National Work Comp Conference Summary
I just got back earlier this week from the National Work Comp Conference in Chicago. It was a productive conference, although I liked the setting of Las Vegas better last year.
The big difference at the conference was the buzz over Coventry. With all of the mergers and deals this year, it was clear Coventry was going to be the main topic for everyone, which held to be true. An irony of the conference was that Coventry seemed to be very quiet themselves. There was not a big splash from Coventry promoting their new “super network”. Instead, there was just a lot of talk from Resellers as to if they were going to be termed by Coventry or see their rates go up (or both).
I also heard a lot of buzz regarding Fair Pay and other “fair and reasonable” business model companies. It seems the time has come for this major form of cost containment.
Otherwise, it was a quiet conference.
November 14th, 2007 at 9:34 am
Well, it was a good Show. I was surprised (well, was I really?) of the lack of presence of Coventry and Aetna. I guess they were thinking that the buzz was enough for them.
Enough about them. I’d like to hear from some other PPO networks and what they’re up to. I spoke to many payors that are tired of them anyway. The market wants to see change but I wonder if the market is really up to the challenge.
I’ve said this before, I know there are other networks out there that are more valuable and are eager to offer solid savings (and I believe superior savings in various state markets) and service and I’m sure that we’ll see them making a run on this window of opportunity that’s been created by someone else’s decisions.
As far as the “fair and reasonable” model, I spoke with a small - but seemingly growing number of folks that are doing negotiations with this “fair and reasonable” model. This model takes nationwide provider charge data from all markets across the country and industry standard benchmarks to calculate “fair and reasonable” recommendations. Definitely worth looking into. Folks like Fair Pay, Qmedtrix and Moody Review and others are doing a pretty good job of this in various forms.
I definitely agree that this will become a major form of cost containtment in the coming months.
December 6th, 2007 at 8:18 am
Like the “fair and reasonable” model talk, proud to report that Medical Cost Remedy (MCR) is primed and prepared for the inevitable paradigm shift from the currently prevailing % of billed charges contracts to an accepted objective equitable payment recommendation methodology. MCR is the only Specialty Bill review company that offers a software and service solution specifically tailored and developed based on actual reimbursement data of providers. By benchmarking the results across local geographic areas, state and country - what better way to demonstrate real usual and customary recommendations. Combined with true web based automation, the end result is a consistent, accurate, and objective review each time - instantly! Keep us in mind!
September 8th, 2008 at 11:44 am
i like the fair and reasonable stuff to but i dont like that libs try to not make it that way they are lame