Medicaid cuts = Higher work comp spend
This isn't complicated folks.
Next year 11 million Americans will lose health insurance when Republicans kill Medicaid expansion.
Healthcare spending will be cut by $99 billion.
Hospitals will see a net loss of $50 billion - $32 billion from lower Medicaid reimbursement and $19 billion in unreimbursed healthcare for the uninsured.
From WRJF - Eight states - Arizona, Indiana, New Mexico, New York, North Carolina, North Dakota, Oklahoma and Oregon would see healthcare spending drop by more than 6%.
What do you think will happen to workers’ comp medical costs?
Will hospitals, ambulance companies, physician groups, ambulatory surgical centers, therapists, medical device suppliers, home health care agencies and pharma suck it up and accept their lower revenues?
Ha.
Like any business, they will look for the softest targets - work comp is by far the most vulnerable - and:
jack up prices,
increase the volume of services delivered,
increase the intensity of services (that X-Ray will become a CAT Scan then an MRI then a PET Scan),
keep workers’ comp patients out of work as long as possible, and
constantly figure out ways to hoover more dollars out of work comp payers.
And, dear readers, this isn’t the worst of it. Republicans are committed to slashing Medicaid even more.
What does this mean for you?
Maybe the $14 billon in excess workers’ comp reserves aren’t really “excess”.
I agree with the comment from NewFiGuy. 30-40% is a low number. Try over 50% in many states. These middlemen PPO and speciality PPO networks that are backed by private equity are a big part of the problem. And they are extorting serious $$ from providers to benefit themselves. They care nothing about injured workers. Joe, you have addressed this topic before and have disclosed you consult with one of these types of networks I refer to. We providers are no fans of them and I think you know that.
To suggest providers will go out of their way to rip off employers/payers is just not something I understand. Most states like the one I am in (AZ) has a regulated fee schedule and utilization review checks for any runaway case. AZ uses ODG. I can tell you from a PT perspective our cases and visits are monitored closely by adjustors and case managers. Frankly, we really do not need these third-party middlemen keeping an eye on us. I do not feel they offer any value to the process while just extorting $$ from providers. Not just some $$, but a lot! I don't think any diligent and good intentioned provider would have a problem doing business with any of them if they paid us fairly and did not treat us like imbeciles. There is one PT/therapy network out there that tries to do things differently, but there model is still using discounts. I get why. It's easy. But tracking outcomes and value in these cases is the only way to really get results in my opinion. Stay well.
🤣🤣🤣 - PT providers can’t raise prices. The middlemen take 30-40% for doing nothing.