Tag Archives: Workers’ Comp

A Personal Appeal

As you may have noticed, I have been re-posting several times articles about my interest In finding opportunities or remote/virtual positions.

To date, I have had no success. As I may have mentioned in my previous post, “Now It’s Personal“, I was diagnosed with End-Stage Renal Disease, and have been undergoing peritoneal dialysis at home.

The treatment is going well, but yesterday I began what will be a long, possibly three year process to get a transplant. As I am doing now, and will be doing in the future, I have been staying home to receive my dialysis supplies every two weeks, and going to the clinic for blood work and follow-up. In addition, I will have tests, and need to go down to Miami, so my schedule will not allow me to work full-time, or even part-time for twenty hours a week at some office.

To that end, I am interested in any work any of you can pass onto me that will utilize my skills and experience. No matter where you are in the world, as long as we can communicate online, I can do something constructive and valuable.

If you need my CV, I will gladly provide it upon request.

I would not do this here if the other postings had been successful, and time is running short.

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New Study Concludes States with Employer Choice Have Higher Claim Costs

While scanning LinkedIn yesterday afternoon, I noticed someone had posted a link to an article in the Journal of Occupational and Environmental Medicine (JOEM) early last month.

The abstract stated that the financial impact of choice of physician within workers’ compensation had not be well studied, and that the purpose of the article was to assess the difference in cost between employer and employee directed choice of physician.

As many of you will recall, this subject was one of the first topics I covered when I began my blog over five years ago.

The following articles are linked here for your review:

Employee vs Employer Choice of Physician: How best to Incorporate Medical Tourism into Workers’ Compensation

Employee vs. Employer Choice of Physician Revisited: Additional Commentary on How Best to Incorporate Medical Tourism into Workers’ Compensation

Employer Choice States See Lower Claim Costs

Follow-up to Employee/Employer Choice: Three Years Later

The authors, Tao, Leung, Kalia, Lavin, Yuspeh, Bernacki (2017) analyzed 35,640 indemnity lost time claims from a 13-year period at a nationwide company, using multivariate logistic regression to determine association of medical direction with high-cost of claims.

Tao et al. found that states that have employer-directed choice of physician have lower risk of having high cost claims, greater than or equal to, $50,000, but had higher attorney involvement compared to employee direction. Their results showed that the net effect of attorneys offset the benefits of employer choice.

This study may be in line with the WCRI study I cited in the article above, “Employer Choice States See Lower Claim Costs”, but because of higher attorney involvement, the benefits are negated.

They concluded that states that permit employer selection of treating physician have higher cost due to greater participation by attorneys in the claims process.

Rural Hospitals to Fail If Medicaid Expansion Ends

In April of 2015, I wrote the following post, Hospital Closures Due to Failure to Expand Medicaid.

This morning, Health Affairs posted a brief, Ending Medicaid Expansion Would Cause Rural Hospitals to Go Under.

As the current regime in Washington, and its allies in Congress slowly dismantle the ACA, rolling back Medicaid expansion will lead to rural hospitals closing, and rural patients being forced to travel long distances to get to a hospital, or to forgo medical at all.

What impact this will have on the entire health care sector is too early to tell, and what this may mean for workers’ comp, is also speculative, but it can’t be good if hospitals in the heartland go out of business.

Some way to make America great again. On the backs of, and on the health of, rural Americans who voted for this clown.

Insurance/Risk Management/Health Care Thought Leader Seeks Opportunities

Insurance/Risk Management (Workers’ Comp)/Health Care Thought Leader and Blogger seeks remote or virtual opportunities. Project work appreciated.

Experience:

Over fifteen years’ experience in Workers’ Compensation, Risk Management, and Property & Casualty Insurance.

WC, GL, P&C Claims Management, WC Statistical Reporting, Data Analysis, Management & Reporting.

Content Writer with five years experience creating and maintaining professional blog analyzing current issues in Workers’ Compensation and Healthcare.

Analyzed the cost of health care and the options of alternative treatments abroad.

Interested in working remotely, willing to travel.

Resume can be found here.

Blog: richardkrasner.wordpress.com

Is this Right?

I just came across the following articles from KOB4 TV in Albuquerque, NM about  two police officers hurt on the job.

The former police officers from Corrales, NM,  Lou Golson and Jeremy Romero, were seriously injured when Golson was shot during a DWI stop in 2015, and Romero was injured when he was involved in a high-speed car chase in 2014. and told he would never walk again.

Officer Romero said he felt abandoned and betrayed by a system that should be protecting him. He says everything started going downhill when he started getting piles of medical bills.

Romero retained a lawyer because the surgeries he needs are not readily approved by workers’ comp.

According to Romero, ““I was immediately denied by my workman’s compensation, and therefore once I receive a denial it goes to the workman’s comp judge,… It will take anywhere from one to six months to see a workman’s comp judge on my complaint.”

On Jan. 3, 2015, Golson was shot four times at point-blank range.

This was just the beginning of an excruciating workers compensation battle. Golson said an adjuster refused to approve procedures he needed because of their costs, delaying care and prolonging time away from work.

This went on for years, the articles said,  with workers comp becoming increasingly suspicious that Golson was gaming the system with claims despite the clear evidence of his serious injuries. Finally, he said his adjuster made a comment he’ll never forget.

“‘Heh, you’re not hurt. You’re just old,'” Golson recalled.

Bills he expected to be covered were denied, Golson said.

“I let the collections people keep calling,” he said. “I never paid them, so as a result my credit was destroyed.”

Nearly three years since the shooting, Golson cannot get a loan. He said his family is financially ruined.

“It’s honestly pathetic that an officer who is willing to give his life — or she — who is hurt, devastatingly hurt, has to go through so much mental pain and agony dealing with a government that doesn’t care about them,” Golson said.

“And in my case, for my family’s sake, it probably should have been deadly,…They would be financially better off if I had died. But I didn’t, and that’s pathetic.”

Golson is advocating for reformed workers’ comp. Actually, both men deserve workers’ comp that actually works the way it was supposed to work, and not the way they have been treated by it.

There would be no need for reform if the system worked as it should, and if they could get the surgeries and treatments they need anywhere they wanted, even if that was out of state or out of the country.

This is just plain wrong. We hear about “Black Lives Matter” and all lives matter, but where is the work comp industry on this?

Five Years

Yesterday marked my five year anniversary as your humble blogger. But all through the month, many of my LinkedIn connections have congratulated me prematurely, only to have me set them straight as to the actual date. LinkedIn does not do a very good job of capturing exact dates on your profile.

But be that as it may, it has been a great five years. Let me recap.

To begin with, I began the blog three days after returning from the 5th World Medical Tourism & Global Healthcare Congress in Hollywood, Florida where I met many people from around the world engaged in the Medical Travel industry.

After attending two more conferences in 2014, one in Miami Beach, and the other in Reynosa, Mexico, where I presented my paper on Medical Travel and Workers’ Comp, my blog was viewed by increasing numbers of people in multiple countries around the world.

To date, my blog is viewed in every continent except Antarctica, and places like Greenland, several countries in Africa, Iran and two of the countries in Central Asia, and North Korea (but who cares?). Even China, with it’s limited access to the internet has viewed my blog.

So it has been a productive five years, and I hope that you have enjoyed reading it. I know not all of my posts are prize winners, but then again, not every writer wins a Pulitzer every day. You may have noticed that my focus has shifted and my tone has gotten more pointed. I make no apologies for the tone, there are too many bad things happening in this country for me to be silent. And as for the focus changing, my medical condition has personalized the fight for health care for all, and not just for those who can afford it.

Let me know what you think, after all, after five years, you must have some thoughts. Also, if you can help me personally with extra work, I would appreciate it.

Thank you, and here’s to another year, and another five years.

 

The Fork in the Road in Medical Travel

Returning to the main theme of this blog, I came across the following insightful article by Ruben Toral last week that posed the question, “Is Medical Tourism Dying a Slow Death?”

As someone who has been interested in opportunities in Medical Travel for some time, and  disappointed in not being able to elicit interest in my idea for Medical Travel, I was interested in seeing what Ruben had to say, and to see if it measured up to my views of the industry, as I know it.

According to Ruben, the industry exhibits the traits of a typical product/business cycle, whereby the first and fast movers establish leadership by developing and commercializing the concept, then late adopters pile in to get in on the action.

He goes on to decry the same speakers at every medical tourism event around the world talking about the same things, which is enough to hit the snooze button and go back to sleep.

He also laments the lack of innovation, and says that key players are just trying to manage the slow growth rather than investing in the next wave.

VC investors, Ruben says, talk of getting burned on medical tourism investments that simply cannot scale like other businesses, because, as they quickly learn, healthcare is a different animal than retail and you burn through a lot of cash fast trying to buy eyeballs and audience.

And investment analysts ask the same question after pouring through hospital financial reports and see how hospitals are managing and protecting profit margins: “Where’s the growth?” And even large meeting and events companies are not “flogging medical tourism” because attendance and interest is way down.

So, is this the beginning of the end or the inflection point for medical tourism?, Ruben asks. For his part, he does not know, but if it is not the beginning of the end, or an inflection point, it is most certainly a fork in the road.

Where it goes from here is as good a guess as mine and Ruben’s, but it is up to those who are serious and dedicated to growing the industry to regroup and start again to build interest and enthusiasm for medical travel, and to address some of the glaring issues facing the industry.

But that won’t happen until there are changes within and without the industry…in technology and in strategy.