I’ve finally figured out that what I think should happen often doesn’t.

Joe Paduda

So, here’s my take on the five things that SHOULD happen in worker’s comp this year but likely won’t.

1. We won’t hear more caterwauling about rising medical costs. Ha. The latest NCCI research indicates execs still don’t understand what’s really happening with medical costs, despite NCCI’s diligent efforts to educate same.
2. Work comp execs will embrace innovation. I wrote about this three years ago, here. Basically:
   • Execs got to be execs by avoiding anything remotely risky.
   • The industry is making billions in profits, so why try anything new?
   • Frequency and premium rates are declining, so why try something for a declining business?
   • And workers' comp is mandatory in 48 states, so they’ll have to buy it from someone.
3. Buyers will stop asking about/measuring/caring about medical savings. I’ve written about this a gazillion times; here’s one example. The net: It’s really easy to show a reduction below the list price. We Americans have been trained to do just that, even when it makes zero sense. Follow this link. Oh, and this industry is pretty lazy.
4. The industry will wake up to human-caused global warming. Ha. Nice to see that some pundits have finally raised this as an issue, but jeez, people — it’s 2024, and we’ve KNOWN we are boiling the planet for decades. Nope, there will be minor moves, with little public discussion among or by work comp execs. Why? Great question.
5. The industry will seriously embrace behavioral health, take major steps to understand this as a disability driver and seek out meaningful solutions. Sure, some have — and kudos to them for doing so. And kudos to good friend, colleague and mentor Bill Zachry; David Vittoria of Carisk (an HSA client); Dr. Les Kertay; and others who have been leading the charge. But let’s get real folks: Disability is as much, if not more, mental/emotional/psychological as physical, yet far too many payers don’t want to accept that blindingly obvious truth, scared of “owning the psych.” You already own it.

Joseph Paduda is the principal of Health Strategy Associates, a consulting firm focused on improving medical management programs in workers’ compensation. This column is republished with his permission from his Managed Care Matters blog.