Insight, analysis & opinion from Joe Paduda
My post on Monday about the internal memo released by CMS regarding MSA allocations triggered a round of name-calling, motive-assumption, and general nastiness by people in the MSA business furious that I awarded PMSI much of the credit for the … Continue reading CMS, MSAs, and credit where credit is due
Read More...The comp industry spends millions on utilization review – certifying a procedure, hospital stay, therapy, or treatment as ‘necessary’ – or not. What most payers don’t realize, or, more correctly, probably realize and don’t discuss, is the reality that their … Continue reading Workers comp’s missing link – tying bill review to utilization review
Read More...Note – The public version of the First Annual Survey of Workers Compensation Bill Review will be released Friday. If you would like a copy, do NOT comment here, but send an email to infoATHealthStrategyAssocDOTcom. I’m finishing up the survey … Continue reading Work comp bill review survey – additional findings
Read More...“it’s all a fee-based business, so actually the workers’ comp business, the more bills there are, the more claims there are, the better that we do.” [emphasis added] Allen Wise, CEO, Coventry Healthcare, Q1 2009 earnings call That was the … Continue reading Wise on work comp – the more bills, the better
Read More...After spending the last part of last week and the better part of this one preparing for two major presentations on ‘US health care 2009’ (both requiring predictions about health reform efforts and results thereof) I’ve been anxious to get … Continue reading What’s up in work comp?
Read More...The periphery of the trade show floor at RIMS is where you’ll find innovators – new companies, with new ideas and concepts, new solutions to old problems, all described by their owners, founders, and top execs. To give credit where … Continue reading Where innovation can be found
Read More...A couple weeks ago I used this space to make a few pointed recommendations to entrepreneurs thinking of selling their companies. This week’s news that FairIsaac is selling off its bill review unit reminds us that mistakes can be made … Continue reading Be careful what you buy
Read More...There are two leads to this story – FairIsaac confirming what we reported yesterday (their bill review unit was sold to Mitchell International), and an amazingly over-the-top example of corporatespeak. We’ll do the serious stuff first. The bill review unit … Continue reading UPDATE – FairIsaac confirms sale
Read More...Fair Isaac will announce today that they have sold their workers comp and auto bill review unit to competitor Mitchell Medical. And no, this isn’t an April Fool’s prank. FI has been on the market, with several financial and strategic … Continue reading Fair Isaac has sold their bill review business
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