Archive for December, 2013

Year End: A Look Back at 2013, A Look Ahead to 2014

Monday, December 30th, 2013

We’ve gathered some year end wrap-ups as well as some predictions for the year ahead.
A look back at 2013

2014: A look ahead

Santa’s workshop: “OSHA problems galore” say whistleblowers

Monday, December 23rd, 2013

Not to be a holiday killjoy, but if Santa does not show up at your house we think we know why. We just saw a press release about a lawsuit alleging that Santa promotes hostile and unsafe work environment in shelf-elf program. The suit is filled with some pretty shocking allegations which, if true might ground the big guy. What’s more, it follows on the heels of some other recent charges by Buddy the Elf, a whistleblower who revealed some horrible and unsafe labor practices in Santa’s workshop. Charges range from elves being paid in candy canes to exposed to terrible health hazards due to being housed with wild ruminants and exposed to their waste. The horror.
Part of the reason Santa has been able to get away with questionable practices is that his workshop is located outside of OSHA’s jurisdiction. He’s not beholden to US labor laws. At the oshatraining blog, Curtis Chambers does a great job explaining other safety problems that were identified at Santa’s North Pole workshop – no machine guarding, no personal protective equipment and no fall protection to name a few. Apparently Santa is getting fed up with all the criticism and bad publicity. Curtis explains that in recent years, to improve his image, Santa has entered a voluntary OSHA compliance program. It hasn’t all been easy, there have been some bumps in the road. You can read all about it in In Curtis’ post How OSHA nearly killed Christmas.
We are hoping Santa will be getting some help soon, though. Between Amazon’s delivery drones and Google’s somewhat terrifying BigDog and PetMan robots, things may get a little more mechanized in his workshop of the future. Then Santa can ditch the sleigh and ride in a driver-less car.

Health Wonk Review: the Letters to Santa edition

Thursday, December 19th, 2013
Portrait of Santa Claus answering Christmas letters

Portrait of Santa Claus answering Christmas letters

Hello Santa! — You’re surely a busy guy this season — it’s no small task sorting out the naughty from the nice all over the globe! Good thing you’re such a wise soul because there are a lot of folks who could really try your patience. Just take the rogues gallery down in Washington DC, for example — everybody has a long wish list and they don’t see eye to eye at all. In fact, for all the talk about keeping the real spirit of Christmas in the holiday, it seems like everyone’s forgetting about the “peace on earth” and “goodwill to man” parts of the deal. Some people are even getting hung up on whether you are black or white, can you believe it? Here’s hoping you can sort it all out!
We’ve collected some healthcare thoughts & wishes from the wonky blogosphere hoping that it will make your job a little easier. These are some devilishly smart and very nice people, so a little special consideration would be appreciated!
Dear Santa – Are some holiday revelers drinking too much egg nog and getting cloudy thinking? Joe Paduda seems to think so. At Managed Care Matters, he finds that some of the “repeal and replace” crowd are getting loud and fighty but not making a lot of sense. He dissects the various ideas advanced by those looking to repeal Obamacare to determine the viability. You be the judge: Repeal and replace Obamacare – making the case.
Dear Santa – When you’re sorting people into the naughty or nice rosters, can you be sure that Professor Tim Jost gets put in the “nice” list? At the Health Affairs Blog, he’s done a detailed and extensive analysis of the health exchange enrollments to date. He looks beyond November’s dramatic enrollment increase to other interesting trends that the metrics hold. Check out his analysis of November’s Exchange Enrollment Report and see if you don’t agree that he deserves some special consideration.
Dear Santa – As we near the holiday, it appears that some folks have been rushing around at the eleventh hour to try to look good after a disappointing year. Billy Wynne, one of our newer and very welcome health wonkers, has been observing the year-end flurry of legislative activity in DC and offers a breakdown of some of the most significant developments and what they might portend for the future, noting that if this week is any indicator, we’re in for more fun in the new year. Check out The Doc Fix is Real – And Other Lessons Learned Last Week posted at the Healthcare Lighthouse blog.
Dear Santa – Before you decide whether the DC legislators deserve coal or candy on the issue of the pending Doc fix – the one that has been bumped into the new year – you might check in with Brad Flansbaum‘s post at The Hospital Leader. In The Problem That Won’t Go Away, he looks at how the rubber meets the road in terms of the impact on hospitalists. (And in a noteworthy post unrelated to the political goings on, Brad looks at the issue of whether the use of hospital readmissions as a lone metric for post-discharge health care quality is incomplete without considering the role of the ED. Check out his take on the matter.)
Dear Santa – Did you catch wind of the widely circulated AP story saying that people with insurance coverage are angry at ObamaCare? At Health Business Blog, David Williams digs through the news narratives and finds some skewed polls and faulty reporting. He notes that despite a botched Obamacare rollout, the public still trusts Democrats on health care by a wide margin. Could it be that people are not as unhappy as the media would have us think? Sounds like you may need to stock up on coal for lots of reporters’ stockings!
Dear Santa – In further considering the matter of naughty reporters, we may have a solution. Insurance industry insider Wendell Potter has developed an excellent checklist for reporters, which he thinks would help them in avoiding the pitfalls of being duped while covering Obamacare “horror stories.” Can you make some room in that big sack of presents? If you could drop the checklist off at newsrooms while you are on your pre-Christmas publicity tour, it would likely make him happy. You can check out his 5 question reporter checklist at’s blog.
Dear Santa – When you’re checking your list this year, please check it twice to be sure that you notice the issue Dr. Roy Poses raises. He has put in a request for some teeth. Oh, not the dental kind – it seems he is hoping that healthcare reform will deliver real accountability when it comes to patient protection — something with real bite that will take organizations to task for bad behavior. Could you put this on the fast track because he has apparently been waiting for some time. Over at Health Care Renewal, he posts about yet another Johnson and Johnson settlement — it would appear that some enforcement is sorely lacking.
Dear Santa – As long as we’re on the topic of teeth, could you be sure to leave a special present under the tree for Louise Norris? At Colorado Health Insurance Insider, she has done some hard work and heavy lifting in sorting out how pediatric dental coverage will be impacted by ACA and HHS regulations.
Dear Santa – Can you settle the matter of whether health insurance improves health? Healthcare Economist Jason Shafrin notes that in most cases, the answer is likely ‘yes’ — but a study in Burkina Faso found that the answer was ‘no’. In considering this question, Peggy Salvatore wonders if we are all asking the wrong question and focusing on the wrong things: she asks the fundamental question of whether we are trying to provide health insurance or health care for all?
Dear Santa – Not everyone is feeling all that jolly this year. Some folks are looking to the future and seeing an ominous ghost of Christmas Yet to Come. Check out John Goodman’s Health Policy Blog – he’s sounding an alert about a severe doctor shortage that’s looming and he explains why he sees this in the cards. And at InsureBlog, Patrick Paule sees a future with a lot of disappointment for a lot of people. He thinks that even those folks who find an insurance plan they like in 2014 shouldn’t count on it — he thinks they are likely to find a blue Christmas in years to come.
Dear Santa –Dr. Jaan Sidorov sees another looming peril and would like your thoughts on the matter. At the Disease Care Management Blog, he asks if the bureaucrats responsible for implementing Obamacare are falling victim to the dreaded condition of “credibility trap,” where government begins to doubt itself. He identifies various symptoms of this condition. Is he over-reaching? You be the judge.
Dear Santa – Some are troubled by other matters than the ACA: it appears that medical education is no longer the unique purview of academic health centers. That’s an issue that Dr. James E. Lewis raises at Wing Of Zock in noting the opening of the Medtronic Surgical Technologies training facility in Florida, which aims to train 750 surgeons and health care professionals annually. Are income streams becoming inextricably intertwined in academic medicine?
Dear Santa – Here at Workers Comp Insider, we’re really not asking for anything for ourselves, but we’d like you to please look after the health and safety of the workers. Lately, we’ve been particularly concerned about the health and wellbeing of the healthcare workers. It’s not bad enough that they face all the stress of a changing healthcare environment, their jobs are downright dangerous, too. And now it would appear that many of the perils they face are not from patients but are are self-inflicted. Can you help?

Thank you, LexisNexis and Julie Ferguson

Thursday, December 12th, 2013

While we don’t usually make a fuss over these things, I want to thank the good people at LexisNexis for once again recognizing Workers Comp Insider as one of the top three national blogs of the year. We’re highly appreciative and grateful for the honor.
I also want to take a moment to thank the Mother of Insurance Blogs, Julie Ferguson.
Julie and I have worked together for more than 20 years, and I cannot tell you how much I value her considerable talent, dedication, professionalism and vision. But even I was a bit confused and surprised when, in early 2003, she came to me to suggest that we might want to create something called a “weblog” for workers compensation. At that time, I viewed these things as the fad du jour, something teenagers used to memorialize what they had for breakfast and what they thought might be neat for the rest of the day, at least until lunch.
But Julie told me that this would be a way to reach a much larger constituency and, if we stuck to it, we had a chance to shape the future of workers compensation communication. I was highly skeptical, but she was persuasive and would not let it go.
And she was right. Thus was conceived and born the first insurance blog in the world. The Insider debuted in September, 2003, and has been going strong ever since. And all the credit goes to Julie. Early on, she said that many blogs would be created, but few would survive because of all the hard work, persistence and dedication it takes to keep them going, to keep them fresh, informative, readable and compelling. She was right about that, too.
So, thank you, LexisNexis, and thank you our faithful readers, but most of all thank you, Julie Ferguson, my visionary friend.

Risk roundup and other news of note

Wednesday, December 11th, 2013

Our colleague David Williams hosts the Cavalcade of Risk #198: Short and sweet edition. He always does a terrific job hosting the roundups – and if healthcare is on your radar, his blog should be a regular read.

Group Health Plans Pay for ‘Zero-Cost’ Workers’ Compensation Claims
– study by Abay Asfaw, PhD, and colleagues of the National Institute for Occupational Safety and Health published in the December Journal of Occupational and Environmental Medicine, official publication of the American College of Occupational and Environmental Medicine (ACOEM).
Businesses Object To Posting On-Job Injuries Online – OSHA wants to make records of on-the-job injuries by employer easily available on a website. It says that would lead to safer workplaces. Manufacturers and businesses are objecting, arguing the data could be misinterpreted.
The other ways health care will change – Joe Paduda recaps some of the points he is making at a talk before the New York Academy of Medicine. In other ACA news, Jonathon Cohn talks about The Obamacare Flaw That Worries Me the Most; Sarah Kliff reports that Since October, 1.2 million have gained Obamacare coverage: 803 via Medicaid and 365 via exchanges. In Medicaid, here are the next 5 battleground states. This is significant because there are reports that hospitals are closing in states that blocked Medicaid expansion. In other news, three states are implementing transparency measures: More healthcare cost transparency for MA, NH [and NC] consumers.
Severity Trends by Undeveloped Size of Loss – NCCI research report.
10 Strategies to Combat the Rx Abuse Epidemic – An Insurer’s Perspective – In October 2013, the Trust For America’s Health (TFAH) issued a report titled, “Prescription Drug Abuse: Strategies to Stop the Epidemic” identifying ten strategies being employed at the State level.This article provides a brief recap of the strategies and shares some insurance company considerations.
In this one year anniversary of the horrific shooting at Newtown, how are we doing? USA has made slight progress on mental health since Newtown; Meanwhile, Two-thirds of gun laws passed since Newtown massacre eased gun regulation – and in that year, about 8-10x the number of children killed in Newtown have been killed by guns. The New York Times issues a report Children and Guns: The Hidden Toll, which attempts a census of accidental gun deaths of children but finds a pattern of underreporting due to idiosyncrasies in the way deaths are recorded. They looked at 259 deaths of children under age 15, while a report from Mother Jones documents 194 children under the age of 12.
News Briefs

More perils for healthcare workers

Monday, December 9th, 2013

In a recent blog post about healthcare workers, Tom Lynch talked about the scourge of patient handling and the resulting epidemic of related injuries. We note that Risk Management magazine and its affiliated blog Risk Management Monitor have recently featured articles on other risks associated with healthcare workers, which we think are noteworthy.
In December’s Risk Management magazine, Alan H. Rosenstein talks about Managing the Risks of Disruptive Behaviors in Health Care Settings. Often, in discussions about threats to healthcare staff, the focus is on threats from patients, family members or outsiders – but Rosenstein tackles peer-to-peer behaviors that cause problems – an issue serious enough in scope that the Joint Commission requires hospitals to have a written policy addressing disruptive behaviors as one of its leadership standards for hospital accreditation. He defines disruptive behaviors as “any inappropriate behavior, confrontation or conflict, ranging from verbal abuse to physical or sexual harassment, that can negatively impact patient care” and notes:

“Research has shown that 3% to 5% of physician and nursing staffs at hospitals exhibit disruptive behaviors. While the actual number of physicians and nurses responsible for these episodes is small, the impact is not. Studies have shown that more than 95% of those involved in a disruptive event feel stressed, intimidated or unable to concentrate, inhibiting their ability to effectively collaborate and communicate patient medical concerns. More than half of those surveyed felt these events led to medical errors and compromises in patient safety and quality of care.”

He identifies training as “an area ripe for improvement” noting that while, for example, physician education emphasizes knowledge and technical competency it does not necessarily address “emotional intelligence.”
In Risk Management Monitor, Hilary Tuttle looks at the issue of violence in her post, Minimizing the Dangers for Hospital Nurses. She includes an infographic, which we pass along below. If healthcare workers are on your radar, be sure to check out both articles
The Dark Side of Nursing

Health Wonk Review & the ACA; plus a news roundup

Thursday, December 5th, 2013

Our favorite Healthcare Economist, Jason Shafrin, is hosting this week’s compendium of posts from the health policy wonks: Health Wonk Review takes on – get up to speed on what the experts think about the ACA rollout.
The Warning Signs of Violence – Security and student safety have always been strong concerns for educational institutions – and heightened to the nth degree after the shooting massacres of Virgina Tech and Sandy Hook. There’s a good article recently posted on Campus Safety magazine on The Warning Signs of Violence, which includes a sidebar on the continuum of violence. This model – developed by Holmes and Holmes in 2001 – has three levels. Level 1 is intimidation, Level 2 is escalation and Level 3 is further escalation. The article also talks about the tactics of manipulation and how to trust your instincts. It’s useful reading matter for HR, risk and safety managers – as well as supervisors.
Related: 8 Verbal Indicators of Violence
Workers Comp Navigation – We really liked this article by Sarah Tayts in WorkCompWire: On the Road to Recovery: Who’s Driving? Her essay talks about many of the themes that we at Lynch Ryan long seen as vital to a positive outcome for all: maintaining good communication and treating the injured employee with respect and concern. Here’s a sampling: “We’re not dealing with claimants. We’re not dealing with plaintiffs. We’re dealing with people who have sustained a disabling event. Maybe they weren’t financially set before the injury, and a twenty-one day compensability determination period is really throwing a wrench into things. Maybe their boss reacted poorly to their report of an injury.”
Related: Top 10 reasons injured workers retain attorneys
NCCI – with Thanksgiving vacations, you may have missed NCCI’s latest Financial Update. One of the key findings: “At this year’s Annual Issues Symposium (AIS) , NCCI estimated an industry wide combined ratio for 2012 of 109. Actual data reported by the industry indicates a Calendar Year 2012 combined ratio of 108.1. The nearly one-point improvement was due to a small improvement in the underlying loss ratio as well as a slight decline in the dividend ratio. ”
And the survey says… – Global pandemics are the the most important extreme risk that the global insurance identifies as a long-term worry, according to a Towers Watson survey. At the III blog, Terms + Conditions, Clarie Wilkinson fills us in on the issues that weigh in as #2 and #3 in concerns, as well as other details about the survey.
Recapping the conference – Joe Paduda offers his thoughts on some of the key trends and takeaways from the recent National Workers Comp and Disability Conference: Recapping the NWCDC. We appreciate the wrap-up but were hoping for some conference tchotchkes, too!
A Christmas Story – You can always count on the inimitable Bob Wilson to ferret out the not-to-be missed news. This week, he has a seasonal offering: My Holiday Advice for Santa: Don’t Grope the Elves.
People notes – One happy, one sad. First, we congratulate our friend Roberto Ceniceros on joining LRP Publications as the editor for all workers’ compensation content. He’ll writing the workers’ compensation column and feature articles for Risk & Insurance and co-chairing the National Workers’ Compensation and Disability Conference, writing and editing the soon-to-be re-launched WorkersComp Forum website.
Our second note is quite sad. We extend our condolences to the family, colleagues and friends of Dave Albertson on his recent passing. We first met Dave in his editorial role at Employee Benefit News – a true professional and a very nice human being who left us far too young. The write up on Dave has the very fitting title “A life well lived.”
News Briefs