Leaders Speak

By Joe Paduda, Author, Managed Care Matters Workers comp payers – TPAs, employers and insurance companies – buy lots of services from many different vendors. Some are ‘purchased’ by adjusters and case managers on a claim-by-claim basis, but most payers use the formal ‘request for proposal’ process when big dollars are at stake. Vendors of… [Read more]

By Dr. William Hopper, CMO, MediCall There is growing concern about the increasing cost of unnecessary health care services.1 The rate of cost increases is being driven by acuity and severity of service categories2, and one of the most accelerated areas is pharmacy services. In addition to cost, the impact on patient morbidity and mortality… [Read more]

By Dr. William Hopper, CMO, MediCall With the recent passage of legislation in both Workers Compensation, Federal and private health plan arenas, more attention is being paid to the rising cost of increasingly expensive and often times unnecessary healthcare services. Utilization Management is one of the mainstays of resources to deal with combating unnecessary utilization.… [Read more]

By: Jim Greenwood, CEO, Concentra The use of Physical Therapy for musculoskeletal injuries in workers’ compensation has been and continues to be a controversial topic.  Is there value when a patient receives physical therapy? The answer to this question is, it depends.  The range of when therapy is received (acute early intervention or delayed chronic… [Read more]

By: Jim Greenwood, CEO, Concentra While many may debate the benefits of a medical fee schedule, most feel they play a part, some believe a large one, in controlling medical costs.  Most will also agree that a fee schedule in isolation, without appropriate utilization controls, really does very little in limiting medical costs. The rub… [Read more]