Paduda: Whither Workers' Comp in 2017 — Part II

Friday, December 30, 2016 | 0

Thursday's post prognosticated about macro-drivers of workers comp; employment, investment returns, medical costs.

Today’s focus is on what those macro-drivers mean for discrete parts of the work comp world – so here are the next five predictions.

6. Winners will focus on execution.

Execution – customer service and end-user experience, defining and delivering the service customers want in the way/when/how they want it; accuracy in reporting/billing/communicating; integration between vendors and customers – will continue to determine which work comp service providers win and who they beat. Notice I lead with customer service – for without focusing on the customer and their experience with your company, the rest doesn’t matter.

7. Telemedicine is coming fast.

What it will look like; who will win (see above); how it will impact patient care and outcomes; what types of medical services are most likely/suitable for telemedicine are all going to be clearer in twelve months. What we do know now is there is a lot of experimentation going on today, much of it driven by smaller companies. Among the models, there’s work comp specific company CHC Telehealth, a partnership between clinic giant Concentra and American Well, and giant TPA Sedgwick is deep into developing a telemedicine initiative.

Several other entities are quietly working on different approaches.

8. Mitchell will continue to add work comp services businesses via acquisition.

The tech company is working hard to expand beyond its traditional auto insurance business, with acquisitions in pharmacy benefit management and specialty bill review in 2016. Expect Mitchell to keep looking for “tuck-in” businesses in PBM and cost management in work comp and other P&C lines.

9. Drug cost decreases will flatten out somewhat, while reductions in opioid spend will continue to increase.

Regulators, payers and PBMs are slowly getting their arms around the issue; kudos to work comp for being in the forefront of this issue.  The group and public sector health insurers will learn a lot from you.

10. More value-based payment pilots will hit work comp.

That’s a really easy prediction, so I’ll quantify it – there will be more than five new pilots or program seeking to deliver care via bundled payments or similar mechanisms that will start in 2017.

11. Bonus pick – more consolidation in case management.

As frequency and severity continue to slide, field case management businesses are going to have to find new revenues from new services they can offer to current clients/cases and get more revenue from current cases.

That’s a really heavy lift. A much easier way to grow revenue is to buy other CM companies, cut expenses…you know the drill.

There you have it – Paduda once again standing out on a limb.

Joe Paduda is co-owner of CompPharma, a consortium of pharmacy benefit managers. This column was reprinted with his permission from his Managed Care Matters blog.