The information every work comp professional needs is ready – the annual comparison of every state’s workers comp laws is available here.  Put together by the experts at WCRI and IAIABC, it includes laws for each of Canada’s provinces too.

Oh, and in case you missed it, you can still get WCRI’s compilation of state laws on treatment guidelines and medical management here.

From NCCI we get a report on the impact of changing workforce demographics on injury frequency. One major change from previous research – older workers are getting injured more often than their younger co-workers. That’s a significant change, and one we need to monitor carefully.

Sticking with work comp, CWCI released it’s analysis of the impact of California’s formulary  – more drugs that are “exempt” from review were prescribed, but that’s just one finding

If you want to know what your REAL cost of healthcare is, check out the Kaiser Family Foundation’s healthcare cost calculator. Plug in some basic information, and – spoiler alert – be shocked.

Finally, there’s much talk about Medicare for All, who supports what, and all that stuff. And, a majority of people in a Fox News “town hall” indicated they support MFA, surprising Bernie Sanders and his interviewers. Find out how much support there really is here.

And happy spring!

A few years back an acquaintance called me to ask for help finding a job; s/he’d been let go after a merger.

While we had known each other for some time professionally I’d always found him/her to be hard to reach, not responsive, and somewhat arrogant. When s/he needed something, the expectation was I – and no doubt others – would respond fully and immediately.

Now s/he was reaching out for help. And again the expectation was a full and immediate response.

I attempted to gently inform the person that they were in a different position now, and would make a lot more progress – and get a lot more help – if they handled things a little more diplomatically.  I won’t characterize the response, as I may have misinterpreted it.

I sort of understand this; as a buyer, the person was used to being accommodated – if not outright fawned over – by vendors eager to curry favor. The golden rule applied – S/he who has the gold rules.

As I think back on this, I recall being in meetings with this person where vendors were told to improve results. When those vendors attempted to meet his/her needs by suggesting program changes, IT connection improvements, or different communications procedures, the answer was always the same – we don’t have the resources to do that, that’s your responsibility, you figure it out.

The net is this.  Buyers do not help themselves by bossing potential vendors around, being unnecessarily difficult, demanding, unrealistic and dictatorial. And, often vendors can’t meet certain objectives unless the client pitches in as well. Sure, every payer has limits, resource restrictions, and budget constraints, but expecting a vendor to deliver data to your system seamlessly, consistently, and accurately while refusing to upgrade your technology to allow that is not only unrealistic, it is certain to fail.

That’s on the business side.

On the personal side, individuals who conduct themselves this way may well find things change when they no longer “have the gold”. Their calls go unanswered, references aren’t provided, job leads not shared.

What does this mean for you?

Many vendors have excellent ideas they’ve learned from working with other payers, ideas that can make your program more effective, efficient, impactful. Ask them what you can do to better work together.

And remember the real golden rule –

In a move that caught all Capitol Hill – and me – by surprise, President Trump and key Senators finalized the outline of the GOP’s new healthcare plan over the weekend.

Set to be announced later today, the plan builds off the faith-based “sharing” programs already in place in the ACA, greatly expands their reach, incentivizes employers to adopt faith-based coverage, and enables these programs to compete in the senior market. There are a half-dozen or so ministry/faith-based programs now in operation with total membership around the million mark.

Unlike regular insurance, members “share” the cost of care by paying into a central fund that then reimburses individuals for needed medical services.

Currently faith-based coverage is provided by entities including Liberty Healthshare, Christian Medi-Share, Samaritan Ministries, and Altrua Healthshare. As of today, these entities don’t have to provide the same level of benefits, coverage, or financial protection insurers do under the ACA. And, they are pretty much exempt from regulation as they aren’t “insurance” per se.

Faith-based sharing programs will compete with the big healthplans for members in the federal – and perhaps states’ – healthcare exchanges. The plans, which are much less expensive than “regular” health insurance, may well see huge gains in membership.

On ABC’s thisweek Sunday talkshow, Whitehouse Chief of Staff Mick Mulvaney  asserted the plan would deliver on the President’s promise to protect Americans with pre-existing conditions. “We’ve heard it over and over again, Americans trust their churches and ministers to do the right thing [which includes addressing pre-existing condition coverage]. So, we’re going to build off the amazingly successful faith-based programs now in place, expanding their reach and helping them compete in the free market.”

When asked how the new plan would maintain or expand the number of Americans covered by health insurance, Mulvaney didn’t get into any details other than claiming “faith-based programs will have much lower administrative costs as they don’t have all the overhead the big insurers do…this will make insurance much less expensive, which means more people can afford it.”

It appears Vice President Mike Pence has been strongly advocating for the faith-based approach for some months.  Evidently Pence, a self-described evangelical Christian, was prepared when the President publicly called for Republicans to be “the party of great healthcare” last week. The VP met with Trump, Mulvaney, and key Senators over the weekend and finalized the outline of the plan.

Mulvaney, who is one of the members of Trump’s team leading the charge on repealing Obamacare, said Sunday “There’s absolutely zero daylight between the president and vice president on this issue.”

Interviewed on CNN’s State of the Union yesterday, Mulvaney went further, describing the plan as fulfilling Senate Republicans’ request that the Administration provide them with “principles” that they could build a healthcare plan around.

Here’s the issue. Faith-based programs don’t have to keep a certain level of financial reserves, can deny payment for any reason, exclude any condition, and cancel coverage. And, in most states no regulator is watching over the programs.

Sure, this will make “coverage” cheaper, but there’s no guarantee it will be there when the buyers need it.

I’d expect this approach to face tough sledding in the Senate, and likely won’t be considered at all in the Democratic – controlled House. However, it’s likely Trump will try to do much of the heavy lifting via regulatory means and Executive Orders. However, these efforts will undoubtedly be challenged in court, where Trump has had a pretty poor record. I’d also expect the big healthplans will roll out their lobbying big guns.

But…the move further cements Trump’s standing with evangelical. As he’s clearly playing to his base to prep for the next election, it will serve him well.

What does this mean for you?

Just when you think you’ve heard it all…