Michael Gavin, Author at Insurance Thought Leadership




Michael Gavin

Michael Gavin

Michael Gavin is president of PRIUM. He is responsible for the strategic direction and management of the medical intervention company. He brought considerable experience in several major sectors of the health care industry to PRIUM when he joined as chief operating officer in 2010, and he is the author of the thought-provoking Evidence-Based blog.

Areas of expertise include:
• Trends in medical treatment in workers’ compensation
• Opioid addiction and treatment, including medication monitoring and compliance
• Optimization of the claims management process
• Best practices for implementing managed care tools and related regulations
• The application of evidence-based medical guidelines
• Issues/challenges in the healthcare provider environment
• The application of evidence-based medical guidelines
• Predictive modeling
• Mergers and acquisitions and private equity in the workers’ compensation space
• Potential impact of proposed legislative/regulatory changes in workers’ compensation
• Health care reform and workers’ compensation

Prior to joining PRIUM, Gavin was a consultant with Kurt Salmon Associates, a leading provider of strategic advisory services to the healthcare provider sector. Previously, he served as the vice president of operations for MDdatacor, a health services start-up that provides innovative information technology solutions to support pay-for-performance programs in the ambulatory care environment. He began his career as a consultant with he Monitor Group, a global strategy consulting firm in Cambridge, Mass.

Gavin brings a keen understanding of the overall healthcare industry as well as workers’ compensation medical management to interviews and speaking engagements. He has been quoted in the Wall Street Journal, WorkCompCentral and other publications and has spoken at the National Summit on Rx Drug Abuse and several workers’ compensation conferences.

Gavin holds an MBA from Emory University’s Goizueta Business School, as well as a BSBA degree in finance from Georgetown University’s McDonough School of Business.

Recent Articles by Michael Gavin

The WC Mistakes That States Make

As 2017 gets rolling, state legislatures are convening all over the country. Several of them are about to make mistakes in the area of medication management in workers’ compensation. My colleague, Mark Pew, and I have written and spoken extensively on the topic of drug formularies. And we’re currently working, formally and informally, with regulators and other […]

Laying the Foundation for Drug Formularies

When Texas announced an 80% drop in the cost of “N” drugs prescribed for new injuries, workers’ compensation stakeholders took notice. (Medications designated as “N” in the Official Disability Guidelines are not appropriate for first-line therapy.) Since that announcement, the implementation of a closed formulary has placed near the top of the list on several […]

Marijuana Case Gets Even Weirder

Of all the states, who would have guessed that New Mexico would be the hotbed of medical marijuana court decisions?  Between the Vialpando v. Ben’s Automotive in May and the Maez v. Riley Industrial case, handed down earlier this month, New Mexico’s court of appeals appears to be one of the most pro-marijuana courts in the nation. Back […]

Physician Dispensing: I’ve Changed My Mind

In the past, I’ve argued that there are legitimate reasons a doctor might dispense medications to a patient and that legislative and regulatory efforts to curb abuses of physician dispensing should be focused on the elimination of the financial incentive to do so while preserving the practice for the limited circumstances in which it might […]

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