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