from today’s WCRI conference
Inpatient hospital costs in MI increased by 13.3% from 02/03 – 04/05. Why?

Continue reading Michigan’s WC cases are paying lots more for hospital care

I’m attending the annual Workers Compensation Research Institute today and tomorrow and will be posting from the meeting.
The first presentation was an analysis of WC provider fee schedules, comparing the actual fee schedules to providers’ operating expenses. It will come as no surprise that some states’ fee schedules are pretty low, while others pay up to 2.5 times more than Medicare (alaska, for one).
No extra credit for guessing which type of service is paid at a higher rate; most fee schedules pay relatively more for surgery than for evaluation and management services.

Continue reading WCRI’s new workers comp medical price research

Coventry’s public statements and documents point to a possibility that the big managed care company will be looking to expand it’s workers comp offerings through acquiistion. The business, known to the cognoscenti as First Health Workers Comp, has made little progress since it was acquired by Coventry almost two years ago. FH is suffering from a lack of attention by Coventry senior management, flat revenues, and serious competition from Aetna and others.
While acquiring more WC entities may help FH, basic logic would indicate that before you add to a company, you ought to make sure the company you have is running smoothly.
Otherwise all you’re doing is putting lipstick on a pig.

Finding malfeasance, mismanagement, incompetence, or just plain fraud related to workers comp is pretty easy if you confine your search to Ohio. The latest comes from the Plain Dealer in a report on vocational rehab companies that have benefited enormously from their cozy relationships with managed care firms.

Continue reading More ohio nastiness

In one answer to the question, where did Ohio’s Workers Comp premiums go?, the answer is to a contractor building Tommy Noe’s house on Lake Erie.
Noe, the defendant in a criminal trial, is alleged to have used workers comp funds set aside as reserves to pay future claims to help pay for his 4200 square foot house on Lake Erie. And another one in the Florida Keys, both of which were worth a million bucks each.
If anyone has photos of these places, let me know.

Coventry announced their third quarter earnings this week, and much of the news was good. Health plans have been experiencing declining medical loss ratios and strong pricing, resulting in solid profiits and increasing revenues, and Coventry’s results mirror the industry.
Before diving into the FH WC business, a caveat. Coventry is a very well-managed company. They run a very solid business, understand the group health, HMO, and Medicare businesses better than most, and have consistently delivered excellent results.
But, while all is good in group health, Medicare and Medicaid land, the same can’t be said for the First Health workers comp business.

Continue reading First Health’s unfulfilled promise

Tommy Noe, the political fund raiser/rare coin investor/investment adviser to the State of Ohio’s bureau of workers compensation (BWC), ought to be teaching negotiation seminars in his next life – that’s after he gets out of the pokey.
The deal he negotiated with BWC is far better than any I’ve come across or heard about, According to the article, Noe’s deal prevented any future BWC administrators from reviewing or rejecting his deal, as he did not want them to interfere with his investment “strategy”.
As well they should have.