Insight, analysis & opinion from Joe Paduda
Is coming from hospital trauma centers vacuuming thousands out of your wallet. Trauma centers are supposed to handle the worst trauma cases – those from major car accidents, gunshots, airplane crashes, building collapses – you get the picture. Smelling gold, … Continue reading that giant sucking sound…
Read More...Prior authorizations – aka 1-800 NURSE MAY I – are either an absolute necessity if you are a healthplan or a complete waste of time and money and affront to the medical profession if you’re a provider. Of course, reality … Continue reading Canaries and coal mines.
Read More...IWP has been a pain in the butt for work comp payers for years. The company’s business model is predicated on getting prescribing doctors and claimant attorneys to have their patients/clients get their meds from IWP. There are a bunch … Continue reading What’s the end game for Injured Workers’ Pharmacy?
Read More...President Biden’s HHS Secretary announced a major new Rule addressing surprise billing for out-of-network emergency services last week. While not yet final, the Rule – and subsequent modifications – may address a major cost area for workers’ comp. To be … Continue reading Surprise billing in workers’ comp
Read More...Doing my best to avoid work on Fridays…so moving this occasional catch-up post to Thursdays… COVID Promising news on the effectiveness of a drug to help infected patients fight off the virus was reported by the Economist. The good news … Continue reading Thursday catch-up
Read More...The workers’ comp services business is brutally competitive; a shrinking pie fought over by increasingly aggressive vendors, each striving to differentiate and demonstrate value. Smaller players and newer entrants are pushing hard, attempting to show how their approach/service model/pricing/technology is … Continue reading A business model in search of a problem
Read More...There are two selfish reasons the US should send as many vaccines as possible to other countries. Variants. The more the virus reproduces, the greater the chance it produces a much deadlier and more transmissible version. Each person vaccinated lessens … Continue reading Risk management 101
Read More...The internet, smart phones, electric vehicles, 9/11, genome sequencing…a lot has changed since 1990. But in workers’ comp…not so much. About 30 years ago OUCH (now part of Coventry) started the national workers’ comp PPO business. Liberty Mutual execs (literally) … Continue reading Has anything changed?
Read More...Let’s get real. You and your kids are driving 80 mph on a highway, when a truck suddenly veers in front of you. Since you are a quick-thinking insurance person, you estimate your chance of dying if you hit that … Continue reading Good luck with the truck.
Read More...I spend a lot of time in the weeds, digging into facility reimbursement details, evaluating COVID infection rate studies, identifying new work comp scams, figuring out if WC claims will increase, railing at insurers and TPAs that aren’t doing what … Continue reading What’s the state of work comp “managed care”?
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