Insight, analysis & opinion from Joe Paduda
A new study by Paul Ginsburg at the Center for Health System Change reveals what we on the inside of the insurance industry have long ‘known’: The balance of power in rate negotiations has moved decisively from payers to providers … Continue reading Provider bargaining power is growing – and that’s a problem
Read More...Two things – facility costs and pharmacy. We’ll get to pharmacy next week (I’m finishing up the Seventh Annual Survey of Prescription Drug Management in Workers Comp), but for now here’s a couple quick hits on the growing problem in … Continue reading What’s driving comp medical costs
Read More...Last week WorkCompCentral’s [subscription required] Bill Kidd wrote about the battle in Illinois over reimbursement for surgical implants. The quick-and-dirty is hospitals are resisting a reduction in compensation for the devices themselves from 65% of billed charges to the manufacturer’s … Continue reading Why is it acceptable to shift costs to workers comp?
Read More...Yesterday I discussed the ongoing debate about potential changes to California’s work comp fee schedule. In case my position was too subtle, I’ve got grave reservations about using RBRVS (Medicare) as the basis for a work comp physician fee schedule. … Continue reading California Work Comp – Part Two – the hospitals…and what to do about them
Read More...There’s a lot going on in California’s workers comp system – medical costs zooming up and driving premium increases along the way, narcotic usage skyrocketing, a dramatic increase in scripts for medical foods and compounds, judges upholding controversial decisions, and … Continue reading California work comp – Part One, the fee schedule debate
Read More...Several clients have asked for more detail on how the reform bill will change Medicare reimbursement for physicians and other non-facility providers. Here’s the synopsis. First, note that this pertains only to reimbursement changes contained within the reform bill. There … Continue reading Changes to physician reimbursement under reform – the details
Read More...The good folks at NCCI just released a report [opens pdf] detailing workers comp medical cost drivers; there are two ‘headline’ findings; severity is increasing at a slower rate, and the price of medical services is becoming a larger contributor … Continue reading Work comp cost drivers – NCCI’s update and implications
Read More...As states take on the growing problem of surgical implant costs – the latest (and arguably greatest) effort by certain providers to reap huge profits from workers comp payers and employers, it’s time to delve into the problem – and … Continue reading Surgical implants – why the ‘price’…isn’t
Read More...Much of my writing over the past few weeks has focused on the future of work comp – the impact of reform, economic influences, the increasing negotiating power of health systems, changes in Medicare’s physician fee schedule (which WILL impact … Continue reading Where the work comp world is headed – part 4, pharma costs
Read More...For the Chinese treasure fleets, voyages went progressively further from their home ports, until, some believe, they circumnavigated the globe. Before we explore the ‘other side’ of the work comp world, we need to consider what lies just out of … Continue reading Where the work comp world is heading – Part 3, just over the horizon
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