Good news Monday…Government is working.

In Bentonville Arkansas last week for the boys’ annual mountain bike trip…30 years and counting…recovering from a long one Thursday meant no GNFriday.

So here we go…

Driving up I-81 last week I encountered LOTS of construction – bridge replacements, repaving, new guard rails, overpass improvements…got me wondering how much impact the Inflation Reduction Act is having on public roads.

A Shipload. As in almost $200 billion to do desperately needed maintenance in every state.

Plus new factories – and lots of high-paying jobs – in rural North Carolina, along with:

  • 13,000 bridge repair projects – including the notorious Brent Spence Bridge between Ohio and Kentucky
  • 257,000 miles of roads resurfaced and/or improved
  • more than 450 port and waterway projects
  • funding for more than 1,400 drinking water and wastewater treatment projects
  • $3 billion for replacing lead pipes.
  • 500 projects for water recycling, storage, conservation and desalination to improve resilience against drought in the Western U.S.

What’s different about the IRA and other new Federal funding is much has been driven by local governments – towns, cities and counties applying for grants to make big improvements.  This from TIME:

The Biden Administration and the 117th Congress did something radical: Together, they decided to invest in the ideas and aspirations coming from Main Streets across America, rather than from inside the Beltway.

What does this mean for you.

Safer roads and fewer accidents.

More construction jobs.

More demand for materials and equipment.



Heat and Virtue Signaling.

The single biggest risk to workers’ comp is heat.

Heat will have more impact on worker safety, injuries, and illness than any other single factor…a risk that will only increase as our planet heats up.

credit WCRI

Aside from a few very recent studies (kudos to WCRI and NCCI) and rare conference sessions the industry has ignored – and continues to ignore – heat.

Politicians have banned local governments from passing laws to protect workers.

Other pols have failed as well; with a very few exceptions states have neglected to pass and governors to sign legislation to protect workers.

Few “Thought leaders” have spoken out to warn their large audiences to protect workers and encourage politicians and regulators to legislate/promulgate regulations to protect workers, or even just to inform employers that claims will increase along with temperatures…kudos to Jeff Rush of CJPIA and LWCC’s Jill Leonard for their efforts.

Outside of WCRI and NCCI, conference planners (NWC’s Michelle Kerr comes to mind) may be the only stakeholder to make an effort – those efforts mostly rewarded with abysmally low attendance at sessions focused on climate change and heat’s impact on worker safety…

The industry has tried mightily to reform its image; Kids’ Chance, injured worker advocacy, behavioral health and addiction treatment support efforts have gone a long way to strengthen the brand…but all that good will melt away unless the industry’s thought leaders, regulators, employers and insurers do the right thing.

Hypocrisy is “Virtue signaling” while actively and purposely ignoring/discounting what heat will do to workers.

What does this mean for you?

Increasing heat means more kids will need a “chance”.

WCRI’s webinar discussing their research on heat is today



Happy Memorial Day Weekend!

Hope yours is filled with family and friends…and time to reflect on those who gave their lives for us.

Thanks to them, we have much to be thankful for.

Starting with…despite what many think we’re NOT in a recession…

From the Guardian’s survey…

The vast majority of respondents, 72%, indicated they think inflation is increasing. In reality, the rate of inflation has fallen sharply from its post-Covid peak of 9.1% and has been fluctuating between 3% and 4% a year.

In April, the inflation rate went down from 3.5% to 3.4% – far from inflation’s 40-year peak of 9.1% in June 2022 – triggering a stock market rally that pushed the Dow Jones index to a record high.

And job creation has been pretty darn great.

Government works!

Remember the botched start-up of the ACA aka “ObamaCare” way back in 2014?

Well, like many new and really big change, its gotten a whole lot better. Almost 2/3rds of Americans view the ACA favorably.

For some, “Obamacare saved my life”…

Support for recovering addicts…

This is really good news…The Feds and California are partnering on a program that pays addicts continuing to remain sober.  The program – “contingency management” –

is the gold standard for stimulant use disorder because you can win things for good behavior. But not a lot of places are providing it yet,” said PK Fonsworth, a psychiatric emergency room doctor and addiction psychiatrist in Los Angeles. (cite WaPo)

Research shows promise for contingency management. For instance, study participants achieve significant periods of sobriety, agree to long-term addiction treatment and even reduce risky sexual behavior.

The Biden administration is pushing more states to consider the approach, calling it a “proven treatment” that “remains underutilized.”

Kudos to CMS (Medicare and Medicaid) and the Golden State for the collaboration.


Heat = More injuries.

With temps here in the northeast nearing 90 degrees F yesterday  – and much hotter in many southern and western states, attention is turning to the implications for workers – and workers’ comp.

Two studies released by NCCI and WCRI show just how damaging excessive heat will be for workers and employers.

WCRI’s study – authored by the estimable Olesya Fomenko, Vennela Thumulaand Sebastian Negrusa, contains a wealth of information which anyone in construction should be aware of…


WCRI will be discussing this in a webinar June 6. Register here.

At NCCI’s recent AIS, researchers noted:

  • Days with extreme temperatures, both hot and cold, exhibit 2%-10% more injuries in NCCI states compared to “mild” days.
  • The largest effects of hot days are seen in outdoor sectors, particularly construction.

What does this mean for you?

Underwriters, actuaries, and risk management folks – pay attention. 


What’s really going on with workers’ comp medical…

Medical inflation in workers’ comp is pretty much flat – as it has been for several years.  Why?

Four reasons.

  1. Claim counts continue to remain pretty flat with lost time claim frequency down yet again.
  2. Drug costs have plummeted over the last decade, and now account for about $2.2 to $2.5 billion or 7% – 8% of total medical spend…down from around $5 billion.
  3. Costs for professional services – docs, PTs/Ots/chiro – remain pretty low. WCRI’s latest publication (available for now cost at the link) shows very little inflation across 36 states. Kudos to WCRI for tracking this up through 2023 – that’s really fresh data.
  4. Facility costs are increasing, but have yet to reach the point where payers actually do anything material about cost control.
    A better way to say this is payers are lazy and complacent, waiting for the crisis to hit before actually doing anything.

What does this mean for you?

Focus on facilities. 


Great news on the economy…

The labor market stays strong, inflation is slowing, and the stock market continues to boom. 

One economist noted “the April report put a soft landing and 2024 rate cut back in investors’ sights…”

That’s about as good as it gets…but just the latest in a long string of economic improvements over the last three years.

About that 401(k)…

Folks with 401(k)s are enjoying a big jump in account value – Bank of America reported the average account increased 17%

Protecting consumers

This week the Supreme Court rejected the payday loan industry’s latest legal attempt to block consumer protections. The Consumer Financial Protection Board was created after the 2008 financial crisis to regulate predatory lending, mortgages, car loans and other consumer finance.

With this ruling, expect the CFPB to push for rapid adoption of consumer protections including:


Lastly, our allies in Ukraine are FINALLY getting the support they desperately need…and using it to great effect. Earlier this week several jets and buildings  at a key Russian Air Base in Crimea were destroyed.

photo credit CNN

More on what’s happening there next week.

What does this mean for you? 

  • fatter retirement accounts, 
  • lower inflation,
  • and a smackdown of predatory lenders.



A Workers’ Comp Quiz

Workers comp is:

a) hugely profitable,

b) way over-priced,

c) even more profitable than it looks,

d) by far the most profitable P&C insurance line,

e) NOT suffering from medical cost increases,

f) a highly mature industry with all the attributes thereof,

g) shrinking as claim frequency continues the 20-year trend averaging -3.4%

h) the financial savior of multi-line carriers, and/or

i) all of the above.

The answer is…i.

NCCI’s Annual Issues Symposium provided a deep dive into the industry’s financials…and the industry is swimming in a lake of profits.

With a net combined ratio of 86%, WC is HUGELY profitable…especially when one considers the industry is over-reserved to the tune of…$18 BILLION.ut wait…when you add investment income, private carriers pre-tax operating profits are a whopping 23%.

Which means premiums are still far too high, employers are still paying far too much for WC insurance, and insurers are sitting on $18 billion that should be returned to policyholders.

This despite ongoing premium rate reductions…in every state.

Oh, and medical inflation is LESS than overall inflation – at a paltry 2%.

Amidst all this sunshine and rainbows, there’s one troubling trend…facility costs.

Specifically ASCs and outpatient, which is the only category showing an increase in share of medical spend. 

As CompPharma has reported drug spend has been trending down for years – and now accounts for just 7% of total WC medical spend – down from 12% in 2012.

The full AIS report is here …

What does this mean for you?

Employers – lower rates – MUCH lower rates.

And BIG dividends if your carrier is a mutual.

Insurers – invest those profits in technology NOW. Workers’ comp – and the P&C industry as a whole – is waaaay behind in tech. NOW is the time to invest – because…

this will not last.



Research indicates state abortion bans will deprive residents of healthcare. Newly minted MDs are avoiding states with restrictive abortion policies, as are physicians seeking advanced training in OB/GYN and primary care.

AAMC-sponsored research found there are fewer applications for residency and more advanced training in states with abortion limits. These are the physicians who deliver a lot of care to folks in the hospital and outpatient facilities.

Implications – untrained physicians and reduced access to healthcare.

From FierceHealthcare:

physicians without adequate abortion training may not be able to manage miscarriages, ectopic pregnancies, or potential complications such as infection or hemorrhaging that could stem from pregnancy loss…

“The geographic misalignment between where the needs are and where people are choosing to go is really problematic,” she said. “We don’t need people further concentrating in urban areas where there’s already good access.”

What does this mean for you?

Poor people will suffer, not-poor people will be able to access care.

Remind me…is this how a great country treats its least fortunate?


Cost Doesn’t Equal Quality Part 2:

All over the country there are areas where the more expensive facility has poor scores for patient safety and outcomes. And with facility costs accounting for about 40% of workers’ comp medical expenditures, you can hardly afford to ignore this reality.

Today we look at Sarasota, Florida. More specifically, we are comparing Sarasota Memorial Hospital against Sarasota Doctors’ Hospital.

According to Health Strategy Associate’s Facility Assessment Tool (c) – Sarasota Memorial Hospital scores:

60+% higher on Clinical Outcomes

50+% higher on Person and Community Engagement

75+% higher on Patient Safety

than Sarasota Doctors’.

And Memorial is a whopping 7 points better on Relative Price – which means you are paying much less for a much higher-scoring facility.

When combining all 5 metrics the Facility Assessment Tool considers, Sarasota Memorial Hospital scores 2.94 against just .16 for Sarasota Doctors Hospital.

Oh, and these two facilities are just 6.4 miles away from each other with Sarasota Memorial Hospital closer to the beach!

Take a look at your network and see just what facilities you are utilizing – and what they are costing you.


Good news Friday…much safer cities and a world-leading economy!

There’s a ton of good stuff happening…we’ll start with the economy.

The US economy is boomingwe now account for more than a quarter of the world’s production.

Over the last three years:

  • 15.2 million new jobs were created
    • 768,000 are manufacturing jobs
  • more people are in the labor force than during the previous 4 years
  • the unemployment rate has been lower than any time in the previous four years
  • the S&P stock index is up by 33% – a massive increase in wealth for retirement plans and IRAs


Jeez, to hear some pundits you’d think cities are burning down, people are getting shot on every street corner, and no one is safe…

That, dear reader, is utter nonsense.


The net – Streets are much safer and so are homes


You’d expect the booming economy would be pumping more greenhouse gases into our air…the VERY good news is carbon dioxide production actually dropped while the economy boomed.

What does this mean for you?

A booming economy, fatter retirement accounts, lower crime, and less carbon emissions = lots to be happy about!