Insight, analysis & opinion from Joe Paduda

Jan
10

Medicare as a business – Coventry’s perspective

Coventry CEO Dale Wolf presented at the JPMorgan Healthcare Investment Conference earlier this week; I was particularly interested in his comments re the business opportunity in Medicare and Medicaid.
Medicare Advantage (MA) programs are likely to suffer a significant cut in funding this year as the Democrats, led by Rep. Pete Stark (D CA) take a chain saw to the subsidies paid to MA plans.
Coventry will be close to a $9 billion business in 2007.
The loss of a good chunk of the subsidy will make the MA business less attractive for many health plans; Wolf believes there is a significant opportunity for Coventry as it has successfully become the low cost producer in their markets, an achievement of which Wolf is quite proud.

Continue reading Medicare as a business – Coventry’s perspective


Jan
9

More intelligence in health care blogging

The number of health policy blogs is going thru it’s expansion phase; with new entrants jumping into the fray every nano-second. The best of the (relatively) recent efforts include Health Affairs, Bob Laszewski, and a brand spanking new blog, The Sentinel Effect.
Richard Eskow, one of the smartest people in the managed care business and has been posting at the Huffington Post for quite a while with much success. Richard has been in the business on the payer side for over 20 years, consulting with HMOs, tech companies, politicians, workers comp insurers, and providers. He’s especially good on the data analysis stuff.
He also plays a mean guitar.


Jan
8

The supply-side economics of health care

“Regular” economic theory doesn’t apply to health care in this country. After much debate, some of it acrimonious, I decided it’s time to lay out my case.
Why? Well, over the next couple of years there’s going to be a growing discussion about health care coverage, universal access, cost containment, yadda yadda. With a whole lot of luck, some of it will be educated, informed, and thoughtful. And with an incredible amount of luck and hard work, we’ll actually reach a solution that works pretty well.
But, if we don’t start with a solid understanding of the underlying issues in health care, we’re dead before we start.

Continue reading The supply-side economics of health care


Jan
5

Directing care

This is a pretty esoteric workers comp post, so if you aren’t so inclined, click on something else now before your eyes glaze over and it’s too late.
In workers comp, employers have the ability to make claimants go to specific physicians or lists of physicians in some states and don’t in other states. The former are “employer direction” states, the latter are “employee choice” states.
Except that’s not really true.

Continue reading Directing care


Jan
2

and the nominees are…

Hey, Managed Care Matters was nominated for one of the Best Medical Weblogs of 2006!.
Thanks to whomever entered the blog, and I’ll send out info on voting when it starts (tomorrow, I think).
Also in the running for the “Best Health Policy/Ethics Weblog” are Hank Stern’s InsureBlog, Health Business Blog, Rita Schwab’s MSSPNexus, Kevin, M.D., Roy Poses’ Health Care Renewal, and Effect Measure.
Now that’s SOME competition!


Joe Paduda is the principal of Health Strategy Associates

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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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