Joseph Paduda's weblog on managed care for group health, workers compensation & auto insurance, covering health care cost containment, health policy, health research, and medical news for insurers, employers, and healthcare providers.

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Third Party Solutions - the latest news

TPS, a subsidiary of Fiserv, has had a rather tumultuous recent history. For sale for a reported $200+ million, then taken off the block when no buyers appeared. Left behind when Fiserv sold the rest of its health business to United Healthcare earlier this year. Meanwhile, TPS was buying its sole competitor, WorkingRx for a reported $25-50 million (highly contingent on AR collections).

Earlier this week I noted that WorkingRx has filed over a hundred individual cases in Utah naming specific employers liable for 'shortpays' (payments of less than WRx thinks they're owed). In my opinion, WRx overreached; the filings named the pharmacies that filled the scripts - and when employers find out which pharmacies are behind this mess, they will be none too happy.

WRx's General Counsel, Rex Huang, left the firm just before the end of the year.
With Huang's departure, the rapid disappearance of senior staff at WRx is now close to complete.

The third party biller market is now a monopoly, and some pharmacy chains indicate the pricing proposals from TPS are starting to reflect that.

Joseph Paduda is the principal of Health Strategy Associates.

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April 2011

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