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Aug
19

It’s been a busy summer in the work comp sales world

The days of summer  – and particularly August – being slow for the work comp services business are over – at least for this year.

Word is the North Dakota state fund aka WSI, has chosen PBM PMSI to handle their work comp pharmacy requirements.  The Tampa-based PBM took the business from US Script; with the extractive industries’ employment zooming – and likely claims severity and frequency as well – this should be a nice addition to the portfolio.

CompSource OK – another state fund – is moving/has moved their bill review business to Medata. No official announcement here, and no other vendor lost the business as the inplace technology was a home-grown system.

Given the expected appearance of a “for sale” sign on Mitchell, there’s going to be a lot more action in the bill review market.  No word on Aetna’s plans for Coventry’s BR 4.0 platform, but there’s no doubt the increasingly creaky infrastructure will require some major investment, a complete re-write, or perhaps they’ll just blow it up and move to a current rival platform.

TPA QBE will be utilizing Sedgwick’s for claims adjudication – the TPA will be outsourcing some/a chunk of/most of that work to Sedgwick.  

I’m not in Orlando at the WCI Conference, so no reports from the Sunshine State, at least nothing first-hand.

Enjoy the week.

 


Joe Paduda is the principal of Health Strategy Associates

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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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