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Monday catch up

What with the HealthWonkReview Tenth Anniversary celebration at HWR HQ last week and finishing up a client project, I neglected my posting duties.

Here’s what I shoulda been writing about.

Work comp

Working with Harbor Health, the State Fund of California has launched an upgraded and updated MPN (that’s medical provider network for those not among the cognoscenti). Contracted thru Anthem, the new MPN is larger and provides more coverage in the rural areas where the State Fund has a lot of business.  While there aren’t any significant changes to how providers will interact with the State Fund, HH’s folks have determined the providers selected are higher performers.  HH will be monitoring performance on an ongoing basis.

Big news in the world of Medicare Set-Asides; NAMSAP has elected a new Board of Directors; the organization’s new leader is Gary Patureau of Louisiana Self Insured Ass’n fame.  Met Gary live for the first time last week, he’s a very experienced work comp exec; he is replacing the irreplaceable Kim Wiswell.  Rita Ayers of Tower MSA Partners is also joining the Board.

Implementing Health Reform

Contrary to the wildly wrong claims by GOP presidential candidates, employment hours have NOT changed due to ACA.  Many economists of that ideological ilk have been moaning for years that employers would cut hours to reduce the number of workers they had to insure.

Well, that hasn’t happened.  Here’s the money quote from a just-published research analysis: 

We did not see increases in 2015 in the probability of working either 25–29 hours or fewer than 25 hours per week. …We also did not observe a large reduction in 2015 (or in 2014, for that matter) in the frequency of working 30–34 hours, as one might expect if employers affected by the mandate reduced hours for workers just above the 30-hour threshold.


A few weeks ago I posted on Millennium Health’s legal problems, $260 million fine and settlement with the Feds.  What I neglected to note was the settlement was with every state AND the Feds; it addressed state and federal legal actions. There have been a few announcements from individual state Attorneys General to the effect that they’ve settled with Millennium; each one was part and parcel of the one announced a few months back.  not – MH is still a consulting client.

News of the Weird 

Donald Trump said he’d save Medicare $300 billion a year by “making Medicare” negotiate drug prices. Alas, Trump doesn’t understand that this is against the law – a law passed by his own party and signed by a GOP president.

Good luck with that.

More on this here. And here.




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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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