Paduda: BWC's Dividends and Drug Costs

Thursday, August 27, 2020 | 0

Last week, Ohio’s Bureau of Workers’ Compensation announced it will consider $1.5 billion in dividends to policyholders.

Joe Paduda

This comes on the heels of a similar payout in April, when $1.35 billion went to private employers and $184 million went to local government taxing districts, such as counties, cities, townships and school districts.

Together, the two dividend payments amount to a refund of all premiums paid by employers in 2018 and 2019.

The bureau’s very strong financial results were attributed to excellent investment performance, a continued decline in claim counts, and “prudent fiscal management.”

A significant piece of this prudent fiscal management was the audit of BWC’s pharmacy program, which led to the state attorney general suing BWC’s pharmacy benefits manager OptumRx. 

Subsequently, AG Dave Yost accused OptumRx of overcharging “the state on 57% of 2.3 million claims between January 2014 and September 2018.” (It is important to note that BWC’s prior PBM was acquired by Optum and operated under a separate business unit.)

The suit was later amended to reflect Yost’s allegation that overcharges exceeded $16 million.

BWC switched PBMs two years ago. Its drug costs have dropped significantly over the last couple of years, and while a decline in claim frequency undoubtedly contributed to that drop, it is safe to say that prices paid for drugs helped slash pharmacy expenses.

And that has helped fund the huge dividend checks BWC’s customers are getting.

What does this mean for you?

Do you know you are paying only what you should? How can you prove that to your policyholders and customers?

Joseph Paduda is co-owner of CompPharma, a consulting firm focused on improving pharmacy programs in workers’ compensation. This column is republished with his permission from his Managed Care Matters blog.