Insight, analysis & opinion from Joe Paduda
Employers, state funds, and insurers are focusing more and more on closing old claims; the most successful ones are partnering with their Pharmacy Benefit Managers. The logic is clear – the older and more costly the claim, the greater the … Continue reading PBMs and legacy work comp claims
Read More...We are stuck in a self-destructive cycle, namely an industry-wide culture that rejects true innovation that leads to a huge talent deficit that prevents innovation. With few exceptions, there is little in the way of innovation, effective marketing, risk-taking, creativity … Continue reading A wake-up call for the insurance industry
Read More...AARP has rather strange positions on drug prices and healthcare costs. AARP positions itself as an advocate for seniors (and no, while I’m eligible, I’m not a member). The latest PR effort by the huge organization touts its lobbying to … Continue reading AARP, healthcare costs and drug prices
Read More...Today, I’m going to convince you that despite years of continued decreases, work comp premiums are still too high. And will likely remain too high for the next few years. That’s how long it will take the impact of reduced … Continue reading Work comp rates are still too high – and will continue to drop
Read More...In which I attempt to describe the top takeaways from the latest research and what it may mean for you. Work comp pharmacy WCRI’s latest report on Interstate variations on Dispensing of Opioids is available; free for members, nominal cost … Continue reading Research Roundup
Read More...What the heck is going on in the Golden State? For the second year in a row, claim frequency for self-insured employers is up (frequency is the percentage of FTEs that file a work comp claim). Over the two years … Continue reading California Conundrum – Work comp premiums are down, but self-insureds’ frequency and claim counts are up
Read More...Happy Friday! It’s Research Roundup time. Here’s my quick takeaways on new research – and how it affects you. WCRI on the interaction of health insurance and workers’ comp Bogdan Savych PhD of WCRI has provided an excellent review of … Continue reading Worker outcomes, opioid reductions, and prices for drugs and hospitals
Read More...Do you have any idea if you are paying your PBM what you should? Work comp payers’ PBM pricing is based on AWP; typically it is a percentage below AWP. Brand drugs are discounted 10-16%, and generic pricing is typically … Continue reading Explaining pharmacy pricing, part 4
Read More...Yesterday was post 2 of Pharmacy Week at MCM, an intro to drug pricing. Today we’ll get you up to speed on why the list prices for drugs are irrelevant – mostly. Recall that almost all work comp drug fee … Continue reading Explaining pharmacy pricing, part 2
Read More...in which I attempt to summarize recent research into workers’ comp and medical management and describe what it means for you. Thanks to Elaine Goodman of WorkCompCentral, we learned this morning that folks who consumed marijuana during recovery from an … Continue reading Research Roundup
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