Insight, analysis & opinion from Joe Paduda
Many payers look at ‘medical’ as a line item and nothing more. This myopia, this failure to look deeper, to try to understand what drives medical, is perhaps the most significant shortcoming in the industry. Many readers will dismiss this … Continue reading The cost of ignorance
Read More...As I noted yesterday, Florida is considering a change to the fee schedule that would increase work comp medical expenses by a full 20%. The change, basing reimbursement for work comp outpatient procedures on what hospitals bill Medicare, would double … Continue reading Florida’s hospital costs – bad to worse
Read More...The US is either in a recession or about to be. What does that mean for workers’ comp? Broadly speaking, there are no studies that indicate WC costs decline as a result of recessions; in general costs tend to increase. … Continue reading What does the recession mean for workers comp?
Read More...I’ve always been a ‘non-advocate’ of tight fee schedules and broad based discounted networks. Actually it’s a little more than that – I believe mandated across-the-board low fees are counterproductive, ill-conceived, harmful, and may actually increase costs while decreasing access … Continue reading What happens when a fee schedule goes up?
Read More...I’m attending the annual WCRI meeting in Boston today and tomorrow, and will be blogging from the meeting. For those not up on all things workers comp, the workers comp research institute is, along with NCCI and the CWCI, among … Continue reading WCRI conference report – how’s Texas doing?
Read More...Today, we’re leading with a quote from W, from a talk in DC October 28, 2003 …”As you know, these are open forums, you’re able to come and listen to what I have to say…” That’s not what we do … Continue reading HWR – the back to school edition
Read More...CMS’ hospital reimbursement change is going to create winners and losers; among the biggest winners will be UnitedHealthcare. Among the losers, their competitors.
Read More...The latest shot in the battle against drug costs comes from the Centers for Medicaid and Medicare Services, which is reported to be denying coverage for off-label use of drugs such as Actiq and Fentora. Whenever CMS moves, the healthcare … Continue reading CMS denies off-label Actiq coverage
Read More...Universal coverage is not needed because its just a replacement for a failed Medicaid/Medicare system that should be covering those folks without employer-based insurance. Once we fix the ‘M’ programs we’ll be fine. That’s another argument against UC, and the … Continue reading Universal coverage is bad – Part Eight
Read More...I’m on a brief vacation mountain biking in Moab, Utah. A gorgeous place, great people, great riding. And upon return from a long and tiring but very fun ride this am, I open up the latest from Fierce Healthcare to … Continue reading A buzz kill
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