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Matching entries from Managed Care Matters
Is Don Berwick going to be Sherrod-ed?
The recess appointment of Dr Donald Berwick as head of CMS has incited a furor among politicians outraged at what they claim are his advocacy for rationing and fondness for Britain's National Health Service. To support their claims, these politicians...
Like it or not, physician ratings are coming
Some physicians and physician groups are quite upset about insurers' recent moves to offer employer customers tight, small networks of providers based on quality and cost criteria. In an effort to block these new plans, the AMA and other groups...
We've got a long way to go, baby... ranking the US health care system
Why do we need health reform? Don't we have the best health care system in the world? No. Not even close. According to a study released yesterday by the Commonwealth Fund, "Compared with six other nations--Australia, Canada, Germany, the Netherlands,...
Auto insurance and hospital cost shifting - so THAT's why my premiums are so high!
Cost-shifting - the practice of seeking higher reimbursement from some payers and patients to cover shortfalls due to low or no reimbursement from others - is rampant in the US health care system. Having worked with providers, health care systems,...
Government-run health care - how bad is it?
There's been a minor flurry of articles about the Veteran's Administration health care system recently, a flurry that is both welcome and a bit tardy. It would have been helpful indeed if these had come out during the furor over...
Where the work comp world is heading - Part 3, just over the horizon
For the Chinese treasure fleets, voyages went progressively further from their home ports, until, some believe, they circumnavigated the globe. Before we explore the 'other side' of the work comp world, we need to consider what lies just out of...
Hospital costs in California - the tide has turned
Health Affairs' most recent edition includes a piece [sub req] on the changing health care landscape in California, one that now has hospitals occupying the high ground. The historical background is telling; too many hospitals to begin led to tough...
Health reform's implications for workers comp
While it's not a done deal, the passage of health reform legislation is all but inevitable. When President Obama signs the bill on Tuesday, the American health care system will begin a change more drastic and comprehensive than anything we've...
Hospitals' strategy - survival thru cost shifting
Over the next few weeks, I'm going to be writing extensively about the death spiral of the American health insurance system, a fate as certain as it is unthinkable. As enrollment in private insurance plans declines, and the Medicaid population...
How's Coventry doing?
Pretty well. With the demise of health reform and the company's continued focus on core businesses at the expense of ancillary or unrelated operations, things are looking up for the mid-tier managed care company. Last week's Q4 2009 earnings call...
Health Wonk Review - so, what do we do now?
If ever there was a time to be writing about health reform, this is it. It's an even better time to be reading about health reform. Is health reform dead, or is it just snoozing, waiting for a Prince Charming...
Work comp medical costs - heading up...
To no one's surprise. work comp medical costs appear to be on their way up, and at a rate significantly higher than the medical CPI. First the what, then the why. The latest data from NCCI indicate comp medical inflation...
Workers comp managed care - predictions for 2010
You'd think I'd learn not to make public predictions that may come back to haunt me, providing ammunition for folks who think I don't know diddly. But I subscribe to Teddy Roosevelt's philosophy" "The only man who never makes mistakes...
Health reform, hospitals, and work comp
As health reform stumbles like an exhausted runner towards the finish line, we are starting to get a clearer picture of the potential changes reform will bring to the health care landscape. One that bears close watching is the increasing...
Where were the payers in Florida?
The ongoing battle over the work comp hospital fee schedule in Florida continues, as challenges have been filed by two hospitals, the Florida Hospital Association, and FairPay Solutions that prevent implementation of a dramatic revision to existing fees pending further...
Are you ready for the hard work comp market?
The soft market that seemingly will never end will - probably by q3 2010. Are you ready? Many employers have lost focus on risk and cost management, lulled into passivity by the longest soft market in memory. Woe unto those...
Clarification - Last chance to avoid higher comp costs in Florida
Florida is scheduled to dramatically change the way hospitals get paid to care for workers comp patients, and if payers don't get their act together, they're going to be paying more - a lot more - for medical care. WorkCompCentral...
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...
UPDATE - Ethics in workers comp managed care
For the update, see UPDATE below. Also, if you would like a copy of Todd's marketing presentation, email me at infoAThealthstrategyassocDOTcom. The presentation is not copyrighted, marked confidential or proprietary, or otherwise protected from distribution. Original post The world of...
The cost of surgical implants in workers comp
A new RAND study reports California's employers are paying $60 million more than they should for surgical implants. Not the surgery, or the follow up care, or the facility costs - just the devices themselves. According to Jim Sams' piece...
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