Emergency room visits and costs are on the rise in the U.S. and expected to get worse with Obamacare according to a recent report which shows people with Medicaid (many of whom have obtained coverage under Obamacare) use ER more often than uninsured individuals. Complicating this picture are the ridiculous high costs of ER visits...
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Joe Paduda’s Predictions for work comp in 2015
Once again I’ll head out on a limb with saw firmly in hand… 1. Aetna will NOT be able to sell the Coventry work comp services division. I’ll double down on last year’s prediction: even if the giant health plan wants to dump work comp, the network – which is where all the profit is...
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Joe Paduda’s 2014′s predictions; how’d I do?
Before jumping into my predictions for 2015, I thought it would be helpful to review my previous prognostications. Here’s how I did, color-coded for your grading ease: 1. Overall, the work comp insurance market will be steady. Yep; rates were up just slightly, coverage availability is fine, and there are no crises. Then again, this...
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Joe Paduda’s Monday Morning Catch-up
After eight days away, time to catch up on the goings on. Lots happened, beginning with the non-renewal of the Terrorism Risk Insurance Act, aka TRIA. Mark Walls’ solid summary of the non-event that is a big event is here; Peter Rousmaniere penned a piece in WorkCompWire on the issue as well. Peter sees this as...
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A Workers Comp Claim’s Iceberg Effect
Workers in the claims profession and also on the employer side will often only think of claims as costs of wage loss and medical exposure. It is true that those costs are the ones on the surface. The injured worker has created a monetary exposure of their loss of wages covered by work comp payments,...
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Impact of Healthcare Reform on Workers’ Compensation
The Patient Protection and Affordable Healthcare Act (a/k/a Obamacare, or ACA) was signed into law on March 23, 2010. This piece of legislation has changed the way we think about healthcare in the United States. Among those changes is the “individual mandate,” which as of January 1, 2014, requires every person to obtain health insurance...
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Work comp in 2015 – predictions from around the web
Before I make my annual predictions for the coming year, I decided to find out what other experts are saying and what external factors may drive the industry. Here’s a quick summary. Work comp combined ratios will continue to improve as premiums hit an eight-year high this year; we can expect continued good news in 2015. These good...
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Joe Paduda’s Pre-Vacation Catch-up
Leaving tomorrow for eight days away, so today’s a quick catch-up. First up, the news that there’s been a dramatic increase in investor interest in addiction rehab. The market for services will increase to $35 billion this year, up more than 50% over the last decade. In a deal emblematic of the industry transition, Acadia will buy Bain...
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The Prohibited Acts Doctrine: Do Not Pass GO; Do Not Collect $200
The Prohibited Acts Doctrine is used in workers’ compensation cases as a primary liability defense. While this defense is something every claims management team should explore in workplace injuries, it is often difficult to employ successfully. A Hypothetical Consider the case of a truck driver. As part of the hiring process, the employee underwent a...
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Oregon Workers Comp Rates among Nation’s Lowest
Many employers in Oregon had to be happy with recent news regarding workers compensation rates. Oregon’s workers comp rates continue to be among the lowest in the nation, according to data released recently by the Oregon Department of Consumer and Business Services (DCBS). The biennial study ranks all 50 states and Washington, D.C., based on rates...
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