Madsion, CT -(BusinessWire)- The workers’ compensation system is sick, according to Health Strategy Associates’ Joe Paduda, speaking at AASCIF recently.
Problems revolve around “medical care that costs too much and extends disability and enriches no one but providers and purveyors of services,” Paduda said. He cited opioids as the largest patient safety issue and cost driver.
“Opioids are not appropriate for long-term use in workers’ comp injuries, but one-fourth of our pharmacy dollars are spent on them,” Paduda said. He noted that a level of “arrogance and/or ignorance on the part of some physicians” fueled opioid use. “Comp is the addiction-creation industry,” he said.
Paduda called on stakeholders to examine the long-term implications of daily decisions and stressed the need for payers and managed care organizations to align their priorities. Managed care organizations with “more bills for more services” and “savings below fee schedule or billed charges” models foster over-utilization and drive up costs, he said. “We are ‘saving’ ourselves to death,” he said.
He applauded organizations that are working with health systems and providers where physicians are not financially motivated to order more tests and visits. “When communication is fast, focused and efficient and care is based on evidence-based medicine, outcomes are better,” Paduda said. “Still, more than 50 percent of the procedures have no basis in science.”
He called for the stakeholders to develop chronic pain management approaches, partner with expert providers committed to evidence-based medicine and implement state-wide policies. He cited Texas, Washington, Ohio, and California as policy victories.
Paduda also touched on private equity’s interest in acquiring workers’ comp companies, saying that around 50 PE firms were actively looking for assets in the industry.
Source: BusinessWire