MSC was sold last year to Monitor Clipper. Brazos invested in Cypress Care (a client). Genex was jsut sold to an investment firm, and another has bought up a big chunk of MSC’s debt. Injured Workers’ Pharmacy is on the block (and close to a deal), Bank of America is asking several hundred million for Third Party Solutions, and WorkingRx is for sale as well. Health Advocates was just purchased by PMSI/Tmesys, and P2P was recently sold to Fiserv. And execs at good managed care firms are besieged by investors seeking to “be helpful”.
Lots of smart money is looking hard at workers comp managed care and related services.
Why?

Continue reading Work comp is hot

Genex, the work comp anaged care subsidiary of UNUMProvident, has been sold to an investment firm. Unum had had the company on the block for quite a while, so the transaction is not a surprise.

Continue reading Genex sold

After the original post (below) I had a chance to review more carefully the recent releases from Texas re the adoption of medical treatment and guidelines and to gain more insight into the guideline selection process.
First, a clarification. ODG guidelines WILL be used for management of physical medicine, including physical therapy.
That said, if physicians or other stakeholders want to provide any type of treatment that differs from that recommended by ODG (surgery, therapy, etc), they can provide information to the payer/state justifying their position. And if their treatment plan is supported by other evidence-based medical guidelines, my sense is it will be approved.
Sources also indicate that MDA’s disability duration guidelines were selected primarily due to their accessibility; they are easier to comprehend and more “usable” for laypeople, while still backed by solid research and data. This accessibility may well make conversations among the stakeholders more productive and reduce confusion and mis-interpretation.
That’s good, as it allows providers and payers to have a discussion about treatment options with science-based guidelines as the ultimate test of appropriateness.
The latest state to adopt clinical guidelines for the treatment of workers comp injuries is Texas. While the adoption of guidelines is a good thing, Texas is clearly marching to its own mariachi band.

Continue reading UPDATE – Texas is getting there

13,000 American civilians have suffered compensable injuries in Iraq and Afghanistan. These are handled through the Federal system, with the Department of Labor having jurisdiction. The volume of cases has grown steadily since 2002, with the DoL now seeing about a thousand cases a month from employers such as Halliburton, Dyncorp, Bechtel and others.
And many of these are not your typical lower back strains. Post-traumatic stress disorder, closed head injuries from IEDs, and shrapnel and concussion injuries, all injuries once limited to soldiers are now suffered by civilians. These injuries are not commonly handled by civilian providers or hospitals, and many claimants are finding it difficult to obtain adequate care for their condition.
Outside of the human cost, the financial implications are staggering. Truck drivers are making upwards of $100k a year, and their workers comp premiums can be as high as $25 – $40 per $100 of payroll. While there is no accurate count of the total number of contractors, at the low end it is 50,000.
Workers comp costs for contractors in Iraq and Afghanistan are over a billion dollars.
Way over.
thanks to the Workers Comp Executive News Digest for the original idea.