Insight, analysis & opinion from Joe Paduda
It looks like NY Gov. Eliot Spitzer (D) has done in two months what his predecessor couldn’t do in two terms – reform the New York workers comp system. If early reports bear out, this will be a huge win for injured workers, employers, insurers, and managed care firms.
That could be a rather significant “if”… but the inclusion of labor, business, and members of the opposition party in the reform process make it highly likely the package will pass.
For those curious about Bush’s health care plan, it’s implications, complications, challenges, and ultimate chance of adoption, Bob Laszewski’s posts are a must read.
URAC, the accreditation body that seems to be into every aspect of managed care, is now looking to certify PBMs. In a presentation at the PBMI conference in Phoenix last week, a representative provided an overview of the process, modules, timing and certification levels contemplated by URAC.
While the process is only for health lines today, URAC is seriously looking into accrediting WC PBMs…
Brace yourselves.
Continue reading URAC’s foray into pharmacy benefit management
As I’ve said a few times before, today’s consumer-directed health care plans (CDHP) are not much different from the $100 deductible major medical plans of forty years ago. (That $100 is now equivalent to over $600) Although advocates loudly proclaim CDHPs as a solution to the health care crisis, experience to date indicates that the adoption rate is quite low and the impact on cost is modest at best.
If consumerism is going to have any material effect on health care costs and utilization, it will have to reflect the realities of the health care purchasing decision process and the demographics and health status of the insured population, and recognize the lack of useful data on health care procedure prices and provider quality.
Other than that…
How drugs make it on to formularies has always puzzled me. After listening to a talk on the process, I’m even more mystified.
The investment debacle at the Ohio Bureau of Workers Comp has resulted in jail terms, millions of dollars in losses, criminal indictments, public pillorying of politicians, and a change in the Governor’s office.
As if that wasn’t enough, Moody’s now informs us that the $300 million in losses will affect the state’s economic outlook. The big investment firm downgraded Ohio’s economic outlook to negative from stable.
The downgrade may result in higher interest rates, raising the state’s cost of borrowing for public works projects. And all because a few political hacks took advantage of their connections.
Yes, it’s been a year since Matt Holt, Julie Ferguson and I launched Health Wonk Review. Thanks to all the guest hosts, tech folks (thanks Dmitriy and Shahid), and readers in wonk-land, HWR is gaining readers and traction.
Julie has the honor of hosting the anniversary edition, and offers a tip of the glass to all.
Salud!
You are wandering lost in the desert for several days without water, parched, your lips cracking, tongue swollen, eyes rattling around in your skull, desparate for an oasis. A man appears, and you think you are saved; he tells you he’s got just what you need, water. But instead of life-sustaining liquid he gives you empty water bottles and a coupon for free water, usable at a well that has yet to be drilled.
Your hopes dashed, you expire.
Pres. Bush’s health reform plan provides individuals with tax breaks to help them buy insurance that for many does not exist. Sort of like water in a desert.
I’ll be releasing the fourth annual survey of prescription drug management in workers comp in a few weeks. Here are a few early findings.
Continue reading Managing drugs in workers comp – the 4th annual survey
There hasn’t been much in the popular press about consumer-directed health care of late. What a relief. That doesn’t mean we can bury the idea, as economists and policy makers of a libertarian bent are going to keep returning to the “market as solution to all” mantra until we successfully implant a wooden cross in their cold small hearts.
And to some degree consumerism in health care is appropriate and warranted, and therefore part of the answer to the health care reform question.
