Health Strategy Associates Releases First Workers` Compensation Bill Review Survey

MADISON, Conn.--(Business Wire)--
Health Strategy Associates (HSA)www.healthstrategyassoc.com has released its
First Annual Survey of Workers` Compensation Bill Review. Principal Joseph
Paduda conducted the survey, soliciting opinions about the role of bill review
(BR) in workers` compensation from a wide variety of payers. It explored
pricing, vendors, internal-versus-outsourced BR processing and other aspects of
the industry that determines reimbursement for $30 billion in workers`
compensation medical care each year.

"Two overarching issues emerged: a lack of electronic integration and a sense
that the industry is generally mediocre," said Paduda. Overall, respondents felt
the industry focuses more on processing speed and throughput than on effective
medical management and that it is more reactive than innovative. However, they
also noted that there have been several vendor acquisitions, mergers and
management changes that could improve BR performance.

One of the most troubling issues for payers is the lack of connectivity between
BR and medical management. "As difficult as it is to believe," Paduda said,
"Very few BR systems are fully and seamlessly connected with medical management
systems and processes, such as utilization review, pre-certification, case
management, or networks."

Among other things, this means that many non-approved medical treatments are
performed and reimbursed simply because the system could not link the
determination to the bill, provider or claimant. "Comp payers spend hundreds of
millions of dollars a year on medical management and a significant portion of
that money may be wasted due to a lack of effective electronic integration," he
commented.

This, too, may be changing. Several vendors and at least one third party have
developed technological solutions addressing the issue: a sophisticated business
rules engine that greatly streamlines processes, increase the number of bills
that are automatically adjudicated and enforces "best practices." As
connectivity improves, Paduda predicts that bill review will become more
sophisticated and viewed by payers as less as of a commodity and more of a
strategy tool.

About the Survey

The 24 respondents were executives at 23 workers` compensation payers, including
insurance carriers, third-party administrators, large employers, state funds and
managed care firms. The firms surveyed represented a broad cross-section of the
industry, geographically and in company size. Telephonic surveys were conducted
by Paduda and data aggregation and analysis was performed by Yvonne Guibert,
marketing consultant.

About Health Strategy Associates

HSA is a national consulting firm serving insurers, employers and health care
providers. Led by Joseph Paduda www.healthstrategyassoc.com/paduda.html, who
also writes www.ManagedCareMatters.com, the firm specializes in helping clients
control health care costs in workers` compensation and group health. HSA is
currently conducting its Sixth Annual Survey of Prescription Drug Management in
Workers` Compensation and will conduct a survey of provider networks later in
the year.

For Health Strategy Associates
King Knight Communications
Helen King Knight, APR, 813-837-1701
813-690-4787 (Cell)
Helen@kingknight.com

Copyright Business Wire 2009