Year: 2022

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

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

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…

1. 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

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