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Medical Marijuana and the Workers Compensation Conundrum

Because the U.S. Federal Government has dug-in its feet, leaving marijuana as an illegal, Schedule I drug under the Controlled Substances Act, state governments have been left to individually pave their own legalization paths, leaving a frustrated public in the wake. Employers, employees, doctors, workers comp case managers, and more feel frustratingly in-the-dark as ever-diversified, continually evolving legislation continues to change the landscape. This is the first post of our two part series of spotlighting medical marijuana in the marketplace.

What We Do Know About Medical Marijuana

By |May 31st, 2017|Drug Utilization Review, Medical Cost Containment|Comments Off on Medical Marijuana and the Workers Compensation Conundrum

Is Regulation the Answer to Rising Pharma Costs?

National pressure has been building for government regulation on pharmaceutical costs.  A recent poll from the Kaiser Family Foundation found that 72% of Americans think drug costs are unreasonable and demand more transparency from drug companies, especially when it comes to how they set prices.(1) In the face of this discourse, the accountability of pharmaceutical companies has grown as a key focus of recent state and federal regulations.

In the state of Vermont, expensive prescriptions drugs distributed by manufacturers must now justify their exorbitant costs, according to a newly […]

By |August 30th, 2016|Medical Cost Containment, Pharmaceutical Cost Containment, Workers Compensation Payers|Comments Off on Is Regulation the Answer to Rising Pharma Costs?
  • Pharmacotherapy Review Medical Cost Containment Strategy
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    The Importance of a Multifaceted Approach to Medical Cost Containment

The Importance of a Multifaceted Approach to Medical Cost Containment

The biggest hurdle in workers’ compensation medical cost containment is that the injured worker is not getting better. Even though WC claims have steadily declined over the last decade, medical costs keep rising as do the sub-par outcomes for the patient and the payer. What we are seeing is that the inter-connectivity of many factors is hindering the end goal of optimized outcomes. A multidimensional approach is crucial not only for combatting pharma costs, but also for ensuring optimal outcomes for injured workers.

At the end of the […]

By |August 15th, 2016|Medical Cost Containment, Pharmacotherapy Review, Workers Compensation Payers|Comments Off on The Importance of a Multifaceted Approach to Medical Cost Containment

How Common is Illegal Drug Use Among Pain Patients?

At the American Pain Society’s 35th Annual Scientific Meeting in Austin, findings were released on the use of illicit substances among chronic pain patients. Of 450,081 patients included in a study by Baltimore-based pain medication monitoring firm Ameritox, 10.4% of urine samples tested positive for the use of at least one illicit substance.

How Many of Those Identified Were Workers Comp Patients?
Workers compensation was the primary payer for 22,525 of the 450,081 patients in the study, conducted between January 2013 and July 2015, which showed the use of illicit substances […]

Putting the Injured Worker First

In the workman’s comp industry, significant effort is put toward breaking the pharmaceutical cost cycle for Payers. As the industry fights for savings, however, injured workers often get lost in the shuffle. The nameless and faceless many among worker’s comp injury statistics are quite removed from the system they rely upon.

Bottom Line Statistics Means Poor Outcomes for Injured Workers

As political pundits fight for special interests, benefit caps are set with no relation to each state’s average weekly wage, ignoring improved wage data and analytical methods that could mend take-home […]

By |June 15th, 2016|Drug Utilization Review, Medical Cost Containment, Workers Compensation Payers|Comments Off on Putting the Injured Worker First

Key Takeaways from a Recent National Safety Council Survey

Subsequent to the CDC’s new guidelines regarding the treatment of chronic pain, The National Safety Council (NSC) released its latest survey regarding doctor prescribing practices. Summarized below, the statistics

CDC Guidelines: Use non-opioid therapies first.
NSC Stats: 74% of doctors erroneously believe opioids (morphine, oxycodone) are the most effective way to treat pain.
The Missing Link: Research shows OTC pain meds (ibuprofen, acetaminophen) offer the most effective relief for acute pain.

CDC Guidelines: Do not use opioids for the routine treatment of chronic pain.
NSC Stats: 67% of doctors base there prescribing […]

By |May 15th, 2016|Drug Utilization Review, Medical Cost Containment, Pharmacotherapy Review|Comments Off on Key Takeaways from a Recent National Safety Council Survey
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    Effective Pharma Management Can Help Offset Increases in Prescription Costs

Effective Pharma Management Can Help Offset Increases in Prescription Costs

2015 saw rising drug prices contributing to the growth in pharmacy spending for American workers’ compensation payers. Meanwhile, opioid and compound drug cost management continues to be an Achilles heel. An effective pharma cost management program can offset these costs by aiming to improve pain treatment regimens for injured workers.

Pharmacotherapy Review Can Reduce Opioid Spend

Opioids continue to be the costliest class of medications for occupational injuries. To combat the rise in opioid utilization in chronic pain treatment of injured workers, ANS introduced a face-to-face and highly proactive approach to […]

By |April 1st, 2016|Drug Utilization Review, Medical Cost Containment, Pharmaceutical Cost Containment, Pharmacotherapy Review|Comments Off on Effective Pharma Management Can Help Offset Increases in Prescription Costs

6 Ways Pain Management is Mismanaged

There is a significant body of evidence suggesting that many Americans suffer from chronic pain and much of that pain is inadequately or ineffectively treated. Particularly in the case of chronic pain treatment via opioid analgesics, proper chronic pain management is critical in determining whether opioids are used in a manner that is both medically appropriate and in compliance with regulations. Pain management is an important area of patient care that is integral to the practice of medicine, yet so often it is mismanaged. Here we review six most […]

By |January 30th, 2016|Drug Utilization Review, Medical Cost Containment, Opioid Abuse, Pharmacotherapy Review|Comments Off on 6 Ways Pain Management is Mismanaged
  • Steps to combat the opioid epidemic using ANS drug utilization review
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    Strategies to Reduce Patient Reliance on Opioids Postoperatively

Strategies to Reduce Patient Reliance on Opioids Postoperatively

Surgeons across the nation are increasing efforts to reduce their overall use of opioids for the long term treatment of chronic pain post-operatively. The driving force- Curtailing the opioid abuse epidemic, an unfortunate but growing trend.

Well-Documented Risks
An epidemic effecting 5 million Americans, half of all opioid-related overdose deaths in the U.S. have been linked to prescription drugs – not “street” or “recreational” drugs. Opioid use, even short term, is particularly problematic for patients with a history of substance abuse.

Changing Practices
Seeing the effects of this epidemic, many surgeons are taking […]

By |December 30th, 2015|Drug Utilization Review, Medical Cost Containment, Opioid Abuse, Pharmacotherapy Review|Comments Off on Strategies to Reduce Patient Reliance on Opioids Postoperatively

Medical Cost Containment Does Not Mean Compromised Care

medical cost containment strategies delivered via legal nurse consultingThe existing way that the workers’ compensation industry handles large loss claims has been contributing to diminished quality in care for injured workers, increased costs associated with treatments, and poorly coordinated care. Care delivery within workers’ compensation programs is arguably even more inefficient than in general healthcare but it does NOT have to be this way. Payers can have the best of both worlds with medical cost containment strategies that provide quantifiable outcomes […]

By |October 30th, 2015|Legal Nurse Consulting, Medical Cost Containment|Comments Off on Medical Cost Containment Does Not Mean Compromised Care