2022 - Know Your Health

December 31, 2022 Health Policy

In 2023, We Are All Health Consumers in Search of Value

Every health/care industry stakeholder will be in search of value in 2023, I explain in my latest post written on behalf of Medecision. In this essay, I forecast what’s ahead for hospitals, digital health innovators and investors, employers, pharma, and patients-as-consumers — all firmly focused on value in the new year.

“Inflation may make consumers and the healthcare system sicker,” Deloitte expects, signaling a sort of “unrest” for the healthcare ecosystem.

One of the most telling data points I include in my assessment of 2023 comes from GSR Ventures, which polled major health care investors on the now and future state of digital health funding.

This piece chart demonstrates that investors have value-based care on their minds, coupled with the consumerization of health care.

Read more on how (and why) we will all be value-minded consumers of health care in 2023 on the Medecision site.

December 23, 2022 Health Policy

Wildly off-topic #11 – the Will to Fight

Last night, Ukraine President Volodymyr Zelenskyy spoke to both Houses of Congress, both parties, and all of us. He spoke eloquently and passionately, describing the suffering of his people and their total commitment to defeating Russia and reclaiming all Ukrainian lands stolen by Putin.

What Zelenskyy knows – and I mean KNOWS – is the more Putin bombs Ukrainians, the stronger those Ukrainians become, and the more committed they are to seeing this through to Putin’s bitter end.

Net – Putin’s attack on civilian targets will strengthen Ukrainian resolve, not weaken it.

Here’s why.

I had long thought that the horrific bombing campaigns of World War II helped bring the war to a close by battering Germans and Japanese into submission. [full disclosure – my father was a machine gunner, bombardier, and armorer in the 8th Air Force in England during the second World War.]

Boy was I wrong.

Credible

December 22, 2022 Health Policy

Wildly off-topic #10 – Manpower

It’s been four months since we talked about Ukraine, a period during which Russia put scores of thousands of poorly-equipped, pretty-much-untrained, and wholly incompetent civilian men into army uniforms (or facsimiles thereof) and fed them into the meat grinder that is Donetsk, Kherson, Bakhmut and surrounding areas.

With this result.

With things on the front lines pretty static, it’s time to think through the factors that will decide who wins. In layperson’s terms, I’d say there are three main drivers

People to do the fighting – today’s topic

Will to fight

Stuff to fight with

Yes, this is pretty basic, but stick with me here.

The “people” need to be found, trained, equipped, clothed, fed and led. These are all hard to do – especially in winter, in Ukraine, after 10 months of often-brutal combat dominated by death-by-artillery.

In addition to the usual recruiting efforts focused on patriotism and

December 7, 2022 Health Policy

Pandemic’s impact on workers’ comp financials has been…

A new report ($25 to download) from the National Foundation for Unemployment Compensation and Workers’ Compensation sheds light on the pandemic’s impact on work comp financials.

MCM readers will not be surprised that the impact has been pretty positive – Mark Priven and I predicted this back in September of 2020.

Several key takeaways.

Medical costs plummeted – by over $3.5 billion – almost 12%, likely due to lower employment resulting in fewer claims, coupled with the relatively lower cost of COVID-related claims (much more on this here).
Total benefit payments dropped by almost $3.9 billion…
Over the last decade, the national average benefit cost per employee dropped by 10.2% – BEFORE adjusting for inflation. After adjusting for cumulative inflation of 17%, the real decline in benefit cost per employee was 27.3%.

What does this mean for you?

Workers’ comp financials are pretty strong…for insurers and employers.

Mark Priven is

December 5, 2022 Healthy Nutrition

Natural Immune System Health

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December 1, 2022 Health Policy

The state of work comp pharmacy

is pretty good.

Here are the very preliminary takeaways from the latest Survey of Prescription Drug Management in Workers’ Comp...so far 21 phone interviews completed and several more still to go.

[if you’re new to MCM, we’ve done an annual Survey since 2004, past public reports are here (respondents get a much more detailed version)]

Drug spend continues to decline, although at first blush it looks like the drop is less than we’ve seen in recent years
Opioid spend is also continuing its downward trend
Generic efficiency – the percentage of scripts that could be filled with generics that are filled with generics – is just shy of 100%
Payers are still struggling with legacy opioid patients with respondents identifying patient resistance (mostly fear driven), recalcitrant prescribers, attorneys and the lack of regulatory/legislative support as key obstacles
Physician dispensing is once again rearing its ugly/profiteering/self-serving/taxpayer-abusing head.
Payers want

November 30, 2022 Health Policy

Work comp and P&C – diabolical opposites

The property and casualty insurance industry is looking at increasing underwriting losses in 2022...while workers’ comp (which represents perhaps 1/10 of total P&C premiums) continues to be hugely profitable.

Which begs the question..will multi-line insurers try to use work comp to offset lower profits in other lines?

According to the Insurance Information Institute;

The (P&C) industry’s combined ratio — a measure of underwriting profitability in which a number below 100 represents a profit and one above 100 represents a loss – is forecast to be 105.6, a worsening of 6.1 points from 99.5 in 2021. [emphasis added]

Amidst troubling trends from other P&C lines – personal and commercial auto, property, multi-peril and homeowners, workers comp stands out…this from Milliman’s Jason Kurtz:

“The workers compensation line continues to stand alone, with its multi-year run of strong underwriting profitability forecast to continue for 2022 and into 2023-2024.”

Premium rates are

November 29, 2022 Health Policy

Work comp rates drop, behavioral health in WC, and workers as assets not costs

Happy Monday – for my American readers, hope your holiday was most excellent.

here’s good stuff you might have missed…

WCRI is hosting a no-cost webinar on Behavioral Health in Workers’ Compensation Thursday Dec 15 at 2 pm eastern. The webinar will discus their recent primer on BH in WC (available here for download)

The good folks at NCCI published their latest take on work comp industry financials...suffice it to say the party continues…although it may be getting close to ending.

courtesy NCCI

The final countrywide analysis of 2021 results shows:

- - WC Calendar Year 2021 private carrier net written premium (NWP) increased from 2020 by 0.5% to $38.2 billion
  - The WC Calendar Year 2021 private carrier combined ratio was 87.2%, and the operating gain was 23.7%

Meanwhile early data makes 2022 look even better; direct written premiums were up almost 10% over 2021, while the loss ratio for the

November 26, 2022 Health Policy

Complacency and arrogance – part 2

Last week’s post on Complacency and arrogance struck a chord with quite a few readers; some commented on on the post and/or LinkedIn while more chose instead to email me directly.

One question was raised by several of you; how does one guard against complacency and arrogance?

a few thoughts…

survey your staff
there’s an excellent piece in this morning’s Harvard Business Review on employee surveys. Key takeaways include:
1. tell your staff you need and want their feedback/input/recommendations
2. confirm that by a) let your staff know you value their input and appreciate their willingness to be honest; b) letting all know what you heard and what you plan to do about it; and c) show some self-awareness by letting them know you recognize one or more of your habits/tendencies that may be a challenge for them and want their perspective on how you can better work with them
3. change what

November 25, 2022 Health Policy

Republicans planning to force Medicare cuts

House Republicans are planning to impose massive cuts to Medicare, raise Medicare’s eligibility age, and withhold payments to early retirees and retirees earning more than a certain limit.

News sources indicate the GOP will use the upcoming debt limit to try and force Medicare cuts, a reprise of earlier efforts supported by 175 House Republicans to slash Medicare spending. The effort is also gaining traction among Senate Republicans, with Senator Lindsey Graham planning to use the Republicans’ leverage in Congress to cut Social Security and Medicare.

Sen. Rick Scott’s 11 point plan goes a lot further; it would end Social Security and Medicare if Congress doesn’t take specific action to renew those programs every few years (see Scott responding to Fox News question at 1:09 of the video here.)

You may well recall that Scott was sued for Medicare fraud back when he ran Columbia/HCA. Columbia/HCA was ordered