Archive for the ‘Uncategorized’ Category

WCRI: Worker Outcomes And The First Contact: Old News, Still New News

Thursday, March 2nd, 2017

Dr. Bogdan Savych, of WCRI, and Glenn Pransky, MD, from Liberty Mutual’s Disability Research Center, today reported on studies looking at predictors of worker outcomes and the way the initial contact following and injury impacts return to work.

It was in the mid 1980s when my partners and I realized that treating injured workers with dignity and respect and building workplace systems that enabled that would be a good business model. Thus, was Lynch Ryan born. We were right, and over the years became successful selling the model across America. These business systems saved employers a lot of money while providing quality care to injured workers. Frankly, I thought that battle had been won. Au contraire.

Doctors Savych and Pransky (PhD and MD) once again reminded attendees at WCRI’s Annual Conference that we still have a way to go.

Dr. Savych presented three main points (preliminary findings, subject to change):

  • In a 15 state study, 14% of injured workers with at least 7 days lost time never had a “substantial return to work;”
  • “Trust in the workplace” is a major predictor of an injured worker’s likelihood of returning to work;
  • Fear of being fired is a major predictor of an  injured worker’s likelihood of returning to work.

Dr. Pransky, whom I have long admired, presented evidence from several studies from the US, British Columbia and Australia aimed at determining the degree to which both the style and words used in the first encounter following injury influence the final outcome. Guess what? They’re really important.

Much has been written recently about the concept of “perceived injustice” in the course of injury recovery. At this year’s National Workers’ Compensation and Disability Conference, Dr. Marco Iglesias, of The Hartford, discussed this in detail, advocating that adjusters empathically listen to injured workers and, generally, improve their communication skills. That is easier said than done, but surely worth the effort.

 

A Poem To Get You Through Today And Beyond

Tuesday, November 8th, 2016

Out of the night that covers me,
Black as the Pit from pole to pole,
I thank whatever gods may be
For my unconquerable soul.

In the fell clutch of circumstance
I have not winced nor cried aloud.
Under the bludgeonings of chance
My head is bloody, but unbowed.

Beyond this place of wrath and tears
Looms but the horror of the shade,
And yet the menace of the years
Finds, and shall find me, unafraid.

It matters not how strait the gate,
How charged with punishments the scroll,
I am the master of my fate:
I am the captain of my soul.

Have courage, friends. Whatever happens, we will prevail.

9/11: A 15 Year Remembrance

Friday, September 9th, 2016

On September 11, 2001, the nation took the biggest of gut-punches. Thousands died that day and hundreds of thousands, all around the world, have died since. If you were in the insurance industry that day, you probably lost at least one friend, maybe more. I know I did. The world changed after that day, and barbarism raised its head like a volcano rising from the crash of tectonic plates.

First Responders have been particularly savaged. More than 5,000 have been victimized by cancer. Dr. Michael Crane, the head of New York’s Mount Sinai Hospital’s 9/11 Health Program Clinic estimates he sees ten to fifteen new cases per week. Today, CBS This Morning told the story of one of them, Sal Terderici. It is heartbreaking.

We all sought healing in our own ways. Because I’m a musician and a singer, I sought to deal with the tragedy by writing an anthem about it. I recorded it in Worcester’s Mechanics Hall and renowned guitarist Peter Clemente accompanied me. We gave the song to Denis Leary, a Worcester native who had lost a cousin, a firefighter, as he battled the Worcester Cold Storage and Warehouse Company fire in 1999. Five of his cousin’s comrades also died in that fire. Denis became passionate about helping firefighters following that. You may recall his hit TV show, Rescue Me, which ran on FX from 2004 through 2011. Rescue Me was a seven year homage to a noble profession. Denis took our song and used it to help raise money for the fallen firefighters of September 11.

This coming Sunday will mark the 15th anniversary of, arguably, the worst day in American history. To mark the event, I want to share our anthem with you. You can find it here.

Tom Lynch

Fresh Health Wonk Review & New: The HWR Blab

Friday, April 8th, 2016

It’s Health Wonk Review week and Jaan Sidorov has posted A Presidential Politics-Free Health Wonk Review at The Population Health Blog. It contains the maximum on health policy issues of the day and the minimum on politics, as promised. All health policy, all the time! Check it out.

We also have a new Health Wonk Review feature to introduce – the Health Wonk Review Blab. What’s a “Blab”? It’s part video conference, part text chat. After every new HWR, David Harlow and Joe Paduda will join some Health Wonk Review regulars to talk about health policy issues of the day. You can find the pilot edition of HWR Blab here — and here’s a notice for the upcoming edition. You’ll need a Twitter account to sign up and log in, but you can watch live on in replay without an account.

Health Wonk Review: 2015 Holiday Edition

Thursday, December 17th, 2015

We’re happy to host this year’s holiday edition of Health Wonk Review. But before we get to the meat and potatoes, we like to check in on The Santa Index to see how the Big Guy is faring. We’re happy to report that he got a raise of 3.8% or $3,130, bringing his annual wage to $143,054, which seems pretty paltry when you consider that “he’s a manufacturing executive, professional shopper, sleigh driver, delivery person, list checker, and heads a customer service department for nearly 2 billion children.” Insure.com calculates his life insurance needs but we learn nothing about whether he’s getting health coverage through the ACA or not. He engages in some very hazardous work, has adopted some bad health habits — too many cookies, driving too fast and lack of seat belts, to name a few — and has a quite a few risk factors, so he’d likely benefit from the lack of restrictions on pre-existing conditions.

via giphy.com: http://work.neongsan.com/

via giphy.com: http://work.neongsan.com/

 

Affordable Care Act

All is calm, all is bright? Let’s get to the controversies right out of the gate:

At Health Affairs Blog, opponents of the Affordable Care Act propose an alternative plan and to enact major reforms to the tax treatment of employer-sponsored health care, Medicaid, Medicare, Health Savings Accounts, and other areas. In their post Improving Health And Health Care: An Agenda For Reform, authors Joseph Antos, James Capretta, Lanhee Chen, Scott Gottlieb, Yuval Levin, Thomas Miller, Ramesh Ponnuru, Avik Roy, Gail R. Wilensky, and David Wilson say that their plan would “reorient health care policy away from bureaucratic regulation and toward the preferences of patients and consumers.”

However, at least one of our wonks has a bone to pick with one of the study authors. At ACASignups.net, Charles Gaba calls out Avik Roy in a recent post for data “disingenuousness” in his critiques of the Affordable Care Act, and again in a follow-on post for lack of acknowledgment of the problems.

In another matter that many use to signify the death knell of the ACA, United Health has made headlines with its rumblings of pulling out of the exchanges. Would such an exit mean that the that the ACA isn’t viable or is United just not up to the challenge of fierce competition? At Health Business Blog, David Williams offers his perspective in his post United pulls out of ACA exchanges: Should we care?

At Colorado Health Insurance Insider, Louise Norris looks at whether or not open enrollment for health insurance plans should end by December 31 and finds she’s recently changed her mind. Previously, she supported consumers having a chance to review and change auto-renewed plans if they learn that changes resulted in a plan that isn’t quite what they expected. While she still supports as much leeway as possible in plan selection during open enrollment, she explains how the system can be gamed and what the long-term implications for adverse selection and rate volatility would be if open enrollment continues after the coming year’s plans have already started to take effect.

In another hotly contested ACA issue, the Supreme Court has agreed to hear Little Sisters of the Poor Home for the Aged v. Burwell, the latest legal challenge to Obamacare’s birth control mandate. Amy Lynn Smith explains what a win for the plaintiffs could mean for millions of Americans in her post at healthinsurance.org Blog, How millions could lose birth control coverage.

At InsureBlog, Hank Stern is thinking about men’s issues. He reports that the new “healthcare freebies” list is out but notes that “once again men’s health is omitted. But they still get to pay.” Check out his post Still sexist after all these years.

via Ryan Todd at http://christmasgifs.org/artists/todd/

via Ryan Todd at http://christmasgifs.org/artists/todd/

How Docs Get Paid

At Managed Care Matters, Joe Paduda says that changes in the way that providers are reimbursed are painful, but they are necessary. He offers a brief explainer of different methodolologies and tells us the three things we should know about what’s happening with provider reimbursement

How will Medicare reform provider payment going forward? Will they tie payment to quality? If so, how will benchmarks be defined? What about providers who participate in multiple quality incentive programs? In Reforming Medicare Provider Payment, Jason Shafrin of The Healthcare Economist investigates these questions and more.

At The Population Health Blog, Jaan Sidorov looks at the Limits of Financial Incentives for Docs. He examines a recently published study showing that financial incentives did not have as big an impact on physicians as commonly imagined. Jaan argues that’s because physicians live by more than bread alone.

via gify.com: www.werobbanks.com

via gify.com: www.werobbanks.com

Compliance, Data and Legal Matters

David Harlow takes his role in “preventive law” seriously in reminding all members of the “regulated community” to get their affairs in order. At HealthBlawg, he posts about recent enforcement activity by “the federales,” which shows that they mean business when it comes to HIPAA compliance and enforcement: Third Time’s a Charm: Triple-S and its Data Breaches. David says this should serve as yet another reminder that when they eventually kick off the long-promised audit program, covered entities and business associates are likely to feel the sting.

Remember the good old days, when times were simpler, and health technology was all about electronic patient records? Not today. Peggy Salvatore points out that world of health technology is about telemedicine, wearables, data collection and privacy. In her post at Health System Ed Blog, she looks at the challenge of how the health system sould harness all this unstructured patient data: Challenge: Consumer Healthware and the Glut of Unstructured Patient Data. 

Calling medical malpractice “bloggers crack” or the gift that keeps on giving, Bradley Flansbaum dedicates his post at The Hospital Leader to examining the results of the recently released Medscape 2015 Malpractice Report, and he his colorful interpretation: More Med Mal Sustenance

Brain Neong San http://christmasgifs.org/artists/san/

Brain Neong San http://christmasgifs.org/artists/san/

Faulty Ethics at Play

Roy Poses is a health care rabble rouser and we mean that in the most positive way.  At Health Care Renewal, he’s shining a light on “highly unethical” medical trials that involved multiple academic medical centers, including some of the most prestigious in the US – yet which received scant media attention. The studies involved sleep deprivation on physician-trainees. Trainees previously worked up to 36 consecutive hours, which new rules now limit to 16 hours. This increased the number of patient hand-offs, so the study goals were ostensibly to assess a method to reduce the hand-off problem. But Roy makes the case that the trials may have violated several major components of the Nuremberg Code, the set of principles for ethical research that were developed in response to Nazi medical-trial atrocities. Learn more at Drinking the Managerialists’ Kool-Aid? – Why Did Medical Educators Launch Trials of Increased Sleep Deprivation of Physician Trainees Apparently in Violation of the Nuremberg Code?

Finally, we have our own submission, a post by Tom Lynch in which he extends kudos to Work Comp Central’s Greg Jones for his ongoing reportage of the Michael Drobot case. If you are unfamiliar with this half billion dollar fraud case in which docs were given kickbacks for referring patients to surgery and legislators were bribed, you can catch up at this post and an earlier one, Workers’ Comp Fraud: The Drobot Case Grinds On.

James Curran http://christmasgifs.org/artists/curran/

James Curran http://christmasgifs.org/artists/curran/

 

See you in the New Year

This is the final edition of HWR for 2015 so we extend our best wishes for t holiday season. Our wonkers will be back bright and early in the new year: Look for a Jan. 14 edition by Hank Stern at InsureBlog.

 

 

Freshly posted Health Wonk Review

Thursday, March 26th, 2015

Grab a coffee and head on over to Wing of Zock. Jennifer Salopek has a freshly-posted Health Wonk Review, Spring Break Edition awaiting your perusal. The wonks are covering a wide range of policy topics and issues today – don’t miss out.

Bi-weekly Risk Roundup

Thursday, March 20th, 2014

Atty. Van Mayhall offers up a new roundup of risk-related matters in a fresh Cavalcade of Risk #204 posted at his Insurance Regulatory Law blog – check it out!

Health Wonkery Calls

Thursday, April 25th, 2013

Hank Stern at InsureBlog has posted the latest edition of Health Wonk Review, Money Tree Edition. If you have no interest in American health care, you can skip it. But given that health care impacts literally everyone on the planet, this timely compendium is worth a few moments of your valuable time.

Health Wonk Review Hath Sprung

Thursday, May 10th, 2012

Hank Stern of Insure Blog has hosted the latest edition of the health work review. It’s a bouquet of wildflowers, well worth a few minutes of your time. And if you think palliative care is just for the terminally ill, check out Diane Meier’s inspiring post, which reads like a sprig of lilacs in a mason jar on the kitchen table.

Compensability of a Crooked Nose

Monday, May 7th, 2012

Imagine the scene at the Pennsylvania Workers’ Comp Appeal Board earlier this year: the judges each carefully examined the nose of Rhonda Walker, to determine just how crooked it was and whether Walker was entitled to disfigurement benefits. Prior to the appeals hearing, a judge had awarded Walker 45 weeks of compensation for scars and disfigurement on her nose.
WorkCompCentral (subscription required) tells us that Walker was a meter reader for Health Consultants. In May 2007 she fell down a flight of stairs and fractured her nose. She was cleared for full duty in August, at which time her indemnity payments were halted. She resigned her position soon after and then filed for permanent disfigurement benefits; she considered herself to be “deformed” because her nose had scars and the tip was crooked.
Following their close and individual examination of Walker’s nose, the judges determined that there was “a slight crookedness” but this was “not noticeably disfiguring.” The alteration in her nose did not “rise to the level of creating an unsightly appearance.” They reversed the award of disfigurement damages. Walker may be self-conscious about her transformed nose, but the changes are not compensable.
Aesthetics and Self-Image
With all the emphasis on personal appearance in this culture, with the myriad options for changing one’s appearance, it is easy to become obsessed with what we see in the mirror. (I often wonder where that aging man in the bathroom mirror came from.) A few years back we blogged the interesting case of Penny Rumple Richardson, one of whose breast implants was damaged in a work-related auto accident. In the understandable interests of symmetry, her doctor replaced both implants. In the similarly related interests of compensability, the comp insurer paid for one implant and denied the other as not being work related.
Rhonda Walker is sensitive to the imperfections that greet her every time she looks in the mirror, but she will not be reimbursed for her troubles. In a mysterious footnote, President Judge Dan Pelligrini dissented without opinion. Given his silence, we will never know what he was thinking, but it appears that he bought Walker’s argument. In the inherently subjective matter of compensability, who knows whose nose meets an elusive standard?