Or, what happened while I was/we were in New Orleans at NWCDC
First up, a most excellent report by WCRI’s Olesya Fomenko and Te-Chun Liu on provider fee schedules in workers’ compensation. Must-reading for investors, bill review entities, networks, and users thereof, the report details:
- which states use what methodologies,
- what changes have occurred over the last few years, and
- trends and developments.
As there is a lot going on with Medicare’s fee schedules, this report provides a sound basis of understanding.
For all those investors, private equity people, and researchers – you can now get – for FREE – what you often pay me for. Information on fee schedules in workers’ comp and the effects thereof is available here. From WCRI, of course!
Wait…did I just post that? Sometimes I’m such a dumbass.
The REAL fraud in work comp is not the odd worker cheating the system – it’s employers misclassifying workers, using labor brokers, under-reporting payroll – you name it. Bruce Woods, formerly of AIA, brought this to the attention of AIA’s members about a year ago, and I thought of Bruce when I got this from Matt Capece about the millions in damages due to fraud in one state – New Jersey.
US spending on health care is approaching 18% of GDP. CMMS estimated 2015 spending hit $3.2 trillion, or $9,990 per person. The primary driver was “residual use and intensity”, geek-speak for what’s left after age, sex, population changes and inflation are accounted for. In other words, people are getting more services which, given over 40 million didn’t have health insurance until 1.1.2014, and just over half of those poor unfortunates now do, isn’t exactly shocking.
You can expect the folks most likely to lose their health insurance under Trump/Price will get every test, procedure, therapy, script, surgery, and treatment they can now, before the ACA is repealed.
Deflation in work comp medical spend
Workers comp medical expense is now just over 1 percent of total US medical spend. While non-work comp costs were up 5.8 percent last year, NCCI reported work comp medical DECREASED 1 percent last year.
Holy flipping unicorn, Batman. Until someone offers a better explanation, I’ll credit ACA’s reduction in the number of uninsured as the major driver.
Good people sometimes win
Congratulations to friend and colleague Danielle Lisenbey, CEO of Broadspire. Danielle was just named Claim Exec of the Year by the New York Claims Association.