WCRI 2017 Conference – Complete First Day Live Blog

Morning Sessions of WCRI 2017 Conference – Please excuse any typos, etc. This is a live conference blogging. It will be updated every 10 minutes.

Dr. John Ruser – CEO

Business People WCRI 2017 Conference Room

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Launching new website next week.
New Logo
Grand Bargain
Research the focal point
Opioid epidemic
Some data is preliminary – do not share

Impact of 2016 Elections on Healthcare and Workers Compensation

Dr. John Ruser – Moderator

The Honorable Henry Waxman – Former Member US House of Representative

All three branches have to get along better
President Trump has not reached out to the Democrats
Dr. Tom Coburn and he are good friends
Affordable Health Care Act -repeal and replace
Now Republicans have majority much like Dems the first two years of President Obama’s term

Features of ACA

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More complicated than even President Trump anticipated
President Trump may not be able to create a complete new market
Mandate created
Most people want to be insured – need to have a third party in the purchase
Competition between insurers
Mandate is to make sure that the healthy people also participate
Catastrophic care and Healthcare Account (HSA)
To make the system work insurers have to stay in the system
Medicare Part D – was not that helpful
Republicans wanted to shift money from poor to tax cuts

Workers Compensation Case Shifting

Yes, there will be case shifting to Workers Compensation
Deduction on tax returns is a very delayed benefit
Medicaid covered a large number of ACA applicants
Setting a limit on what states will get will make a skimpier Medicaid program
Naturally will shift cases to Workers Comp if Medicaid is not there
Medicare has been successful
If people do not have insurance – going to other programs

Does not object to tax cuts – but have to borrow money from the future to fund tax cuts, never paid for the wars

The Honorable Dr. Tom Coburn – Former Senator from Oklahoma

President Trump Executive Orders – Congress ceded much power
Limited action by Federal Government
17th Amendment not good

Features of ACA

Pharmacist And Woman With Baby WCRI Conference Picture

Wikipedia – Elmvh

Amish families buy healthcare at lower due to their own healthcare market they created
Oklahoma City hospital – provides healthcare to indigents
Disagree with Senator Waxman – have to create a marketplace
$1,200 deductibles
MRI at 10 PM for $100 in Tulsa
Medicaid system does not provide quality – outcomes better if you self-pay
Could fix ACA system -but Republicans/Democrats are too polarized
Bill Hatch -Upton Bill in place to completely replace ACA – go look at the bill as it will likely be the new law
$120 billion deficit on Medicare

Federal Government is out of control. Congress wants to look good not do a great thing for the US.

Workers Compensation Case Shifting – WCRI 2017 Conference

Medicaid is working in Oklahoma
Deductibles shot up under ACA
Freedom always beats governmental control
Rhode Island Medicaid system works
Medicine is getting ready to change – precision care
Workers Compensation will benefit from this care
Most cancers will be cured in 15 years
$105 trillion unfunded liabilities
$1,700,000 per millennial over their lifetime
Medicaid is not the answer – does not guarantee good care
Medicare Part D not that great

Letter to DOL on Federal Oversight of Workers Comp -WCRI 2017 Conference

Wikipedia – U.S. Department of Labor

Senator Waxman – should be some type of oversight for minimum standards – not a big issue right now

Senator Coburn – let states handle it – not a big issue right now

Senator Coburn – If you are not taking care of a person’s injuries – 27,000,000 on SSDI – system bankrupt – 2004 most people were just approved for SSDI as the department was so far behind they were just approved – Opiates are a big problem

Senator Waxman- SSDI should not be a replacement for Workers Comp, 80% of people had insurance that were on SSDI, SSDI should not be a replacement for other insurance systems including Workers Comp

QUESTIONS

Senator Coburn

Healthcare transparency – publish price and outcomes, no transparency, insurance companies have contract with hospital to not disclose prices,
Healthcare is not an individual right but should be provided to all, great book on American Compassion – how people were personally responsible for the first 175 years
North Carolina Medicaid program- holistic care but still requires responsibility, Oklahoma Opt Out will need to be looked at again
SSDI is safety net for Workers Comp denials
SSDI should not be a substitute
$600 – $800 billion wasted in healthcare, eliminating waste would pay for everyone’s healthcare, price vs. quality
ICD10 was a huge cost $12 billion with no benefit to healthcare

Senator Waxman –

Healthcare is basic human right, single payer system, personal responsibility, social responsibility is part of being compassionate people,
Repealing ACA would reduce public health, more money into prevention if there are cuts and increase to military spending
Very worried about what is/may be coming out of Congress, whole healthcare system may be in dire trouble and headed in wrong direction

WORKER OUTCOMES AND RETURN TO WORK

Dr. Bogdan Savych, WCRI
Dr. Glenn Pransky, Liberty Mutual Research Institute for Safety

This is very similar to Six Secrets to Cutting Workers Comp costs – See Return To Work and Employee Treatment

I had performed studies on public entity files

Return to Work

Man Talking To Colleagues WCRI 2017 Conference Room

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MA
KY
GA (18%) did not have successful Return To Work

Largest Predictor in Successful Return to Work was Trust In Workplace

22% of workers that did not Return To Work did not trust workplace

firm shrinking
poor relationship
pessimist by nature

22% of unsuccessful return to work had attorney

Need to focus on worker – employer communication <<<<very important

People felt very positive about positive and early communications

Characteristics of return to work coordinators – most important was ability to communicate

This is very similar to my recommendation – adjusters main job is communication

Sheet on Communication Tips to Help Shorten Disability Leaves – the main concern once again is that the employee thinking they will be treated well. I will see if I can get a copy to share with everyone in the future.

Question from Peter Rouismainerre – any other factor that are as important? Unsure

AN ALTERED STATE: CALIFORNIA’S POST-REFORM OUTCOMES AND COMING ATTRACTIONS
Mr. Alex Swedlow, California Workers’ Compensation Institute (CWCI)

California is now several years into the post-2013 reform era. Placing the reforms in historical context, Alex Swedlow will unpack the intended and unintended consequences of the reforms and discuss some of the competing issues that continue to challenge the system, including fee schedule and utilization controls, confronting fraud and abuse, dispute resolution, cumulative trauma, the highly anticipated drug formulary, and the arrival of legalized marijuana.

SB 863 performance

Woman Overjoyed WCRI 2017 Conference Room

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Good news

Medical cost increase trend has stabilized

Cannot cite this part of presentation – considered preliminary – but all positive results

CA paying twice for spinal surgery hardware
30% reduction in spinal surgeries
Opioids – 27% of all prescription are opioids , but an increasing trend
24% increase in opioid prescriptions
Opioid strength has fallen
412% increase in average medical costs 1990 – 2015
Still most expensive state for Workers Comp
#1 in medical cost containment expense
Loss Adjustment Expenses is almost as high as Indemnity and Medical Payments