Insight, analysis & opinion from Joe Paduda
Consumer directed health plans will make all of us better users of the health care system. We’ll shop for price, be careful about what procedures we get from whom for how much how often. We’ll bargain, examine data, and carefully compare providers.
And as a result, we’ll all save a bundle, and the US health care system to boot.
Sort of.
More evidence is emerging about the rather minimal impact medical malpractice has on medical costs.
The financial reporting season for publicly traded companies using the calendar year is just about over. AIG’s numbers look rather good, with a 34.1% improvement in net profits on revenue growth of 3.9%. Sure, the company has had its struggles with regulators, but the overall results are quite impressive.
The increase in profits came on the heels of a $1.8 billion increase in reserves for workers comp claims over 2005. The reserves were bumped up despite an improvement in the loss ratio for the DBG operation (domestic business group, the home of most of AIG’s work comp business) from 82.5% in 2005 to 69.1% in 2006.
No, I’m not obsessed. At least not with the Concentra-FirstHealth merger. But information keeps popping up about various aspects of the deal that a few readers actually find very interesting.
The latest concerns the IME business.
The fine may be a million bucks, but the PR damage is much worse.
California workers comp rates are likely to drop again. Clearly, the WC reform initiatives are starting to pay off.
That’s good. Sort of.
When rates drop, employers’ costs go down, leaving more money for investment, profits, higher wages, and perhaps even health insurance.
That’s the good news.
Continue reading California’s rate reduction – not all good news
Coventry has hired a new medical director for their workers comp managed care business. Dwight Robertson has long experience in the business (starting in the late eighties); knowledge of the provider, payer, and managed care industries (USHealth Works, Zenith, Crawford, AIG, UnitedHealthcare, Conservco); and a frank, open, and direct style.
He also has recent experience as a First Health customer, a perspective that may help focus his new company on the customer.
You’re swamped. I’m swamped. Work, kids, parents, sports, Iraq, vacation plans, tax season, Anna Nicole – there are hundreds of urgently important things filling your time, demanding your attention.
Health care reform is too complicated, too big, too partisan, too much to think about.
It’s also going to affect you, your family, your income, our economy and quality of life more than any other issue on the table today.
Health care reform is the biggest, most influential issue facing America today.
Sources indicate Fiserv has terminated its efforts to sell third party biller Third Party Solutions thru Bank of America. This despite Fiserv’s interest in shedding non-core assets, begun under CEO Jeff Yabuki. While Fiserv may still entertain offers, it is unlikely any will approach the rumored goal of $275 million Fiserv was asking for TPS.
While more than a few private equity/venture firms assessed TPS, evidently no term sheets approached the desired valuation. Issues may have included concern about TPS’ “complicated” A/R situation.
Meanwhile, competitor WorkingRx is still for sale…
What does this mean for you?
A temporary continuation of the current awkward third party biller-pharmacy-PBM-payer struggle/business relationship.
The short answer – elimination of a major network and bill review competitor, acquisition of a PBM and case management operator, and an annual revenue increase for Coventry’s specialty division of about $320 million.
Continue reading What Coventry is getting from Concentra – the details
