I wanted to do a post on all the things work-related I’m thankful for – but there aren’t enough pixels to include them all. So, here are the top few.

Most of the people in the work comp industry are committed to doing the right thing. Whether it’s getting injured workers the best care possible along with their indemnity checks, paying good docs fast and well, or helping employers lower their costs and increase productivity, the folks who do the work (mostly) do it well and diligently.

I’d like to single out a few organizations, jobs, and people:

• Medical directors are a way under-appreciated force for good. Payers need to use them more effectively, elevate their importance and give them more responsibility.
• The workers in the trenches – case managers, adjusters, bill processors. You are the “sharp point of the spear”, where all those brilliant ideas from home office end up in your work flow along with every other to-do.  How you manage we’ll never know.
• Research organizations – specifically CWCI and WCRI, and the leaders thereof.  Rick Victor has remade WCRI into a more relevant, proactive, insight-delivering organization that uses social media quite effectively; his replacement at WCRI has enormous shoes to fill.  CWCI’s Alex Swedlow is brilliantly effective; a great speaker, Alex and his team are able to get more relevant research done faster than humanly possible, and present it in a way that demands attention.
• Bob Wilson of workerscompensation.com.  Bob’s coverage of Plotkin-Gate is one of the best examples of what social media can do and how effective it can be. We don’t agree on much anything politically, but we both agree Bob’s efforts have been a major force for good. Actually Bob probably thinks they’re even better than that…
• The American Insurance Association, and especially Bruce Wood and Leigh Ann Pusey.  AIA’s leadership on critical issues, tireless advocacy, and commitment to doing the right thing for employers and injured workers has deeply impressed me. These are very good people.
• The new crop of entrepreneurs and the companies they are running are shaking up the industry, finding under-served or poorly-served niches and fighting for business.  Whether run by newbies or veterans of other successful start-ups many of these new entrants are making a mark.
• The work comp PBM industry.  Sure, I’m biased, as I run a trade group for PBMs – that also gives me a very good view into the business.  There’s no other segment of the industry that has been as effective in its core responsibility – delivering the right medical care at the best price to the most injured workers.  Across the industry customer service satisfaction is high, costs continue to decline, access continues to be a non-issue, and the quality of care improves with tighter controls on dangerous and inappropriate drugs.
• Finally, the 5706 subscribers to ManagedCareMatters.com.  I deeply appreciate your readership, comments, views and contributions.  Even when I don’t agree.

Enjoy the holiday.  You’ve earned it!

Quick takes from the blur that was NWCDC.

MedRisk’s Restore presentation was sitting-room-only; the company’s new venture is a comprehensive approach to managing delayed RTW – Restore targets all factors including psychosocial issues and involves comprehensive physical therapy, opioid-withdrawal management, and delayed recovery treatment.  (yes, MedRisk is a client)

Heard former Coventry CEO David Young is back in the game as CFO of a new venture with an old name – Occusystem.  No details available yet…

Speaking of Coventry, stopped into their booth yesterday to say hello.  Learned that their perspective on the move of AIG’s bill review business – and pending move of Liberty’s – is (surprise!) different from mine.  They noted that Coventry had informed both parties a couple years back that they would no longer be in the BR application business, therefore they took issue with my statement that they’d “lost” the business. I suggested that if the business was no longer their’s, then they had indeed “lost” it. Rather than argue semantics, I’ll report.  You decide.

Spoke with several investment types about Coventry’s possible re-emergence on the auction table.  As I’ve said ad nauseum, it’s value is the network, which is declining in effectiveness/size/discounts; the re-contracting effort is going to take a long time, and there’s not much else of value. (no, Coventry is not a client)

HealtheSystems has added Johns Eastern as a PBM client- word is things are going well.

Had a great time jousting with Bob Wilson, Becki Shafer, and David DePaolo at the bloggers’ roundtable.  Was hoping for a bit more “Jane you ignorant slut” and a bit less “I agree with…”

Caught up with Foresight Medical – they’ve engineered a pretty interesting surgical implant solution that is gaining traction.  Working with Broadspire and Medata, so they’ve already gone thru the virtual endoscopy.  (no they are not a client)

Ascential Care is growing fast.  Adding clients and getting more business from old ones, thanks to a focus on quality that’s like no other CM firm I’ve ever seen. The case management company also has one of the best websites in the business – and those people are actual AC folks. (no, they’re not a client either)

Finally, had a great session with three private equity executives.  Can’t thank Camilo Horvilleur, Jeff McKibben, and Hunter Philbrick enough – as the brains and dollars behind deals involving PMSI, MSC, OneCall, Align, Sedgwick, Mitchell, and many other work comp companies, this was a rare opportunity to hear about the process, understand what investors look for, get their views on leadership, management, and execution, and find out where they think the market is going.

Hope the conference was blindingly successful for you. Unless you were that ass in the elevator.  

The work comp services market is bifurcating. The big are getting (much) bigger, the $100-$250 million companies morphing into giants as they merge together or are acquired by private equity backed firms.

Meanwhile a whole host of new entrants are appearing – more on that in a minute.

Much of this has been rather mysterious to most. A good bit of light will be shed on the big-getting-bigger phenomenon today in a session at the NWCDC. I’ll be moderating a panel of three eminent investment executives tasked with explaining the whys and hows and whats; it kicks off at 10:45. Don’t be late as this is going to be very popular.

One of the key topics will be the factors that make some of the newly-constructed companies succeed while others don’t. There are a couple firms that provide real-world examples…

Back to the little gals and guys. I lead with gals because women seem to be inordinately represented among the CEO ranks of these emerging companies.

Whether its transportation or home health/DME or SIU, the exhibit floor and attendee ranks are brimming with hyper-motivated, very focused, totally committed small companies looking to take advantage of distracted, stodgy, slowly moving megacorps seemingly more focused on managing perceptions than service.

Many will succeed.

The long-rumored York acquisition will not close during the show, but it will close. Final details are being wrapped up and regulatory approvals obtained. Knowing the parties and principals involved, it’s very likely they will not make the same mistakes  noted above.

The first day is more ease-into-it than jump-in-with-both-feet. For we East Coasters that’s a good thing as we can’t keep up with the late night events after waking at 3:30…

One noteworthy item and a couple observations from Tuesday.

The Coventry bill review RFI is out and rumor has it – it is Bill Review only. As in no other services needed. And lots and lots and lots of requirements. And the info required in a response is voluminous.

There is a rather limited pool of potential respondents; as in fewer than five. The business potential, while large, is shrinking. With the loss of AIG and pending loss of Liberty any successful bidder is going to have to staunch the bleeding.

Or more accurately, hope Coventry does.

Behavior

As noted last year, what happens in Vegas gets posted to youtube. On an elevator departing a social event last night several men were commenting loudly and often in vulgar terms on the physical attributes of a woman. Who was also on the elevator.

I’m looking forward to meeting these boys on the exhibit floor. And their boss. I hope she’s a woman.

Selling

No one cares about your product or service. They care about their needs, which you don’t and can’t know unless you ask questions, shut up and listen.

Much more going on, but alas I heard “this is off the record” all too often yesterday.