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Amazon Plans New Virtual Care Offering Based on Messaging

Amazon is stepping back into virtual care with a new service that uses secure messaging to connect patients with doctors for help with nearly two dozen conditions.

The retail giant said it will launch “Amazon Clinicin 32 states to provide medication refills and care for conditions like allergies, erectile dysfunction, hair loss, migraines and urinary tract infections. That list does not include the flu, COVID-19, ear infections or other urgent care conditions for which patients often seek help through telemedicine.

Amazon said it will work to add other conditions over time to the service, which will not accept insurance. It also plans to expand the service to more states in the coming months.

Virtual care, or telemedicine, exploded in popularity when COVID-19 hit a couple years ago and patients initially hunkered down in their homes to avoid catching the virus. Its use has since waned but remains popular for its convenience and its ability to improve access to care.

Some doctors had started providing care through secure messaging before the pandemic. They began working through companies like 98point6 or CirrusMD, which touts its ability to connect people with a doctor in less than a minute.

Tuesday’s announcement from Amazon comes more than two months after the company said it will shut down Amazon Care, a hybrid virtual, in-home service it spent years developing. The company launched that service in 2019 for its Washington employees. It expanded it last year, allowing private employers nationwide to sign up for the service. But that effort didn’t get much traction.

The company shifted its target, announcing in July that it planned to acquire One Medical, a primary care organization that, as of March, had about 767,000 members and 188 medical offices in 25 markets. The $3.9 billion deal was seen as way for Amazon to reposition its health ambitions towards a model that was more established and could me more profitable. The Federal Trade Commission is reviewing that deal.

The planned purchase of One Medical was the first major acquisition announced under Amazon CEO Andy Jassy, who took over the role from founder Jeff Bezos last year. He has said he sees health care as a growth opportunity for the company beyond its more established retail and cloud computing businesses.

Amazon’s foray into health care also includes Amazon Pharmacy, an online drug store that allows its Prime members to order medication or prescription refills, and have them delivered to their front door in a couple of days. In its announcement on Tuesday, Amazon said Amazon Pharmacy and One Medical were two key parts of its health care plans.

“But we also know that sometimes you just need a quick interaction with a clinician for a common health concern that can be easily addressed virtually,” the company said.

Amazon.com Inc. said the price for care will be set by the providers, not Amazon Clinic, and it did not offer a range in a blog post announcing the service.

Industry Leaders Share Ideas at Healthcare Conference in Las Vegas

When HLTH launched in 2017, it embarked on an ambitious goal to disrupt the status quo for events within the healthcare industry. It set out to bring a new vision to healthcare events that embodied the industry’s highest aspirations for innovation and transformation, all while evolving the antiquated approaches that have existed for decades.

Healthcare is complex, and the community HLTH serves is multi-layered and consists of diverse individuals and organizations from around the world. Additionally, as the industry experiences a period of rapid change, one important adaptation HLTH is making to address these factors is a focus on audience journeys-tailoring pathways through content, programs and meetings based on a deeper learning about each population and individual that interacts with them.

Over the past five years, HLTH has become the preeminent event in the healthcare industry. This years industry event took place in Las Vegas starting on November 13. Content sessions this year showcase the most exciting, compelling thinkers and industry leaders. The event this year includes the StartUp Health Festival which has gathered thousands of CEOs, investors, world leaders and entrepreneurs to focus on solving the world’s biggest health challenges.

The fifth annual event drew thousands of healthcare leaders and innovators to Las Vegas. It’s only five years old, but the HLTH Conference has emerged as a big deal in healthcare. More than 300 people were expected to speak at the event. Some of the speakers included Greg A. Adams, chair and CEO of Kaiser Permanente, Sam Hazen, CEO of HCA Healthcare, Rosalind “Roz” Brewer, CEO of Walgreens Boots Alliance, U.S. Health and Human Services Secretary Xavier Becerra, and more.

Thomas Kurian, Google Cloud CEO, spoke to healthcare and technology leaders, outlining some of the company’s latest news and talking about how technology is changing the industry. Google Cloud is working with payers, providers, and pharmaceutical companies. “It’s an ecosystem that needs to deliver the care that people need,” Kurian said.

Google Cloud and Epic, the electronic health records firm, have signed an agreement hailed as the first step in enabling customers to run their Epic workloads on Google Cloud. Hackensack Meridian Health said it plans to move its Epic workloads to Google Cloud, touting gains in efficiency, innovation, and security.

Even with the COVID-19 pandemic and its assorted challenges, HCA Healthcare CEO Sam Hazen says the company has emerged with a commitment to embracing healthcare technology. Speaking at the HLTH Conference Sunday, Hazen said technology is the key to advancing everything from patient care to workforce development. “We’ve come out of the pandemic with a very focused effort in digitizing HCA healthcare in ways other industries have done,” Hazen said.

Geisinger CEO Jaewon Ryu made a case for value-based care. Ryu outlined impressive statistics demonstrating the effectiveness of Geisinger’s home-based health program and an initiative to help patients get better food.

To engage in such efforts, Ryu said, “You need a payment model that supports it.” And that’s where he made the case for health systems to move more toward value-based care, and away from the traditional fee-for-service model.

With value-based care, health systems are rewarded for improving patients’ health, and are essentially taking on the risk that they will be successful in keeping patients healthy, or at least from avoiding more costly care.

The Geisinger at Home program, which brings healthcare professionals to patients’ homes to manage complex conditions, has enjoyed considerable success, Ryu said. Patients in those programs have 36% lower hospitalization rates, and they have seen a 20% reduction in emergency department visits.

More summaries of these topics can be read on the Chief Health Care Executive website.

WCIRB Releases Multibureau Evaluation of COVID-19 Claims & Costs

The Workers’ Compensation Insurance Rating Bureau of California (WCIRB), in collaboration with nine other workers’ compensation rating bureaus, has jointly released COVID-19 and Workers’ Compensation – Phase II of the Multibureau Collaboration.

This updated study includes two years of claims data – Accident Years (AY) 2020 and 2021 through year-end 2021 – from the following workers’ compensation bureaus: California, Delaware, Indiana, Michigan, Minnesota, New Jersey, North Carolina, Pennsylvania, Wisconsin and National Council on Compensation Insurance (NCCI).

One result of this effort is the creation of a COVID-19 claims database, which includes a comprehensive view of COVID-19 claim characteristics and trends. The analysis does not include experience from self-insured employers or denial and expense-only claims.

Key findings in the report include:

– – This analysis relied on data from 45 jurisdictions, representing $1.1 billion in COVID-19-related losses from about 117,000 claims. The average claim cost during the two-year period was approximately $9,600.
– – On average, COVID-19 claims decreased from 11 percent of workers’ comp lost-time claims reported in AY 2020 to 4 percent in AY 2021 across the jurisdictions included in the study.
– – For California, COVID-19 claim shares were somewhat higher in 2020 with 13 percent of lost time claims involving COVID-19. For 2021, the California COVID-19 claim share of 4 percent was similar to the national average.
– – Approximately 75 percent of reported COVID-19 lost-time claims were from the healthcare sector, while that sector only accounts for about 9 percent of non-COVID-19 lost-time claims.
– – In California, with its relatively broad presumptions, about one-half of COVID-19-insured employer claims were from the healthcare sector.
– – The share of COVID-19 claims and losses was largest in the second and fourth quarters of AY2020.
– – COVID-19 was not a significant loss driver for most industry segments.
– – However, COVID-19 claims in the Healthcare sector accounted for nearly 50% of all lost-time claims and more than 20% of paid+caselosses.
– – For most states, the largest share of COVID-19 claims has been in the Healthcare industry sector.
– – Although COVID-19 claims have been a significant driver of overall claims for the Healthcare sector, COVID-19 claims represent a small share of claims for other industries.
– – Healthcare with Overnight Care (which includes retirement homes and nursing homes) had the highest relative share of COVID-19 claims.
– – Healthcare workers have had the highest share of indemnity-only claims (60%) and a relatively low share of medical-only claims (15%).
– – Most hospitality-industry claims have been medical-only (71%).
– – Average severities are relatively consistent among years.
– – Severities for both COVID-19 and non-COVID-19 claims were relatively stable across years.
– – On average, COVID-19 claims have closed faster than non-COVID-19 claims, primarily due to the higher prevalence of indemnity-only COVID-19 claims.

This updated report confirms significant findings from the WCIRB 2020 report and includes additional insights on industry sector and accident-quarter metrics. Claim and loss activity varied across jurisdictions, impacting individual states and sectors differently and at varying times. Uncertainties remain about the long-term impact of COVID-19.

Employer Cannot Refuse to Hire Worker on Medical Examination Alone

La Vonya Price suffered a stroke in 2003 that initially left her paralyzed. After years of treatment, she eventually regained the use of her body and relearned how to speak, stand, and walk, yet she did not fully recover. Price suffered some permanent paralysis, which limited her ability to walk and the use of her left foot. Throughout 2005 and 2006, Price had to use a walker and a wheelchair because of her limited mobility. By 2007, Price’s condition had improved, but she still struggled with grasping and holding items, although she could hold small items without them falling.

Price first worked part-time for the Victor Valley Unified School District between August 2006 and September 2006 as a substitute para-educator for special needs students. She was not required to take or pass a physical examination for the position, and she did not tell the District she had a disability or any medical restrictions.

After moving to another job elsewhere in 2013, but she returned to the District again in February 2018, when she was hired as a substitute Instructional Assistant for special education students. Price was assigned to work one-on-one with an autistic student, who would sometimes run away from teachers and aides, including Price.

In July or August 2018, Price applied for a full-time position as an Instructional Assistant for special needs students. She received an offer for a full-time position that was contingent on passing a physical exam. When she failed the physical exam for not being “medically suitable for the position,” the District rescinded the offer, terminated her as a substitute, and disqualified her from any future employment with the District.

The part-time and full-time Instructional Assistant positions have the same duties and responsibilities. As a part-time Instructional Assistant, Price was assigned to a one-on-one position with a “runner,” and she successfully performed that position before being offered the full-time position, even though she frequently had to run after students.

Price sued the District for retaliation and various disability-related claims, but the trial court granted summary judgment in favor of the District.  Price contended on appeal that the trial court erroneously granted summary judgment to the District because there are triable issues of fact concerning all of her claims. The Court of Appeal agreed as to her first claim for disability discrimination, but disagree as to the rest of her claims in the published case of Price v. Victor Valley Union High School Dist.- E076784 (November 2022).

The District asserts the fact that Price failed her physical examination means that she was not qualified to perform the job. The Court of Appeal disagreed.

The District reads Quinn v. City of Los Angeles (2000) 84 Cal.App.4th 472 to stand for the broad proposition that an employer may always impose physical requirements as a condition of employment and thus may always refuse to hire someone who does not meet those requirements. In Quinn the plaintiff-police officer was not qualified for the position because he failed a “sound localization test” due to a hearing impairment. “The ability to localize sound is particularly significant to police officers in split second, life-threatening situations when an officer cannot clearly see.” The Quinn court held that the plaintiff’s termination was lawful because he “was never initially qualified for the position” as a matter of law.

The court Quinn court “did not hold that employers have unfettered discretion to deny employment to anyone who fails any physical test, as the District suggests.” Rather, the Quinn court recognized only the “fundamental principle” that employers may deny a position to an applicant who cannot safely perform the essential functions of the job due to a medical condition.

Because the determination of essential job functions is a “highly fact-specific inquiry,” it is usually an issue of fact for the jury to decide. The District argues Price could not perform the essential functions of a special education Instructional Assistant because of her medical restrictions. In particular, the District contends the job had physical demands that Price could not meet, namely, running after students. Even if true, Price has raised a triable issue of fact as to whether this was an essential function of a full-time Instructional Assistant.

Attorney General Sues Team Owner & NFL for Hostile Workplace Cover-up

The District of Columbia Attorney General announced a lawsuit filed against the Washington Commanders, team owner Dan Snyder, the National Football League, and NFL Commissioner Roger Goodell for colluding to deceive District residents “Commanders’ core fans” about an investigation into toxic workplace culture and allegations of sexual assault to maintain a strong fanbase and increase profits.

After years of public reporting and outcry in response to sexual assault and workplace abuse allegations against Washington Commanders executives, including team owner Dan Snyder, the Office of the Attorney General (OAG) took action and launched its own investigation in the fall of 2021 into the Commanders’ and the NFL’s response to allegations of sexual harassment. During the investigation, OAG interviewed numerous witnesses, including former Commanders employees who experienced and witnessed harassment. OAG also reviewed thousands of internal documents produced by the Commanders and the NFL, including emails.

OAG’s investigation revealed that the Commanders, the NFL, and their executives, Snyder and Goodell, worked to prevent District residents from learning the truth and keep profiting. They publicly promised to fully cooperate with an independent investigation into the toxic work environment and sexual harassment within the Commanders organization and promised results the fans could trust.

According to the announcement “behind the scenes, Snyder waged an interference campaign to cover up years of harassment. And the NFL let him do it, betraying fans’ trust by enabling Snyder to have a say at the end of the investigation into him and the Commanders.”

Specifically, the Attorney General alleges that after the NFL took over the investigation from the Commanders to publicly help ensure it was independent, the Commanders and the NFL entered into an agreement that the public knew nothing about.

The agreement declared they had a joint interest in the investigation and gave Snyder and the Commanders the ability to block the public release of any information he chose, including the investigation’s ultimate findings. Throughout the investigation, Snyder actively sought to interfere with it, including intimidating and suppressing witnesses. Then, the NFL chose to shield the results of the investigation from the public.

The Commanders are valued at $5.6 billion and the NFL is a roughly $18 billion industry. The Commanders and the NFL make money off of fans’ ticket sales, and purchases of merchandise and entertainment that is targeted to DC residents.

The District’s Consumer Protection Procedures Act (CPPA) prohibits unfair and deceptive trade practices. OAG has broad authority under the CPPA to hold accountable any company or any head of a company if they mislead or lie to District consumers, regardless of where they are located. The Washington Commanders actively view District consumers as their fanbase, as evidenced by marketing campaigns to align the team with the city, including selling jerseys with the District of Columbia flag on it and other merchandise with “D.C.” clearly visible.

OAG’s lawsuit seeks to hold accountable the Commanders, Snyder, the NFL, and Goodell for violating the CPPA by lying to the public and District fans and withholding critical information.

With this lawsuit, OAG is seeking financial penalties under the CPPA for every incident in which the Commanders, Snyder, the NFL, and Goodell lied to District residents dating back to July 2020. And a Court order forcing the NFL to release the findings from attorney Beth Wilkinson’s 10-month independent investigation into the Commanders’ workplace culture, to give the fans and the public the truth and information they expected.

Walmart Sues 45 National Carriers For Opioid Settlement Costs

Walmart claims in Arkansas state court that 45 of the nations largest insurers wrongly refused to cover losses incurred as a result of defending itself against more than 2,400 opioid lawsuits. Jurisdiction in Arkansas is claimed because Walmart is headquartered in Bentonville, Arkansas, and the parties conduct business in Arkansas, including the Insurers selling insurance to Walmart in Benton County, Arkansas.

This action involves nearly 200 insurance policies spanning two decades, and many of those policies are dozens or hundreds of pages long.

According to the Complaint they failed, they allege that Walmart has paid millions of dollars to 45 Defendant Insurers – many of the nation’s leading insurance companies – for broad general liability policies designed to protect Walmart against potential risks to its business.

They say those risks have now manifested themselves in the form of more than 2,400 Opioid Lawsuits that have been filed against Walmart. Those lawsuits seek damages because of, among other things, bodily injuries allegedly arising out of opioids or opioidcontaining products that Walmart sold, distributed, or dispensed.

Walmart claims it has spent tens of millions of dollars defending itself against the Opioid Lawsuits and expects to spend much more in the future. Walmart timely notified the Insurers of each of the Opioid Lawsuits. But now they say “the Insurers have turned their backs, providing a litany of excuses why the policies supposedly do not cover the Opioid Lawsuits.”

Those excuses are meritless, as Walmart has repeatedly explained to Insurers, yet they continue to refuse to live up to their obligations under the policies.” And they go on to claim that “the underlying Opioid Lawsuits seek damages sufficient to exhaust all layers of coverage provided by Insurers’ Policies.”.

“Insurers have either reserved their rights to deny coverage, denied their duties to defend or indemnify, and/or otherwise failed to acknowledge their obligations to provide coverage for the Opioid Lawsuits on a series of baseless grounds.”

“For example, certain Insurers have asserted that these lawsuits are not brought “because of bodily injury,” despite complaints and settlements expressly stating otherwise and making clear that the underlying plaintiffs’ alleged damages are because of alleged injury and death to hundreds of thousands of individuals as a result of opioid abuse and addiction.”

“Certain Insurers have also asserted that coverage for the Opioid Lawsuits is excluded because the damages at issue in them were “expected or intended,” even though these lawsuits include numerous allegations of negligent or otherwise unintentional conduct or injuries, many of the settlements are expressly based on negligent conduct, not intentional harm, and Walmart has vehemently denied that it intended or expected to harm anyone.”

Many of the Policies are “primary” or first-level policies, meaning that they obligate the issuing Insurers to defend or to pay for Walmart’s defense and to indemnify Walmart either from the first dollar spent, or once a self-insured retention is satisfied. Those policies were issued by Defendants National Union, American Home, and the Insurance Company of the State of Pennsylvania.

Other Policies are umbrella or excess-layer policies, which, among other things, obligate the issuing Insurers to defend or to pay for Walmart’s defense costs and/or to indemnify Walmart for settlement or judgment costs when those costs exceed specified retention amounts or amounts of coverage available under lower-layer Policies or when coverage is not available or not collectible from such lower-layer Policies. The umbrella and excess-layer Policies were issued by various Insurers.

WCIRB Releases- 2022 Geo Study with Interactive Map

The Workers’ Compensation Insurance Rating Bureau of California (WCIRB) released the 2022 WCIRB Geo Study, which underscores regional differences in claim characteristics across California. The web-based interactive map allows you to quickly view key measures across regions.

The study, related exhibits and mapping of nine-digit zip codes o the regions referenced in the study are available in the Research section of the WCIRB website.

Key findings include:

– – Even after controlling for regional differences in wages and industry mix, indemnity claim frequency is significantly higher in the Los Angeles (LA) Basin and significantly lower in the San Francisco Bay Area.
– – During the pandemic, indemnity claim frequency increased significantly in Orange County relative to the rest of the state and decreased significantly in Ventura and Santa Monica/San Fernando Valley.
– – The share of open indemnity claims has decreased substantially in all regions since 2013. The decreases have been larger in the LA Basin regions that had the highest initial open indemnity claim shares.
– – The share of larger indemnity claims (those with incurred costs greater than $250,000) at third report level tends to be higher in regions that have lower indemnity frequency. Northern California regions, including the Bay Area and Peninsula/Silicon Valley, tend to have higher shares of larger indemnity claims.
– – During the pandemic, the median injured worker’s average weekly wage increased significantly in all regions. The increases were largest in Fresno/Madera, San Gabriel Valley/Pasadena, Santa Monica/San Fernando Valley and Tulare/Inyo. The median wage in these regions has often been lower than the statewide average.
– – The share of cumulative trauma claims as a percent of all claims increased for all regions during the pandemic. The increase was largest in San Bernardino/West Riverside and LA/Long Beach which also have high relative frequency of indemnity claims. It was also relatively high in the Bay area and Sonoma/Napa which saw decreases in the relative frequency of indemnity claims.
– – Medical-legal costs are significantly higher in the LA Basin, Orange County and Santa Monica/San Fernando Valley regions than in the remainder of the state.
– – Paid allocated loss adjustment expenses (ALAE) are significantly higher in Southern California regions.
– – In 2020, nearly one in eight indemnity claims reported in California were due to COVID-19. Shares of COVID-19 claims were higher in Southern California.
– – Average weekly wages for workers with COVID-19 claims were significantly higher than average weekly wages for workers with non-COVID-19 claims in all regions. The differences were greatest in the Ventura, San Bernardino/West Riverside and San Diego regions.

The WCIRB will host a free webinar to discuss the 2022 WCIRB Geo Study. Click on the registration link to sign up. Please submit your questions while registering; time permitting, we will answer your questions during the webinar or follow up via email afterward. – Wednesday, December 7, 2022, 10:00 AM – 11:00 AM PT. WCIRB Presenters: Dave Bellusci, Executive Vice President and Chief Actuary; Laura Carstensen, Vice President, Actuarial Research; and Shane Steele, Research Actuary.

For those unable to attend the live webinar, a recording will be posted in the Research section of the WCIRB website following the event.

WCAB Defines “High Velocity Eye Injury” Required for Extended TTD

Andrew Glick claimed injury to his left knee, lumbar spine, neurological system, and “ophthalmology/vision/eye,” while employed as a truck driver by Knight-Swift Transportation Holdings, Inc. when he was injured on November 26, 2018.

Glick was struck by a motor vehicle while crossing the street. The vehicle was traveling at approximately 30 miles per hour at the time of impact, and he was thrown approximately 10 feet, landing on the ground on his left side. Glick was knocked unconscious, and was transported by ambulance to Riverside Community Hospital, where he was diagnosed as having sustained a fractured left tibia, left fibula, left femur, right scapula, right clavicle, right and left temporal bones, L1 vertebrae, L2 vertebrae, L3 vertebrae, L4 vertebrae, and a left “brain bleed.”

On June 9, 2020 the Qualified Medical Evaluator (QME) in Physical Medicine and Rehabilitation noted his “number one problem” was vision difficulty:” The report said that “He was told he has nerve damage behind the right eye, so if he drives or does activities requiring any kind of balance or proprioception, he closes the right eye and only uses the left.” Mr Glick remained temporarily totally disabled.

A QME in ophthalmology reported in August 2020 that he was “not yet permanent and stationary, and required a strabismus (eye muscle) surgery to address superior oblique palsy, because “[t]he function of the 4th nerve cannot be restored.”

After an Expedited Hearing on the issue of whether Mr. Glick was entitled to temporary disability continuing from the last date paid of approximately 11/24/20 and continuing, pursuant to the applicability of Labor Code § 4656 (c)(3)(F), the WCJ issued his F&A, finding that Glick sustained injury to the “ophthalmology/vision/eye,” caused by a “high velocity impact,” resulting in “temporary total disability for which defendant has paid 104 weeks and which said benefit is ongoing.” The WCJ found defendant liable for ongoing temporary total disability pursuant to Labor Code section 4656(c)(3)(F).

Reconsideration of this Award was denied in the panel decision of Glick v Knight-Swift Transportation Holdings, Inc – ADJ11799924 (November 2022).

The WCJ filed his Report, observing that the statutory requirements were met because applicant sustained a high velocity impact to his person, which was the direct cause of both a concussion and a resulting eye injury.

The employer contended that the “plain language or common meaning” of the term “high-velocity eye injuries,” as set forth in Labor Code section 4656(c)(3)(F) refers to “at least some impact of the eye.” And cites as authority Cruz v. Mercedes-Benz of San Francisco (2007) 72 Cal. Comp. Cases 1281 [2007 Cal. Wrk. Comp. LEXIS 247] (Appeals Bd. en banc), were the WCAB applied a “common sense and ordinary meaning” to the term “amputation,” and that a similar analysis of section 4656(c)(2)(F) requires there be “some impact to the eye.”

Andrew Glick cites Glover v. ACCU Construction (June 15, 2009, ADJ665716 (BAK 0154393) [2009 Cal. Wrk. Comp. P.D. LEXIS 301] Glover was operating a mulching mower when he was struck by a metal fragment that entered his nostril, lacerating the nose and fracturing the eye socket before traveling through the brain and lodging in the back of the skull. In Glover the panel concluded “We are not persuaded that “eye” should be defined so narrowly, yet we need not delineate the outer limits of our definition at this time. We have examined applicant’s medical records and find ample evidence of injury to and treatment of the right eye.”

Turning to the issues in the claim of Mr. Glick, the panel followed its reasoning in Glover and concluded “Here, the facts support a similar analysis.”

Walgreens VillageMD to buy Summit Health for $9B

VillageMD, which is majority owned by Walgreens Boots Alliance, plans to pay nearly $9 billion to pick up medical practice Summit Health, the parent company of urgent care clinic chain CityMD.

According to the report by Fierce Healthcare, the deal, announced Monday morning, is valued at $8.9 billion and includes investments from Walgreens Boots Alliance and Cigna Corp’s healthcare unit Evernorth, which will also become a minority owner in VillageMD.

The deal will expand Walgreen’s reach into primary, specialty and urgent care. The transaction creates one of the largest independent provider groups in the U.S., the organizations said. Combined, VillageMD and Summit Health will operate more than 680 provider locations in 26 markets. The two companies will have 20,000 employees.

Last year, Walgreens invested $5.2 billion in VillageMD and said it planned to open at least 600 Village Medical at Walgreens primary-care practices across the country by 2025 and 1,000 by 2027.

The deal comes amid a frenzy of Merger and Acquisition activity in the past two years. Major retailers like CVS, Walgreens and Amazon are ramping up their focus on providing medical services to gain bigger footholds in the healthcare market.

Drugstore rival CVS Health won the bidding war for home health and technology services company Signify Health and plans to shell out $8 billion to acquire the company. Amazon also plans to buy primary care provider One Medical for $3.9 billion.

The move signals that Walgreens wants to become a “dominant entity in the overall healthcare services ecosystem,” according to David Larsen, healthcare IT and digital health analyst at financial services firm BTIG.

“Walgreens Boots Alliance is graduating up from being a drug retail store to owning the life-cycle of members’ health,” he wrote in an analyst’s note. “We view this transaction as being a statement by the market that primary care continues to be one of the key drivers of healthcare long-term.”

The deal also will put additional pressure on CVS Health to break into the primary care business “sooner rather than later,” Larsen wrote.

VillageMD provides value-based primary care for patients at traditional free-standing practices, Village Medical at Walgreens practices, at home and via virtual visits. VillageMD and Village Medical have grown to 22 markets and are responsible for more than 1.6 million patients, according to the company.

The acquisition also expands Walgreens’ reach into providing medical care directly to patients. “This transaction accelerates growth opportunities through a strong market footprint and wide network of providers and patients across primary, specialty and urgent care,” Roz Brewer, CEO of Walgreens Boots Alliance, said in a statement.

NCCI Publishes Update to 2021 State of the WC Line Report

At its Annual Insights Symposium (AIS) in May 2022, NCCI presented the State of the Line Report – a comprehensive account of financial results for the workers compensation (WC) line of business. The results presented in that report reflected the most current data available at the time, including NCCI’s preliminary estimates for Calendar Year 2021.

In this new report, NCCI provided updated results for 2021, as well as preliminary information for 2022.

For Calendar Year 2021, NCCI previously estimated WC written premium volume net of reinsurance (NWP) to be $38.3 billion for private carriers. The most recently reported industry data for that year is $38.2 billion, which represents a 0.5% increase from 2020’s NWP volume of $38.0 billion.

For Calendar Year 2021, NCCI previously estimated a WC net combined ratio of 87% for private carriers. Updated industry data indicates a net combined ratio of 87.2%, which represents a 12.8% underwriting gain.

The 2021 combined ratio is the fourth lowest combined ratio in recent history and the eighth consecutive underwriting gain for the WC industry. The current period of consecutive underwriting gains is unprecedented in terms of both duration and magnitude.

The 2021 combined ratio is the fourth lowest combined ratio in recent history and the eighth consecutive underwriting gain for the WC industry. The current period of consecutive underwriting gains is unprecedented in terms of both duration and magnitude.

The WC pretax operating gain measures the overall financial performance of the WC line of business, reflecting both underwriting and investment income. The Calendar Year 2021 underwriting gain of 12.8%, combined with the investment gain of 10.9%, resulted in a WC operating gain of 23.7% for that year. This value is slightly lower than the preliminary estimate of 25% shared at AIS 2022 and marks the fifth consecutive operating gain exceeding 20% for the WC industry.

Changes in rates/loss costs impact premium growth and are one of several factors, such as changes in the economy, cost containment initiatives, and reforms that may impact overall system costs. All else being equal, NCCI expects premium to decrease in 2022 by 7.5%, on average, as a result of rate/loss cost filings made in jurisdictions for which NCCI provides ratemaking services. Improved experience driven by long-term declines in lost-time claim frequency has contributed to this decrease. The changes shown below reflect both voluntary and assigned risk market approvals.