Insight, analysis & opinion from Joe Paduda
Investors focused on the workers’ comp network and specialty managed care businesses are a bit obsessed with “white space” – the “potential” business, the “opportunity” to capture unmanaged services, to get patients to network providers and thus deliver lower costs … Continue reading What’s all this about “white space” in workers’ comp?
Read More...Some weeks back, the Feds announced they’d reached a settlement with Millennium Health on allegations that drug toxicology firm Millennium Health was involved in illegal practices (my characterization, not theirs). More recently, Millennium has been working through a reorganization wherein the company’s … Continue reading The Millennium Health settlement
Read More...Yesterday we focused on enrollment, and more specifically the change in the number and percentage of eligible Americans covered by health insurance. In sum, about 9 million more non-elderly folks were insured earlier this year than were at the end of 2013; … Continue reading How’s the ACA doing? Part Two
Read More...Each year I publicly prognosticate about the year to come – and, being one committed to personal responsibility, I report back 12 months later. Here’s how prescient I was this time around. 1. Aetna will NOT be able to sell … Continue reading 2015 Work Comp predictions – how’d I do?
Read More...CompPharma’s annual meeting was held last week; CompPharma is an association of workers’ comp PBMs of which I am president. This year the focus was on connecting payers’ Medical Directors, PBMs, and regulators in an effort to broaden all parties’ … Continue reading Monday catch-up
Read More...Today’s WorkCompCentral brings an editorial on the “trend” in some state capitals towards plans legitimizing opting out of workers compensation. Friend and colleague Peter Rousmaniere has done more research and investigation of opt-out programs than anyone else I know. He knows … Continue reading Would you want your family covered by Opt Out?
Read More...The pushback on opioids has accelerated dramatically; every day there’s at least one major announcement about states, the Feds, or other entities taking major steps to attack the overuse of opioids. We are starting to see some progress. Perhaps most … Continue reading The Anti-Opioid Movement is gaining speed and traction
Read More...First, benefit plans offered on Exchanges are evolving rapidly, with smaller, closed networks getting a lot more traction. A recent report from Avalere found: from 2014 to 2016, the percentage of plans offering PPO networks dropped from 39 percent to … Continue reading ACA – what can we expect in the healthplan market in 2016?
Read More...What was noticeable about this year’s NWCDC was what wasn’t. That is, I didn’t hear or see much that was surprising or new or revelatory. After a score of scheduled and many more unscheduled meetings, what emerged was an overall sense … Continue reading NWCDC – key takeaways
Read More...Kudos to NWCDC for the Keynote – a real, live health care expert spoke for 90 minutes (!) on achieving excellence in medical care. Arthur Southam MD, the leader of Kaiser’s hospitals and health plan operations, was a great choice. … Continue reading NWCDC – the Wednesday Report
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