Insight, analysis & opinion from Joe Paduda
Sometimes it takes a few deaths for people to wake up. That appears to be the case with Fentora, the powerful narcotic manufactured by Cephalon. Four deaths have now been linked to Fentora, deaths that are all the more troubling because they appear to be from off-label use of the drug.
I’m not surprised.
Bob Laszewski at Health Policy and Markets makes an intriguing case that the current UAW battle w auto manufacturers over health benefits is directly related to California’s efforts to resolve who should pay for health care reform.
Well worth the read.
may be yet to come. The second-tier managed care company has positioned itself well for the future, diversifying away from its traditional small group HMO plans in secondary and tertiary markets into a mix of governmental, ASO, individual, and workers comp managed care services.
The strategy makes sense.
The latest data shows that while there has been some growth in the two types of consumer-directed health plans, it is not ‘statistically significant’ (3.8% of covered workers are enrolled in these plans in 2007, up from 2.7% in 2006).
Put another way, it looks like the CDHP movement is running out of steam.
That’s too bad.
The average cost for a family’s health insurance coverage this year is $12,106. That amounts to just over a quarter of gross median household income ($46,326). (a ‘household’ is defined as two or more individuals).
Lets put that in context.
Coventry appears to be wasting no time in flexing its market-share muscles. Sources indicate they have begun efforts to restructure deals with their network resellers – the bill review and managed care companies that have traditionally marketed Coventry’s networks to their customers.
Aetna will be Coventry’s workers comp network in 19 states. As I reported last week, the deal replaces Coventry’s underperforming networks with AWCA’s offering, strengthening Coventry’s lead in the WC managed care business while eliminating it’s toughest competitor.
Continue reading It’s official – the Coventry/Aetna deal is done
Depends on who you listen to. I finally got around to listening to the August quarterly conference call re earnings, and the picture is rosier-than-rosy. The TPA acquisitions are paying off handsomely, earnings are up, new technology is driving up margins, and the new CEO is doing a great job.
Well, we screwed up, but our mistake is your delight.
Many thanks to Dr Bob at The Doctor Is In. We mistakenly directed Blog Carnival posts to his blog instead of the similarly named host of today’s issue, The Doctor Weighs In.
The good Doctor kindly took the initiative to make a posting today so we have double the HWR coverage. Our thanks to Dr. Bob for being on the ball! His blog is quite interesting – go check it out!
Aetna and Coventry are negotiating a deal whereby Coventry’s WC customers would gain access to the entire AWCA network thru Coventry. While parameters could change (or the thing could fall apart entirely), multiple sources indicate the AWCA network would replace most or all of the Coventry network offering (in those states where AWCA is viable).
This would represent a sea change for many payers, and yet more consolidation of power at Coventry.
Continue reading Big doings in the workers comp network business
