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Louisiana appellate court rules against Coventry's work comp network
Yesterday's Louisiana appellate court ruling against Coventry's First Health work comp network is a major blow to comp insurers, employers, and networks in Louisiana, with potential impact in other states as well. The ruling is here. The court's finding supported...
Florida's (repackaged) drug problem
Mike Whitely of WorkCompCentral's article [sub req] on Florida Governor Charlie Crist's veto of the bill limiting reimbursement for physician-dispensed repackaged drugs illustrates just how confusing the weird world of work comp can be to the uninitiated - like Mr...
Two points - EHR and the government's incompetence
Bill Sota posted a brief piece about the Veterans Administration's adoption and use of Electronic Health Records, citing: "Good news on the cost savings performance of Vista which is the VA's electronic medical record system:" Bill is referring to the...
Health reform's implications for work comp, part 3
Yesterday and Monday we reviewed the macro and micro impacts of health reform on work comp. Today we're going to focus on how reform will impact the comp network business. There are two types of comp networks, those based on...
Texas' efforts to add science to the art of work comp medicine
As anyone who has studied physician practice patterns is only too aware, there is wide variation in how physicians practice; the kinds of tests they order, whether they admit patients to the hospital or treat on an outpatient basis, the...
How to change health behavior
I've been working with a mid-sized self-insured employer on their health benefits plan; they got hit hard with costs from diabetes last year and the (relatively thin) data available suggests it's going to get worse in the near future; there...
Big on health, light on reform
Paraphrasing Sen Ron Wyden (D OR) produces the most accurate soundbite description of the House' health reform bill. Is this the best we can do? If the answer is yes, we're in deeper trouble than even I thought. I'm really...
Who's the crook?
Few things I've encountered in my twenty-five-plus years in the insurance business are as outrageous as the prosecution of Sandy Blunt, the former head of the North Dakota work comp fund. I've posted on this case several times; what originally...
Health reform and workers comp - the view from IAIABC
Reform - whether it happens this year, in ten years, in one big change or a series of smaller steps - is going to have a big impact on workers comp. That's the takeaway from one of the sessions yesterday...
Top ten misconceptions about health reform
There are definitely more than ten, but here's my list. 10. A federal death panel will decide who gets care and who gets 'suicide-d'. This has been debunked almost as many times as it's been 'bunked', Section 1233 of America's...
Work comp pharmacy news - RiteAid dropping FirstScript
Retail pharmacy giant RiteAid is no longer accepting work comp claimants administered by PBM FirstScript. RiteAid, which owns almost ten percent of all retail pharmacies in the nation, decided to terminate their relationship with FirstScript due to a dispute over...
Universal health care and workers comp - the Canadian experience
IAIABC President Peter Federko had twenty minutes to discuss the impact of health reform on workers compensation. I've posted on this several times, for those interested here's where a summary post. Before we delve into Mr Federko's comments, I'd be...
What self-insureds want from TPAs
The work comp TPA business is at last beginning to emerge from a very long, and very cold, winter. The soft market drove many of their customers back into the arms of insurers, as premiums were very competitive with the...
Daschle withdraws nomination
Politico.com just announced that Tom Daschle withdrew his name from nomination for Secretary of Health and Human Services. The former Senator's failure to pay taxes on his multi-year use of a car and driver and huge income from his work...
Predictions for Comp managed care in 2009
Much against my better judgment, here are my predictions - in no particular order - for the work comp managed care world in 2009. 1. Coventry will be acquired. Currently trading just under $15 per share, Coventry Health looks to...
The pre-election health policy debate
Editor's note - this is perhaps the most serious, thought-provoking edition of HWR I've had the honor of hosting. There's a lot of meat here, so don't expect to multi-task your way through. These are momentous times. Not only will...
Aetna's plans for workers comp - (a little) more clarity
At the behest of readers and clients, I've been working to get some answers from Aetna on what exactly the 'restructuring' of their workers comp business division means for customers and prospects. I'm not having much luck. I'd note that...
What happened to Aetna's work comp division?
The short answer is - it got combined with other sorta-kinda related businesses and put under one boss - Dan Fishbein, MD, in the "New Product Businesses" unit. According to an Aetna Communications staffer; "AWCA is part of the New...
Another insurance screw-up
Like a man stumbling through a darkened room full of sharp objects, the individual health insurance industry continues to bash itself bloody. Today's painful encounter is the news that individual health policy marketer HealthMarkets agreed to pay a $20 million...
Two can play that game
Providers are now rating payers. And in the ratings game, Aetna looks to be doing better than other big health plans. There are several 'payer rating' sources now available, each with their own approach. One of the more intriguing is...
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