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Predictions for 2011 – how’d I do?

I’m all about accountability – and that means each year I have to report how I did on my predictions for the preceding twelve months. Not always a happy time, especially when it’s one of those “learning experiences.”.
Yep, it’s time for the annual review of my predictions for the year gone by – an annual event more likely to humble than honor your faithful author, while providing a bit of entertainment for you, dear reader.
So, somewhat reluctantly, here goes.
1. Business will pick up – a lot.
This referred to the work comp sector; it looks like my outlook was overly optimistic. While there’s been an uptick in initial claims, and severity continues to increase, and premiums are going up a bit, it’s only “a bit.” Have to score this a wrong…
2. We’ll see several new comp writers enter the market as capital comes in, providing increased underwriting capacity in selected markets.
I’d have to score this as a partial; there is plenty of capital in the comp market but not much in the way of “new writers”.
3. Sedgwick will continue to snap up TPA operations, supply-chain pieces, and managed care vendors
A definite “correct”, as the nation’s largest TPA, Sedgwick continues to grow in part by “vertical integration”, buying workers comp service companies and other TPAs. The latest deals include XChanging and SRS.
4. The exploding growth of opioid usage in narcotics in comp will become even more prominent.
Another “correct”. The research published by CWCI, NCCI, WCRI and individual PBMs has documented all too well the sad state of affairs. And if this wasn’t enough, there’s been reports of opioid-related claimant deaths in the mass media as well.
5. Obesity’s impact on work comp costs will gain more attention, as additional research will show significantly higher costs
Another yes, as well-documented by our colleagues at Workers’ Comp Insider and excellent research from NCCI
6. Congress will not solve the Medicare physician reimbursement conundrum,

This has to rate as a “gimme”; there’s no evidence Congress will ever solve ANY problem, much less one as knotty as Medicare physician reimbursement.
7. Hospital and facility costs, both inpatient and out, are going to get a lot more attention in payers’ C suites.
I can only comment on this anecdotally, but several payers I work with are quite alarmed about the cost of facility fees, especially in Illinois, California and Florida. That said, there hasn’t been the public discussion I thought would happen when this issue really gets traction. So, I’ll give this a “not really”.
8. We’ll see more litigation around ‘silent PPOs’ in more states.
Fortunately, this looks to be a “not really.” Madison County Illinois is one of the hotbeds of class action suits alleging silent ppo violations; most recently a federal judge refused to certify a class in a silent ppo case.
9. Social media is going to make its presence felt broadly and deeply in comp, in ways obvious and not, good and bad
Again, no question – yes. Whether it’s the usage of Facebook, Twitter, and other vehicles by payers looking for information on claimants, or service companies using social media for marketing purposes, or industry wide discussion groups (Mark Walls of Safety National’s LinkedIn Group, Bob Wilson of, or blogs (led by the originator, Workers Comp Insider) breaking news about developments in the market, there’s no doubt social media is a large and growing presence in comp.
10. The impact of health reform on workers comp will happen in ways mostly subtle.
Absolutely. While reform is a long way from full implementation, the added coverage of 2.5 million young people due to the expansion of parental coverage to children under 26, greatly expanded use of electronic medical records and e-prescribing, and increase in funding for medical research of comparative effectiveness are all making a difference.
What’s the result?
Well, six corrects and four “not corrects” – better than a great baseball hitter, but not what I’d hoped. (That said, a couple of the “not corrects” may get partial credit)
Next up – predictions for 2012. I’m off to get the crystal ball polished up at the local gemologist…

2 thoughts on “Predictions for 2011 – how’d I do?”

  1. David – thanks for the comment and great question.
    I’m certain we will see litigation increase for inappropriate prescribing; with more people dying of overdoses, I’d expect the DEA and others also to crack down on egregious prescribers. We’ve seen this is Scioto County Ohio and Florida already, and those are just the worst of teh worst.

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Joe Paduda is the principal of Health Strategy Associates




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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