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MedRisk is buying Conduent’s bill review business – What’s next, Why, and How.

Physical medicine management firm MedRisk will acquire Conduent’s Casualty Claims Solutions business.

So…what and why and how?

What will MedRisk do now?

Improve Conduent’s performance is Job One.  
Conduent has – to be kind – struggled to deliver customer service, to respond to client needs, to keep systems, regulations, and fee schedules updated, to keep its customers much less win new ones, to actually perform. MedRisk has a wealth of experience and expertise in turning around an entity with those problems, has the staff and internal knowledge to help fix Conduent’s major issues, and has the leadership to actually get it done.

Stabilizing the current business is the first, and by any measure the most important task.

I’d note that MedRisk is the most successful physical management company in the space because it listens to its customers; partners – in the truest sense of the word – with them and works very hard to make payers’ front-line staff’s jobs easier, less stressful and less complicated. (I know, MedRisk is not perfect, no organization is…)

That corporate culture will be hugely helpful for Conduent’s bill review clients.

Why did MedRisk do this deal?


It’s all about the data.  I CANNOT emphasize this enough.

MedRisk’s analytics folks are quite adept at assessing provider performance  – “performance” being based on what its customers value. Payers want more control over physical medicine (which is one of the fastest growing costs in workers’ comp). Now, with access to terabytes of data on provider billing, treatment practices, related services e.g. surgeries, medications, facility visits, treatment documentation, claim demographics, duration of care and lots of other hugely valuable data points, MedRisk will be able to help customers better:

  • assess and identify high- and low- performing providers
  • get instant notice of changes in billing patterns (e.g. new Revenue Cycle Management tricks designed to hoover dollars out of payers’ pocketbooks)
  • reduce leakage from provider networks
  • evaluate treatment plans to identify effective and less effective approaches to specific types of claims, diagnoses, and cases
  • and a host of other things we haven’t yet thought of.


Is MedRisk – a rehab management company (!!!) – becoming the major provider of bill review services which are generally recognized as the most important and impactful of workers’ comp services?

Simply put, because it is very well run, has a really impressive growth record of late, and is worth a ton of money. That corporate equity gives it a relatively low cost of capital and access to even more investment.


I’ve worked with MedRisk for more than 2 decades. In no way am I responsible for or attempting to take credit for what Shelley Boyce, Mike Ryan, Sri Sridharan, Michelle Buckman, Ed McBurnie, Vic Pytleski, Rommy Blum, Jamie Davis, Tom Weir, Mary O’Donoghue and many others from the most senior to the least senior workers have accomplished.

The company’s leaders – starting with Shelley and continuing to today – have focused on doing right by customers and pushed that ethos throughout the organization. Yes, MedRisk had its stumbles along the way…but it recovered and became more successful by learning from those mistakes and returning to its core principles.

What does this mean for you?

Success is all about delivering your customers what they want how they want it.

2 thoughts on “MedRisk is buying Conduent’s bill review business – What’s next, Why, and How.”

  1. Joe, you are absolutely correct regarding the data’s value. However, cutting down on choice, on competition can prove to be dangerous to the marketplace. Would you agree?

    1. Hello Steve and thanks for your note.

      The reality is this may well increase competition as Conduent has been pretty much a non-factor in new business for some time now. Rejuvenating Conduent is likely very high on many payers’ wish lists.

      I’d also note there is at least one new competitor entering the space – accuro solutions is gaining traction and winning business. CorVel somehow manages to convince payers to use their bill review service, CompIQ split away from Conduent some time ago and is active in the market, and Careworks has a raft of clients as well. Then there’s Enlyte’s Mitchell, the dominant player in the P&C bill review market.

      be well Joe

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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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