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Nov
30

The work comp rumor mill

There’s been a lot of news, non-news, and rumor about deals and transactions and changes in the work comp managed care industry floating around out there. As usual, for some of the rumors there’s a little basis in fact and none at all for others. Here’s a compendium of the more solid stuff.


Managed care firm Genex (which has been on the block for some time now) is being pursued by two private equity firms, at least one of which is looking to use the managed care firm as the basis for a roll-up of WC.
Bill review software company Stratacare is well on the way to being sold, with a finalist selected and due diligence underway.
The Crawford – Broadspire transaction is moving ahead, with the center of gravity apparently heading south to Broadspire’s Lauderdale location. That despite news of layoffs in the legal and other departments at Broadspire.
CorVel had no presence in the exhibit hall at the National WC and Disability conference in Las Vegas…
Fair Isaac’s new bill review application SmartAdviser appears to be having a few hiccups. Current customers are few, and the expansion within those existing customers appears to be on hold. No word on the ongoing dispute between Texas Mutual and Fair Isaac on issues arising out of Texas Mutual’s issues with SmartAdviser.
The work comp pharmacy benefit management business gets the “most popular new business idea that’s not really a new business idea” award. There are at least a dozen new entrants to the field, many of which had booths in Las Vegas staffed by folks who were not exactly conversant with the fine points of WC drug management.
Aetna’s Work Comp Access looks to be taking a few more states from First Health’s long time customer Liberty Mutual early in the new year. That’s the positive for AWCA; the negative is AWCA’s Hartford relationship is somewhat tenuous due to the managed care firm’s failure to have networks in several states ready in time to meet commitments.


Joe Paduda is the principal of Health Strategy Associates

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A national consulting firm specializing in managed care for workers’ compensation, group health and auto, and health care cost containment. We serve insurers, employers and health care providers.

 

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