staff
    there’s an excellent piece in this morning’s Harvard Business Review on employee surveys. Key takeaways include:

    1. tell your staff you need and want their feedback/input/recommendations
    2. confirm that by a) let your staff know you value their input and appreciate their willingness to be honest; b) letting all know what you heard and what you plan to do about it; and c) show some self-awareness by letting them know you recognize one or more of your habits/tendencies that may be a challenge for them and want their perspective on how you can better work with them
    3. change what you do and how you do it based on staff feedback
  2. survey your customers
    1. ask what you can do better
    2. identify one thing they’d like you to do differently
    3. ask how you can make their interactions with your company easier/faster/more useful
  3. be self aware
    1. seek to better understand why you react/respond the way you do to criticism or disagreement. Are you defensive, aggressive, placid, dismissive, apologetic? Why? is it because you aren’t as self-confident as you’d like to be? Perhaps a bit over-confident and egotistic?
      The way you react speaks volumes about you – and will determine if your outreach is a success or another nail in your coffin.
  4. Don’t talk – listen.
    No one cares about you, your company, your story, your successes – and the more you blather on, the less they care.
    Until you’ve convinced the audience you understand their need/wants/problems/fears and can help solve them. Ask questions, and follow-up questions, and more questions. Listen hard. Repeat what they’ve told you “If I heard you correctly, you said XXX is limiting your ability to do YYY…Did I get this right? Ok…what have you tried to do to address that? What’s worked, what hasn’t, and why?
    for more on this – here’s a post from 11 (gulp) years ago…

OR, hey, just ignore doubters and staff and customers…

What does this mean for you?

If that little inside voice is bugging you, you’d best listen…and listen. hard. 

Oct
28

Complacency and arrogance

Posted by Joe Paduda on Friday, October 28th, 2022 | Comments

Reading your own press clippings.

Belittling competitors.

Overweening self-confidence.

All are all too common when companies are succeeding, growing and taking marketshare. Everything is going well and senior leadership is blissfully confident that it always will. Any hint of a shadow on the horizon is rapidly dismissed as insignificant, unimportant, and nothing to be concerned about. After all, everything we do is well thought-out, smart, and insightful, if not outright brilliant.

Internal dissent, contrasting opinions and concerns about troubling indicators are quickly dismissed. After all, things are going so well, those can’t be right. Nah…that negativity is just the product of jealousy…feeble efforts by detractors unable to compete in the marketplace or staff unable to grasp how smart the C-Suite is.

You gotta see the new product/service we developed…it’s a game-changer, a big leap forward, way better than our erstwhile competitors! How do we know? Well because we built it…and everything we touch turns to gold.

But wait, what about continuing to improve our core product, enhance our service, incrementally get better? That’s where most of our revenue comes from, what made us successful and built our stellar reputation…

Sure of course yeah let’s do that…but look at this shiny object!
this webinar! This industry award! This way-better-than-anyone-else-has product! This brochure that features a big picture of…me! This interview in (insert media outlet)!

This is all too common in the world of work comp services. As in sports, business, entertainment and politics, leaders that focus on themselves, their successes, their brilliance – and fail to focus on continuing to do what made them successful in the first place – will inevitably fail.

Success is not about you, your social media followers, your past successes, resume, or brilliant ideas.  It certainly isn’t about how much better you are than your competitors…or rather how much better YOU think you are.

Success is about nurturing customers, listening hard to them, seeking to understand what they want, why they want it, and how they want it. It’s about making damn sure the people who pay your bills – your customers – know you are 100% focused on them.

what does this mean for you?

1. if you are darn sure you’re really good and all is well…it isn’t.

2. It’s not about you  it’s about your customers.

 

 

Oct
21

Leaving Las Vegas

Posted by Joe Paduda on Friday, October 21st, 2022 | Comments

After 2 1/2 days of nonstop meetings, change encounters, and talks, it is a relief to be heading out.

What was notable

Loved the way the conference planners set up the sessions in “rooms” surrounding the exhibit hall. Exhibitor attendance has been…declining for some time, with exhibitors rightly bemoaning the lack of traffic.

This generated more traffic – as did locating lunches and beverage consumption opportunities.

Newbies – lots of tech-focused entities on the floor this year. I’m not sure they all entirely understood their value proposition, what drives workers’ comp buyers, and exactly how they fit it. But hey, great to have them and their cool stuff on the floor.

Coolest premium – myMatrixx’ charger. Now, I didn’t spend a lot of time trolling for freebies – but this was far and away the best I saw. (disclosure – mM is a consulting client)

Biggest disappointment

Attendance at the session on impact of climate change on workers’ comp.

Aren’t you paying attention?

Every day there is more news about floods, fires, droughts, blazing heat and devastating storms – all of which have direct and major import for work comp.

And more regulations about heat exposure, polluted air, and employee safety.

And more discussion of unforeseen impacts of climate-change driven weather – from flesh-eating bacteria in the swampy waters inundating Florida communities to new regulations addressing exposure to smoke-filled air in western states.

Two claims professionals all-too familiar with hurricanes, floods, and wind (Jill Leonard of LWCC) and fires, heat, and drought (Jeff Rush of California Joint Powers) spent a ton of time preparing to help you handle what is coming. They know all about preparation, planning, the impact on injured workers (where’s my check!!?), dealing with new “employers” that flood an area after a hurricane, and all the things you can only learn from decades of experience.

As Jeff noted, Mother Nature doesn’t care about your opinions on human-caused climate change.

But your boss sure will when the stuff hits the fan and you aren’t ready.

 

Oct
17

National Work Comp conference – go time…

Posted by Joe Paduda on Monday, October 17th, 2022 | Comments

The annual gathering of the work comp tribes begins tomorrow – here’s a few thoughts from a post a few years back.

1.  Realize you can’t be everywhere and do everything. Prioritize.

2.  Leave time for last-minute meetings and the inevitable chance encounters with old friends and colleagues.

3.  Unless you have a photographic memory, use your smartphone to take voice notes from each meeting – right after you’re done – or write down key points immediately.  Otherwise they’ll all run together and you’ll never remember what you committed to.

4.  Get the app for your Droid or iPhone –  you got an email with the info…It has the schedule, exhibit hall layout, local map, and a bunch of other handy information and tools.

5.  Introduce yourself to a dozen people you’ve never met.  This business is all about relationships and networking, and no better place to do that than this conference.

6.  Wear comfortable shoes, get your exercise in, and be professional and polished.  It’s a long three days, and you’re always ‘on’.

7. Remember what your mom told you in high school…nothing good ever happens after 10 o’clock. 

This year I’ll be (mostly moderating) two sessions – one on fraud with my good friend Bill Barbato of Change Healthcare and SA Jefferson Grace of the FBI’s Las Vegas office, and

another on the impact of climate change on workers’ comp with Jill Leonard of LWCC and Jeff Rush of California Joint Powers. Hope to see you there.

Stop by the AppliedVR booth – it’s 769 right across from the networking zone – I’ll be there a good bit.

Finally, in these day of YouTube, phone cameras, Twitter, Instachat and SnapGram, what you do is public knowledge.  That slick dance move or intense conversation with a private equity exec just might re-appear – to your dismay.

And beware white man’s overbite…

Oct
17

Defining health plan value – what’s really important

Posted by Joe Paduda on Monday, October 17th, 2022 | Comments

If your health plan could show it:

  • reduced the days kids stayed home from school due to illness;
  • helped members with mental health conditions maintain a high level of functionality and engagement;
  • reduced workdays lost due to illness;
  • sped recovery from illness and injury; and
  • helped amateur athletes avoid injury and recover quickly;

would that be important?

Heck yes.

So…why don’t healthplans do that?

It’s doable – if they stopped focusing on and worrying so much about star ratings and patient experience and net promoter scores – which research shows consumers don’t really pay attention to or care about –

(conclusion – no.)

and focused on what consumers really care about – staying healthy and able to do the things we want to do:

  • play with our kids and grandkids
  • do chores around the home
  • do our sports
  • shovel our walks, rake leaves, coach youth sports
  • lift stuff and move it around
  • got to the bathroom without help
  • dress and undress without help
  • go for a walk
  • oh, and work.

What’s even more puzzling is why employers don’t demand health plans complete on the basis of delivering fully functional, engaged workers.

What does this mean for you?

The most important component of any organization is its workers.

No employers hold their health plans accountable for ensuring those workers can actually, you know, work.

And that is why our healthcare system is so dysfunctional, ineffective, and expensive.

Oct
12

How we measure “value” in healthcare is all wrong.

Posted by Joe Paduda on Wednesday, October 12th, 2022 | Comments

The most popular formula for calculating the “value” of healthcare is pretty simple…

If you want to get a bit deeper into details, there’s this…

It’s about the “quality” of the medical procedure (was it done right? was the patient re-admitted? was there a surgical error or infection), perhaps the appropriateness of that procedure, and the “patient experience” – measured…somehow.

Pretty much every formula, discussion, or description of the healthcare value equation is focused on “outcomes” defined as the result of a surgery or treatment (did the patient get better?) or avoidance of sickness or injury (did the patient stay “healthy”).

None – as in none – focus on what’s really important to you and me –

Did the healthcare we received maintain/improve our ability to function – to raise our kids, work, exercise, function in society, do things we like to/have to do.

Functionality is the only “value” metric that matters, yet pretty much no one in healthcare and no healthcare organization – except in workers’ comp – talks about functionality, measures their results based on functionality, reports member functionality, studies it or seeks to improve overall member functionality as a core goal (except for a few unique healthplans).

Further, employers, who pay hundreds of billions of dollars on healthcare insurance premiums don’t even think about the impact of that healthcare on employee functionality/productivity.

Why?

Procurement, CFOs, finance departments and management are constantly challenged to show a return on investment on any project, hire, new initiative, acquisition or investment.

But never when they are buying healthcare – which, after payroll, is the biggest single part of the budget for most service companies and a major cost for every type of employer – public, private, not-for-profit.

Nope, it’s the thickness of the provider directory, whether or not some health system is in that directory, perhaps some “quality” rating, plus the biggie – cost.

What does this mean for you?

We are buying healthcare all wrong.

Oct
11

The problem with primary care?

Posted by Joe Paduda on Tuesday, October 11th, 2022 | Comments

It doesn’t generate profits for the medical-industrial complex.

From a societal perspective primary care is wildly undervalued – and wildly under-appreciated – because primary care doesn’t make money for anyone, especially primary care providers.

Which makes no sense on every front but the profit one. If everyone had good primary care,

  • they’d be healthier,
  • their health risks would be identified early and a plan developed to address them,
  • they’d have a provider who treats them as a whole person, who understands that we are a bunch of tightly-interrelated organ systems that have to be considered as a whole, not as individual organs,
  • they’d understand non-physical issues can be just as impactful as physical ones,
  • there’d be a lot less need for specialists, and
  • healthcare costs would likely be a lot lower.

Healthier people don’t need as many medications, devices, treatments, injections, therapies, surgeries, rehab, inpatient beds or surgical centers as unhealthy people.

And that’s where the money is.

Kaiser Permanente has generally excellent primary care – yet it can’t/hasn’t been able to translate that excellence into a sustainable competitive advantage.

I believe that’s because KP – and pretty much everyone else – is thinking about the “value” of healthcare the wrong way.

Tomorrow – how we define value today – and why that is wrong.

Oct
10

Private health insurance – can it be fixed?

Posted by Joe Paduda on Monday, October 10th, 2022 | Comments

I’ve been thinking long and hard about why our health insurance and healthcare systems are such a clustermess. Hugely costly, lamentable outcomes, a morass of bureaucracy, red tape and stupid rules enriching a few and impoverishing many.

So, I think I have a solution – and it involves workers’ comp.

First, the problem.

Today I’m reprising a post from a couple years back – if anything it is more accurate today than it was way back then.

If you had “government” health insurance for the last decade, your costs would be 20 – 25% lower today.

That’s because private insurers have not controlled spending nearly as well as Medicare and Medicaid have.  This from KFN via Axios.

Doesn’t matter what your economic or political ideology is – that’s a fact.

You and your insurance company pay your doctors and hospital more than twice what Medicare does. Yes, the Feds can exert pricing power – but why can’t United Healthcare, or Aetna, or Blue Cross?

Those healthcare giants should be able to negotiate better deals with providers; they have massive buying power and millions of members to leverage. They should be able to use that power to give you lower insurance costs – but they can’t.

Those private insurers are (theoretically) more nimble, smarter, better run, and more efficient than the government. And they have hundreds of billions of healthcare dollars to leverage.

Yet they’ve failed to outperform a bunch of bureaucrats.

I won’t dive into the “whys” today, because that would take away from the over-arching truth – government has been much more effective than private insurers.

What does this mean for you?

Cutting your health insurance costs by a quarter = more dollars you could have spent on other stuff.

note – happy to hear other thoughts; please use citations to back up any assertions.

Oct
6

Work comp drug spend – profiteering rampant in LA FL and PA

Posted by Joe Paduda on Thursday, October 6th, 2022 | Comments

WCRI’s webinar on interstate variations in drug payments reminds us that lax regulations and absent legislators cost taxpayers and employers millions.

Slides are here – and are free to access. The report itself is here – available free to members and a nominal fee for non-members.

There’s a ten-fold variation across the 28 states studied by WCRI, with WI MN and MA around $22 in quarterly drug spend per claim, but LA and FL right around $200. A far higher percentage of claimants get scripts in the two high-spend states than in those on the lower end – and I’ll bet most of those are from dispensing physicians and attorney-represented workers using mail-order pharmacies.

WCRI looked at data from non-COVID claims less than 3 years old in 28 states from Q1 2018 to Q1 2021.

Top takeaway – overall quarterly drug payments dropped from $102 in Q1 2015 to $68 in Q1 2021 – but PA FL and CT – states with physician dispensing and/or mail order pharmacy problems – actually saw an increase – and that increase was largely driven by dermatological agents.

Want more evidence of the rampant profiteering enabled by lax regulations and compromised legislators?

  • Dermatological payments account for about 20% of payments in the median state – although there’s a wide variation, from 6% in the lowest state to over half (52%) of payments in the highest state.
  • These dermatological agents are almost always combos of lidocaine, menthol, diclofenac sodium and other generics – profiteers mix ’em up and bill at a huge markup.
  • PA is especially egregious – the vast majority of these dermatologicals are pharmacy-dispensed, and the average price paid was over $300.
  • Physician dispensed drugs accounted for more than half of drug costs in several states including Florida
  • It’s not just dermatologicals…California saw a big jump in NSAIDS driven by fenoprofen and ketoprofen…both questionable medications that have become darlings of the physician dispensing/mail order profiteers.

There’s good news too…after dermos, NSAIDs have the next highest payment across all drug groups at 18%…while opioids account for about 7% in the median states – way down from 13% in the same quarter three years ago.

I’d note that this is for claims <3 years old, and likely reflects the successful effort to avoid prescribing opioids to patients better served by other therapies.

What does this mean for you?

PA FL LA and CT  – stop screwing employers and taxpayers.

 

 

Oct
5

You have to go

Posted by Joe Paduda on Wednesday, October 5th, 2022 | Comments

to comp laude.

It’s unlike any other work comp conference – it is focused on what people and organizations are doing right, the right way – and the impact that has on the people we serve – injured workers.

There are some pretty emotional moments…injured workers sharing their stories about horrific accidents and their months if not years of recovery. One came from Brance Tully, a young man of eighteen who fell through a skylight two years ago – when he was 16.

After dozens of surgeries, untold hours of therapy and what could have only been an incredibly painful and seemingly-interminable journey, he is back at work. He called his adjuster the day he returned to be met with incredulity – justifiably so.

That was just one. Injured workers recovered from shootings, fires, vehicle accidents, falls and all manner of accidents.

There are several other reasons to attend:

  • plenty of time to connect and network
  • solid attendee list with folks from large employers, payers, and other buyers
  • terrific location – the Pasea Hotel is pretty nice.

Kudos to Yvonne Guibert – a dear friend and colleague, and the best marketer in workers comp – for making this happen. Shout out to GB and Greg McKenna – his engagement with the “stories” folks are remarkable.