What happened while we were at WCRI wrap-up

Just digging out after WCRI; between built-up work and a desire to give you, dear reader, a break after filling your inbox late last week, MCM has been on a brief holiday.

We’re back!

While we were buried in all things work comp-related, the real world kept a-spinning. First up, what’s been going on with health reform, the costs thereof, and the impact on budgets.

A lot.  The most recent federal budget projections show a decline of around $300 billion in future costs for health insurance.

That’s huge.  Gigantic. Monumental.  Unprecedented.

In comparison, cutting NASA completely – $77 billion.  Ending Amtrak subsidies – $14 billion. Eliminating the deduction for all charitable giving? $214 billion.

There are two ways the federal government “pays” for health insurance – subsidies for folks insured via their employer; the portion of their “pay” isn’t taxed.  Second, the feds subsidize premiums for individuals buying insurance via the Exchanges on a sliding scale based to income. A more detailed discussion of the changes and impact thereof is here.

Note this does NOT include Medicare – although those projections are decreasing as well.

The latest budget estimate has Medicare costs over ten years coming in about $700 billion below 2010 projections.  

One of the reasons Medicare cost projections are declining – Between January 2012 and December 2013 there have been 150,000 fewer readmissions among Medicare patients—an 8% decline.” – hat tip to the Economist, and don’t forget to credit PPACA!

As if that’s gonna happen…

From a couple weeks back  is this news that California’s docs aren’t likely to be overwhelmed with patients due to ACA.  This from California Healthline:

  • 13.04 additional emergency department visits per week by newly insured individuals; and
  • 1.16 additional primary care visits per week by newly insured individuals.

 Back to work comp…

Good piece by PRIUM CEO Michael Gavin in WorkCompWire on work comp drug formularies; my only suggested add would be to make sure formularies aren’t rigid.  Need to allow payers, and their PBMs, to okay and reject meds based on the claimant’s diagnosis, medical treatment, other drug regimen, and other clinical factors.

Medata has promoted long-time COO Tom Herndon to president.  Tom’s not only a black belt in all things bill review and IT, he’s also a good guy, knows ops inside and out, and casts a mean dry fly.  Congratulations to Tom and his colleagues at Medata.

Enjoy hump day!

One thought on “What happened while we were at WCRI wrap-up

  1. Joe:
    Sorry to post so late but Tommy Herndon is well known for hooking trees on the bank and the ears of his fellow fisherman. A much better surfer!
    JMcL

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