Insight, analysis & opinion from Joe Paduda
One of the top issues in work comp pharmacy – heck in all pharmacy – is transparency. More than half of the 27 respondents to our latest Survey pf pharmacy management in workers’ comp want more transparency, while several others … Continue reading Transparency in drug pricing
Read More...Buyers are asking healthcare intermediaries for “transparency”. We talked about why this is happening yesterday; today I’ll try to concisely describe what this transparency thing is. The emphasis on try is an upfront admission that a blog post is NOT … Continue reading What – exactly – is “transparency”?
Read More...In healthcare and work comp, “transparency” is becoming the latest popular word, or more accurately, customer request. Nationally, the Trump administration is requiring hospitals post their list prices. More and more large employers and healthplans ask their pharmacy benefit managers … Continue reading Why “transparency”?
Read More...A report on TPA transparency from the New Jersey Office of the State Comptroller (OSC) on transparency “found that workers’ compensation third party administrators (“TPAs”) may be utilizing undisclosed side agreements with third party vendors which require payments back to the … Continue reading TPA transparency – another warning
Read More...It just won’t stop. Over the last few years, long-suffering TPAs, hammered by the soft insurance market, went from making a few bucks on managed care services to earning most if not all of their profits from commissions on same. … Continue reading TPAs and transparency – the bigger issue
Read More...Transparency. The basic requirements of consumer-directed health plans (CDHPs) are price transparency and outcomes data. The foundational concept underlying CDHPs is that consumers will ask how much services cost, and providers will be able to tell them. Oh were it … Continue reading Where’s the pricing transparency?
Read More...An article in CFO.com analyzes the complex web of transactions, relationships, and incentives that exist in the employer-TPA-managed care firm web. David Katz notes: “risk managers, by some accounts, often hand over the management of claims and medical costs to … Continue reading Managed care fees, TPA charges and transparency
Read More...Texas has some rather troubling healthcare problems…and Texas’ legislators are asking the state’s largest workers’ comp insurer to help solve those problems. First, a few Texas healthcare data points… more Texans are uninsured than in any other state, access to … Continue reading Can Texas Mutual help Texas’ health insurance/healthcare needs?
Read More...WCRI is out with its latest inventory of state regulations re prescription drug management. This is a must-have for claims execs, managed care leaders, medical directors and risk managers…pricing, utilization review, opioid management, formularies and PBM regs are all covered. … Continue reading Stuff I missed while my server was down…drugs, profiteering hospitals
Read More...is pretty good. Here are the very preliminary takeaways from the latest Survey of Prescription Drug Management in Workers’ Comp…so far 21 phone interviews completed and several more still to go. [if you’re new to MCM, we’ve done an annual … Continue reading The state of work comp pharmacy
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