Brian Klepper’s the host of this biweek’s edition of HWR; his writing is terrific, especially when he opines on the posts.
And the selection of posts is provocative…
Sep
6
Insight, analysis & opinion from Joe Paduda
Sep
5
A group of docs in Texas has decided that two can play the ratings game. They are working on a project to rate insurers – on their “billing procedures and issues”.
It strikes me that these physicians may be engaging in the same type of behavior that infuriates them when exhibited by insurers – using an arbitrary, internally-developed methodology to evaluate payers solely on administrative indicators.
Sep
4
Managed care execs at WC payers are getting increasingly nervous, and well they should be.
There are major changes afoot in the WC managed care market. The consolidation at the top means that changes in policy and practice by the industry leader(s) is likely to have much more impact today than last year. And if that consolidation continues, customers and providers alike may find themselves with even less bargaining power.
Continue reading Is the WC PPO marketplace becoming a monopoly?
Sep
4
Health care leads the list of domestic issues for voters, with 27% citing HC as their top issue, and 42% listing it as one of their top two (no prizes for guessing that Iraq is the leading topic).
Health care is top of mind for both Dems and GOP respondents, although more Democrats want their candidates to talk health care (42%) than Republicans (21%).
Yet according to the KFF report, “nearly six in 10 people don’t know or can’t name a candidate who best represents their own views on health.”
I’m guessing that’s due to ignorance. There are sharp differences between the parties in their positions on health care, with Republican candidates favoring the use of tax policy and ‘free markets’ to deliver reform, while Democrats lean more towards universal coverage using private insurers.
And no, despite the rhetoric from Republican candidates, rare is the Democrat who is calling for single-payer or government-run health care.
Aug
30
Live it up while you can, because tomorrow is coming – and it probably won’t be near as nice as today.
That’s the message from a recent report on the property/casualty insurance industry, which by all accounts is enjoying halcyon days.
Aug
29
And the bad news just keeps on coming. The ranks of the uninsured increased for the sixth straight year, to 47 million. The increase this time was 2.2 million; 15.8% of Americans, or about one in seven, does not have health insurance.
This despite a slight decline in the national poverty rate and a leveling-off of health insurance premium increases.
So in a ‘best-case’ environment, 2.2 million Americans still lost their health insurance.
If the problems in the credit markets continue, they will likely drag down the economy, leading to even more becoming uninsured. And this will all happen just in time for the fall 2008 elections.
Aug
27
Carol Gentry of the Tampa Tribune has authored one of the more accessible pieces on the hows and whats of hospital price variation.
Carol’s piece illustrates two key issues – the data is available, and consumers aren’t using it.
Aug
27
My firm has conducted a survey of pharmacy benefit management in workers comp each year for the past four, and the latest has been completed. Executives in managed care and claims as well as program managers from 20+ payers responded to the Survey, some for the fourth time.
Here are a few of the highlights.
Continue reading Pharmacy benefit management in Workers Comp – Survey results
Aug
24
The latest edition of Health Wonk Review is up at Medical Humanities. Get out your dictionary, you’re going to need it!
Aug
24
Here’s a shocker – quoted from a FierceHealthcare piece last November.
“oncologists accounted for only 1 percent of the 187,076 Actiq prescriptions filled at retail pharmacies in the U.S. during the first six months of 2006, The Wall Street Journal reported.”
Actiq is only FDA approved for breakthrough cancer pain.
My firm’s research indicates that Actiq is among the top three drugs in dollar volume dispensed to workers comp patients. The incidence of cancer in WC is so low as to be unmeasurable.
