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Friday catch-up

The first week of September marks the start of the busy season in health care, insurance, and workers comp.  This week certainly maintained that tradition.

here’s what I noticed this week.

Health care costs

The news this week was pretty good – current health care cost trends are significantly lower than earlier projections, although predictions for future increases remain higher than we’d like.  That said, recall past predictions weren’t that accurate.

While we don’t KNOW what the impact of ACA, recovering employment, and health care system chances will be, we can look to Medicare – which isn’t affected much by the economy.  Jonathan Cohn’s take: “the slowdown in Medicare spending (which has little to do with the economy or changes to private insurance) is a powerful indicator that health care really is becoming a more efficient enterprise.” [emphasis added]

Another perspective is from the Washington Examiner – you can tell their bias as they lead with “President Obama’s health care law” – which PPACA decidedly wasn’t. Disregarding the Examiners’ disregard for accurate reporting, they cite a CMS actuary study which indicates government spending on health care will increase from 41% of the total to 48% in 2023.  That is accurate – however recall that CMS’ past projections for Medicare and medicaid growth have been shown to be too high.

 Health reform implementation

One of the concerns about PPACA was the employer mandate would encourage smaller employers to move workers to part-time status.  Early indications are there isn’t much of a shift – if any – to part-time work due to PPACA.  Rather the slow recovery of the economy seems to be the key factor.

A great piece by Incidental Economist Austin Frakt (a long time Health Wonk Review contributor!) in WaPo’s Upshot blog finds that the more competition in local markets, the lower the insurance premiums are.  Specifically, Austin notes the absence of United Healthcare from markets led to premiums that were 5.4% higher than they would have been with UHC participating.

Another take is that premiums in less competitive states were higher than in those with more health plans participating in the markets.

Pennsylvania is joining the ranks of the sane states that are expanding Medicaid, and in so doing will avoid:

*   $37.8 billion in lost federal spending over the next decade

*   $10.6 billion in lost hospital reimbursements over the next decade

*   380,000 low- and moderate- income people would not gain coverage in 2016

Workers’ comp

The BIG news just came out today – a study by McClatchy found rampant misclassification of workers as independent contractors receiving money from the 2009 stimulus. This is a damning indictment of governmental oversight, and one that demands our attention.

Liberty Mutual produced an excellent study that appears to indicate back pain patients who got MRIs early on had worse outcomes than those who did not have MRIs.  Their conclusion:

The impact of non adherent [not consistent with medical treatment guidelines] MRI includes a wide variety of expensive and potentially unnecessary services, and occurs relatively soon post-MRI. Study results provide evidence to promote provider and patient conversations to help patients choose care that is based on evidence, free from harm, less costly, and truly necessary.

Kudos to Liberty for conducting this research.

Remember – no emails, no business after 5 today – unplug!


4 thoughts on “Friday catch-up”

  1. Referring to PPACA as President Obama’s Health Care Reform is not biased. On a great many occasions, POTUS has himself referred to it as Obamacare.

    The bias is manufactured outrage over something innocuous

    1. AZWraith – thanks for the comment.

      I have to disagree. Not sure if you had the chance to read the Examiner piece, but I was NOT referring to the use of “Obamacare, but rather referring to the author’s statement “President Obama’s health care law”.

      As I noted, and as the link detailed, PPACA was decidedly NOT the President’s idea nor did it match his platform. One example – he and Ms Clinton disagreed strenuously on the mandate, with candidate Obama fiercely opposing said mandate. To say that this was “his” law is misleading at best.

  2. It was suggested by a gentleman from Stratcare that I contact you regarding my issue. I represent Mettler Electronics. We are the manufacturer and distributor of medical devices used for Physical Therapy. One of our produts, Polar Frost, is FDA approved with NDC numbers and is also listed on the First Data Bank – however, it is NOT listed on the Workers Comp Website. This is causing Mettler to loose business as customers are not buyng our product and even returning it – since they are not getting reimbursed by Workers Comp. when they use it. I have been trying for three weeks to get someone (anyone) to asist me, via e-mails and phone messages, and am getting no reply. I am seeking a consultant to assist Mettler with this matter – is this something you can help with or can you point me in the right direction? Thank you

  3. Thanks Joe! As always, great job throughout the week and on this one to end the week.

    Truly appreciate your keeping us informed. Helps us all to stay connected and competitive.

    Have a wonderful weekend! My best!


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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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