Insight, analysis & opinion from Joe Paduda

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Catch up Monday

On holiday this week, hiking in Arizona.  Hope your week is fabulous, unless you are a physician dispensing advocate or opioid overuse apologist, in which case I hope it is anything but.

Speaking of which, opioid guidelines are becoming more commonplace – a welcome event indeed.  One well worth your time has been put together by the estimable Steve Feinberg MD and his colleagues.  Dr Feinberg is a practicing physician in California; he deals with a lot of chronic pain patients, many workers’ comp claimants. Note – CompPharma, the work comp PBM consortium of which I am president, participated in the guideline review process.)

Dr Adam Fein’s Drug Channels has this useful graphic detailing the US pharma distribution and reimbursement system.  Worth downloading and posting on your cube wall.

The good doctor has also penned a brief and compelling synopsis of the current drug pricing landscape, forecasting that the rampant generic price inflation of the last few years is over.

Implementing health reform

Following up on last week’s report indicating ACA’s employer mandate has not had a material effect on hours worked comes news that the expansion of Medicaid in most states has had the same “non-effect”.  Evidently there was some concern that low-paid workers would drop out of the workforce or reduce their hours once they got coverage via Medicaid; the latest research indicates that – at least so far – this does not appear to be occurring.

Work Comp

Heard last week that OneCall has (internally) announced its plans to revamp operations and detailed the impact on employees.  There will be about 150 folks affected; job responsibilities will likely change for those who remain, others will be moved to different locations, and it looks like some will lose their jobs.  This comes after the sales meeting of a few weeks ago where a shift in emphasis towards more focus on HQ sales was reportedly unveiled.

And don’t forget the WCRI Annual meeting is coming up in less than a month.  I’ll be interviewing Dr John Ruser later this week and will report back on what’s on the agenda.  Registration is here.  

Time to hit the trail – literally.

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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