I just can’t stop myself.
The Ohio Bureau of Workers Comp scandal is so big, so juicy, so full of great stories and bizarre twists and turns and corruption and lying and deceit and, well, we could be talking mini-series here!
The latest news is Tommy Noe, coin dealer, real estate developer, and scam artist extraordinaire, will not be needing either of his waterfront homes, at least not for ten years. Tommy may have thought he would be living in luxury courtesy of the state; while he will be living off the taxpayers, the accomodations will be somewhat more spartan.
It could have been worse; they could have re-opened Alcatraz for him and his co-conspirators…

Patient satisfaction, return to work, and other outcomes were the subject of another presentation at WCRI. I can’t provide details as the actual material is embargo’ed, but here are the key points.

Continue reading What I learned about outcomes at WCRI

OK, I know a lot of readers are not exactly holding their collective breath waiting for more updates from the WCRI conference…but a few are. (hard to believe, I know…)
So, for those eagerly waiting, here’s the latest.
A panel discussed the results of the reforms to the California WC system. Overall, the results have been quite favorable wiith rates declining, and better control over medical care and costs.

Continue reading Results of California’s WC reforms

A panel at the WCRI conference discussed the TX workers comp reform initiatives aka House Bill 7; here are my impressions in chronological order.
The (relatively) new WC fee schedule, (new as of 8/2003), set reimbursement at Medicare +25%, and allowed for employers to direct injured workers to specific health care providers. The change was a significant decrease for surgery, and an increase for Evaluation & Management services. Surgical prices dropped 31%, while E&M prices jumped by over 23%.

Continue reading Texas’ WC reforms – predictions for the future

from today’s WCRI conference
Inpatient hospital costs in MI increased by 13.3% from 02/03 – 04/05. Why?

Continue reading Michigan’s WC cases are paying lots more for hospital care

I’m attending the annual Workers Compensation Research Institute today and tomorrow and will be posting from the meeting.
The first presentation was an analysis of WC provider fee schedules, comparing the actual fee schedules to providers’ operating expenses. It will come as no surprise that some states’ fee schedules are pretty low, while others pay up to 2.5 times more than Medicare (alaska, for one).
No extra credit for guessing which type of service is paid at a higher rate; most fee schedules pay relatively more for surgery than for evaluation and management services.

Continue reading WCRI’s new workers comp medical price research

Coventry’s public statements and documents point to a possibility that the big managed care company will be looking to expand it’s workers comp offerings through acquiistion. The business, known to the cognoscenti as First Health Workers Comp, has made little progress since it was acquired by Coventry almost two years ago. FH is suffering from a lack of attention by Coventry senior management, flat revenues, and serious competition from Aetna and others.
While acquiring more WC entities may help FH, basic logic would indicate that before you add to a company, you ought to make sure the company you have is running smoothly.
Otherwise all you’re doing is putting lipstick on a pig.

Finding malfeasance, mismanagement, incompetence, or just plain fraud related to workers comp is pretty easy if you confine your search to Ohio. The latest comes from the Plain Dealer in a report on vocational rehab companies that have benefited enormously from their cozy relationships with managed care firms.

Continue reading More ohio nastiness

In one answer to the question, where did Ohio’s Workers Comp premiums go?, the answer is to a contractor building Tommy Noe’s house on Lake Erie.
Noe, the defendant in a criminal trial, is alleged to have used workers comp funds set aside as reserves to pay future claims to help pay for his 4200 square foot house on Lake Erie. And another one in the Florida Keys, both of which were worth a million bucks each.
If anyone has photos of these places, let me know.