Coventry's work comp strategy.

Wednesday, October 17, 2007 | 0

--By Joe Paduda

Coventry was wasted no time. Just a month after the company signed an (essentially) exclusive deal to market Aetna's workers comp network, a deal that eliminated its last major competitor, it is seeking price increases from many customers.

A (very informal) survey of large and medium-sized WC payers over the last two weeks revealed a consistent pattern. Not only is Coventry looking to raise network access fees for renewing customers, it is also trying to get current customers to re-negotiate existing contracts. The company's representatives cite several reasons for this strategy.

1. The new combination of AWCA, First Health, and Concentra/Focus delivers significantly better network penetration and savings (albeit on a per-bill basis) than FH and Focus alone.

2. The new arrangement has required Coventry to make significant investments in its bill review platform, investments that have to be recouped.

3. Coventry now has to share revenues with Aetna (on the AWCA network states).

Unstated but obvious is the most important rationale - as the Coventry combo is the last big WC network standing, national WC payers have no other options. Yes, CorVel does have a national network, but none of the payers surveyed consider it a serious option.

Several early adopters did note that the new Coventry network has significantly increased network savings (again, that's on a savings per bill basis; it is too early to tell if there will be equivalent reductions in medical costs) and penetration. That's no surprise, as the combination of the three networks should include every living and most dead providers.

Coventry Dale Wolf has been quite clear about his intentions - he is looking for the WC division to grow by double digits for the foreseeable future. There are two ways to do this - sell new customers and raise prices. The first is unlikely, as between Coventry, Concentra, and Aetna they already served most of the large and medium-sized payers.

That leaves price increases, which not only increase top line revenue, but also jack up profits.

What does this mean for you?

Monopolistic power is good. If you're the monopoly.

Joe Paduda