before I even hit the floor (exhibit, that is), it became evident that the big thing this year is...MSAs!

Really.

For those of us who were under the impression that the Medicare set-aside business had peaked some time ago, it looks like a lot of folks were reading the tea leaves differently. With "a lot" defined as seventeen.

There are no fewer than 17 vendors that list MSAs (of something very close to that) in the conference guidebook. Most sell other services as well, a few specialize in MSAs, and there are a couple law firms that do the legal work part of the MSA process.

With that much competition, it's pretty apparent the MSA business is fast becoming commoditized, with prices likely falling rapidly. Sources indicate Coventry has been hit hard, and ha recently shut down an MSA office, laid off some of the staff, and transferred the remaining work to another Coventry location. This may well be an astute decision as competing in a commodity market is not a good long term tactic for any but the most focused, and Coventry's attention is clearly elsewhere.

For those just entering the fray, get efficient quickly, deliver great customer service, don't overpromise or commit to things you don't control (eg acceptance by CMS) and communicate well and often with adjusters. And be prepared for shrinking margins.