Insight, analysis & opinion from Joe Paduda
If anyone can get workers comp reform addressed in New York, it’s new Goc. Eliot Spitzer (D). In a wide-ranging interview conducted yesterday by the Journal-News, Spitzer noted that work comp reform is at or near the top of his list of priorities.
Likely changes will include a cap on the duration of benefits for injured workers.
One of the potential side effects of the Concentra-First Health deal relates to Aetna’s workers comp network. Concentra is one of, if not the, largest customers for AWCA (Aetna acronym for their network). Concentra re-sells the Aetna network to its bill review customers; these deals may now be at risk.
Continue reading FirstHealth and Concentra – the impact on Aetna
Timing is everything; Coventry’s fourth quarter financials release came on the heels of the Concentra acquisition announcement, allowing the observer to compare results to prognostications.
Continue reading The Concentra – First Health deal: Coventry’s views
It looks like the Concentra workers comp deal is coming none too soon. In today’s earnings release, Coventry disclosed that subsidiary First Health’s revenues dropped for the second straight quarter to a two-year low of $49,175k.
This marks the seventh consecutive quarter of flat revenues for the big WC managed care provider.
As part of the Concentra acquisition, First Health will own a large field case management force. From all indications, Coventry (FH’s parent company) has wanted to get into the case management business for some time – it generates steady fees, as opposed to the ups and downs of Coventry’s core HMO business.
Well, they’re certainly in the case management business now. Concentra has hundreds of nurses and vocational rehab specialists located around the country who spend hours each week driving to attend office visits with work comp claimants, meeting with employers, and discussing cases with adjusters.
At least FH hopes they’re getting lots of windshield time. If they aren’t, they will be sitting around doing nothing while getting paid.
Continue reading UPDATE – The monster in the basement – case managers at First Health
Coventry has bought all the non-clinic operations of Concentra Inc. (with the apparent exception of Concentra Payment Systems) for $387 million in cash, making the deal worth about 1.2 times trailing 12 months’ revenue.
Here’s my take.
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 very expensive procedure.
If you want to know why the US health care system is so dysfunctional, I give you low back pain.
In a move designed to reassert control over the mechanisms of government, Pres. Bush recently signed an executive order requiring all regulatory directives be approved by political appointees. (registration required)
This will have a significant impact on occupational health initiatives, regulations, and enforcement.
MSC was sold last year to Monitor Clipper. Brazos invested in Cypress Care (a client). Genex was jsut sold to an investment firm, and another has bought up a big chunk of MSC’s debt. Injured Workers’ Pharmacy is on the block (and close to a deal), Bank of America is asking several hundred million for Third Party Solutions, and WorkingRx is for sale as well. Health Advocates was just purchased by PMSI/Tmesys, and P2P was recently sold to Fiserv. And execs at good managed care firms are besieged by investors seeking to “be helpful”.
Lots of smart money is looking hard at workers comp managed care and related services.
Why?
Genex, the work comp anaged care subsidiary of UNUMProvident, has been sold to an investment firm. Unum had had the company on the block for quite a while, so the transaction is not a surprise.