Insight, analysis & opinion from Joe Paduda
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...Yesterday the NYTimes reported the Justice Department is suing Blue Cross Blue Shield of Michigan for allegedly violating antitrust laws. BCBSMI is accused of requiring hospitals to give BCBSMI ‘most favored nation’ pricing, thereby increasing the prices paid by other … Continue reading The Blue Cross of Michigan suit – yes, it affects you
Read More...There’s been a lot going on in New York’s work comp system; heated discussions over adoption of disability and medical treatment guidelines, an uproar over assessments for self insured groups, and ongoing actions and attempted actions regarding the pharmacy fee … Continue reading Changes afoot in New York’s work comp system
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...In the course of my consulting practice, I see a lot of work comp medical bill review ‘savings’ reports. Over the last fourteen years (since founding Health Strategy Associates in 1996) I’ve collected, reviewed, and analyzed scores of savings reports … Continue reading Defining work comp medical cost ‘savings’
Read More...Mark Farrah and Associates’ latest report indicates health plans enjoyed a nice bump in enrollment in Q1 2010 from the previous quarter, with the entire increase coming from ASO (large, administrative-services only plans that are sold to larger employers) business. … Continue reading Health plan enrollment is up, but that’s just part of the story
Read More...Just in case you thought the problems with abuse of powerful prescription drugs have been overstated, here’s a wake-up call. The CDC’s Director is taking this very seriously, saying: “Overdose with prescription drugs is one of the most serious and … Continue reading Narcotic usage – too much, or too little?
Read More...Today’s Kaiser Health Tracking Poll contains interesting data about support for health reform (steady positives, declining negatives), what’s much more telling is the extent of seniors’ a) ignorance of basic facts about health reform and b) widespread belief that reform … Continue reading The power of mis-information – a cautionary tale for health plans
Read More...The work comp pharmacy benefit management industry is growing increasingly sophisticated, and the release of PMSI’s Annual Drug Trends Report this morning adds to the trend. Many of the larger work comp PBMs produce similar reports, providing deep insights into … Continue reading Work comp pharmacy – one company’s experience
Read More...The public spat between retail drug giant Walgreens and PBM/retail giant CVS Caremark ended last week. The first question most will ask is ‘who won’? After asking that myself, I realized that’s not the most important issue. From here, it … Continue reading CVS Caremark and Walgreens – what happened?
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