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Ideological blinders, work comp, and Obamacare – part 9 of 9

We can all agree on something – No one – and I mean NO ONE – thinks PPACA aka Obamacare is the perfect solution to the health care insurance, cost, and quality mess.

Liberals decry it for the failure to offer a public option, if not a single payer.

Conservatives hate it because it represents what they see as a big intrusion into private decision making process.  The fact that PPACA closely resembles former Republican Senator Bob Dole’s plan, and one advanced by the neo-uber-right Heritage Foundation just a couple decades back isn’t enough to overcome that “negative feeling”.

Let it go, folks.

The reality is, PPACA is going to be a reality.  You can either continue to complain, or start figuring out what to do about it.  Here are a few things it would behoove any workers’ comp payer or stakeholder to get done.

  1. Get much, much closer to key providers to ensure your claimants can get access to surgery, primary care, PT and the like.
  2. Watch for changes in billing practices by hospitals who are looking to adapt to reduced Medicare reimbursement.  Expect higher prices and more services.
  3. Watch for physician practices billing as facilities, with all the additional cost inherent due to fee schedule anomalies.
  4. Monitor drug prices; as more people get coverage, manufacturers may decide they can raise prices a tad.  It happened after Part D, and it may well happen again.
  5. Add “health insurance coverage status” and the name and policy number of the insurance plan to your FNOI process; that way, if you have to pay to treat non-occ conditions, you know who to send the bill to.  As well you should.

There’s a lot of potential side effects, many of which we won’t see until several years out.  The key is to look for them, and blinders will restrict your vision such that you won’t be able to adapt and maybe even take advantages of positive side effects.

What does this mean for you?

Rewards await those who see broadly and clearly.


One thought on “Ideological blinders, work comp, and Obamacare – part 9 of 9”

  1. And if it fails, the only option left will be a single payer. So conservatives may have to be careful what they don’t wish for, because they just might get it.

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Joe Paduda is the principal of Health Strategy Associates



A national consulting firm specializing in managed care for workers’ compensation, group health and auto, and health care cost containment. We serve insurers, employers and health care providers.



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