Convincing Data Shows Physician’s Writing Scripts For Profit

A new study from Cambridge-based Workers Compensation Research Institute (WCRI) entitled “Physician Dispensing Associated With Unnecessary Prescribing Of Opioids,” found evidence that physician dispensing encouraged some physicians to unnecessarily prescribe strong opioids. The study analyzed the prescribing behavior after Florida banned physician dispensing of strong opioids.

 

 

Physician Prescribing Practices Consistent With What Benefits Their Pocketbook, Rather Than Patient Health

 

The authors of the study, The Impact of Physician Dispensing on Opioid Use, expected little change in the percentage of patients getting strong opioids—only a change from physician-dispensed to pharmacy-dispensed. Instead of finding an increase in pharmacy-dispensed strong opioids, the study found no material change. Rather, there was an increase in the percentage of patients receiving physician-dispensed weaker pain medications—specifically, nonsteroidal anti-inflammatory medications (e.g., ibuprofen)—from 24.1 percent to 25.8 percent, and the percentage receiving weaker (not banned) opioids increased from 9.1 percent to 10.1 percent.

 

The study found there was a high level of compliance with the ban by physician-dispensers. Prior to the reforms, 3.9 percent of injured workers received strong opioids dispensed by physicians during the first six months after their injuries. After the ban, only 0.5 percent of patients with new injuries received physician-dispensed strong opioids. If the pre-ban strong opioids were necessary, researchers would expect that workers who received weaker physician-dispensed pain medications after the ban would later need strong opioids (that can be dispensed only at a pharmacy). But only 2 percent of those with weaker physician-dispensed pain medications in the first six months after the ban received strong opioids at a pharmacy in the next six months.

 

 

Policymakers Should Consider Reforms That Limit Physician Dispensing

 

According to the study, the policy debate in a growing number of states has been focused on the much higher prices charged by physician-dispensers than pharmacies for the same medications. The debate has recently begun to focus on whether the economic incentives attendant to physician dispensing (like any form of physician self-referral) lead to prescribing and dispensing of unnecessary medications. Over the past 10 years, 18 states have modified reimbursement rules to reduce the prices paid for physician-dispensed drugs. Until recently, few of these states also limited the use of physician dispensing. The findings of this study raise the question of whether policymakers should consider reforms that limit the use of physician dispensing of certain medications in addition to reforms aimed at limiting the prices of physician-dispensed drugs.

 

“When we compare pre- and post-reform prescribing practices, it appears that physician-dispensers not only reduced their dispensing of strong opioids, but also reduced prescribing of strong opioids. This raises concerns that a significant proportion of pre-reform physician-dispensed strong opioids were not necessary, which means injured workers in Florida were put at greater risk for addiction, disability or work loss, and even death,” said Richard Victor, WCRI’s executive director. “Since Florida has banned physician dispensing of strong opioids, the lessons of this study are relevant for the other states concerned about eliminating unnecessary costs in their system while protecting injured workers from unnecessary medical care.”

 

This study analyzed data on the medications dispensed for injured workers covered by the Florida workers’ compensation program. It included both open and closed Florida claims. The claims were divided into two groups: pre-reform, with dates of injury from January 1, 2010, to June 30, 2010 (prior to the July 1, 2011, effective date of the ban) and post-reform, with dates of injury from July 1, 2011, to December 30, 2011 (immediately after the ban). The data included 24,567 claims with 59,564 prescriptions in the pre-reform group and 21,625 claims with 52,747 prescriptions in the post-reform group.

 

For more information about this study or to purchase a copy, visit http://www.wcrinet.org/result/PD_opioid_result.html.

 

 

ABOUT WCRI:

 

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Cambridge, MA. Founded in 1983, the WCRI is recognized as a leader in providing high-quality, credible, and objective information about public policy issues involving workers’ compensation systems. WCRI’s diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand. For more information, visit: http://www.wcrinet.org.

 

 

 

Author Michael Stack, Principal of Amaxx Risk Solutions, Inc. He is an expert in employer communication systems and helps employers reduce their workers comp costs by 20% to 50%. He resides in the Boston area and works as a Qualified Loss Management Program provider working with high experience modification factor companies in the Massachusetts State Risk Pool.  As the senior editor of Amaxx’s publishing division, Michael is on the cutting edge of innovation and thought leadership in workers compensation cost containment. http://reduceyourworkerscomp.com/about/.  Contact: mstack@reduceyourworkerscomp.com.

 

©2014 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 

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5 Steps Employers Can Take To Control Opioid Abuse in Work Comp

Opioid Abuse is Hot Workers Comp Topic
 
The hottest workers’ compensation topic currently is the run-away cost of opioids, which are very strong narcotics, in the treatment of employee injuries. Key findings from the recent WCRI conference state that most injured workers received opioids for pain relief, over 80% in some states. In addition, the amount of opioids received per claim has been unusually high in some states with fewer longer-term users of opioids receiving services for monitoring and management. 
 
Whether an employer is self-insured for workers’ compensation, or has a work comp insurance company, the cost of opioids can have a significant impact on the employer’s overall workers’ compensation cost. Unfortunately, too many employers take the approach that they cannot do anything about the impact of opioid costs on their work comp claims. Employers do not have to accept the conventional wisdom that there is nothing they can do to control the cost and abuse of opioids.  There are several approaches an employer can take to deal with these issues.
 

Steps Employer Can Take To Control Opioid Abuse

 
Control Selection of Medical Provider
 
The first step employers should take to control opioid abuse and opioid cost is to control the selection of the medical provider. In the states where the employer has the right to select the medical provider, and in the states where the employer is required to provide a panel of doctors for the employee to select from, all medical providers should be prescreened.  This is to eliminate doctors that are too quick to prescribe narcotics and doctors that keep injured employees with chronic pain on narcotics. 
 
There are several other approaches doctors can use to treat pain besides narcotics. Physical therapy, exercise, injections, acupuncture, neural blocks, implantable devices and psychological intervention can all be used as alternatives to narcotics.
 
Empirical evidence also shows that the opioid problem is much worse in the states where the employee is free to select their own medical provider. This is especially true in states where the medical provider cannot only prescribe an opioid, but can also dispense it (and make an additional profit in doing so). If your state law allows the employee to select their own doctor, you can still post on the work place bulletin board a list of nearby recommended (not required) doctors that have been screened to eliminate medical providers who over-prescribe narcotics.
 
 
Initiate Drug-Free Workplace Program
 
As stated in the "Effective Interventions" presentation at WCRI, employers with an actively managed Drug-free Workplace program have significantly lower percentage of injured employees utilizing opioids. Employers who do not hire people who use illicit drugs and employers who have random on-going screening for illicit drugs have far fewer employees who are predisposed to developing an opioid addiction when they incur an on-the-job injury.
 
Pain is subjective, and there is no diagnostic test to measure it. This often results in the injured employee being asked to self-rate their pain on a zero to 10 on a ten point scale with zero being no pain, and 10 being pain that is totally incapacitating. Watch out for the employee who rates their pain 9 or a 10 but was able to transport themselves to the doctor’s office. An extremely high pain self rating that is not supported by objective findings is a red flag pointing to a desire for secondary gain or a desire to obtain narcotics.
 
 
Nurse Case Manager Should Be Assigned to Red Flag Cases
 
When an employee reports a high level of pain, especially after a medical provider has prescribed an opioid, it is imperative that close supervision of the injury claim be maintained. If a nurse case manager (NCM) is not already working on the claim, one should be assigned. The nurse case manager should review the medical diagnosis to verify there is acute musculoskeletal pain supported by significant objective evidence of injury (as opposed to “my back hurts”).
 
The NCM should discuss with the medical provider the reason for the opioid treatment, the anticipated length of time the opioid will be provided, the quantity being provided on a daily basis and most importantly, the possibility of alternative non-narcotic medication or alternative pain management treatment methods. If the medical provider is non-cooperative with the NCM, the NCM should bring in a doctor that specializes in pain management for a peer review of the treatment, and if necessary, a doctor to doctor discussion of the opioid treatment be provided to the injured employee.
 
 
Review Opioid Usage with Pharmacy Benefit Manager
 
The employer should review opioid usage with their Pharmacy Benefit Manager (PBM) company. The PBM processing the prescriptions submitted to them need to do much more than see whether or not the prescribed opioid is on their formulary list. The PBM should:
 
  • provide utilization review to prevent the consumption of a narcotic faster than the manufacturer’s recommendation or faster than the medical provider’s prescription amount
  • be able to prevent prescriptions from multiple doctors being processed for the same drug or duplicate use drugs
  • have the capability of preventing multi-pharmacy submissions (where the employee fills the opioid prescription at one pharmacy chain using the paper prescription received in the doctor’s office, then calls the doctor’s office claiming to lost the prescription and having the doctor’s office call the prescription into a different pharmacy chain)
  • the ability to provide correct pricing for any opioids dispensed from the doctor’s office
 
Engage Employee Assistance Program for Opioid Users Longer Than 60 Days
 
While there is a debate over when the use of opioids becomes an addiction problem, if the injured employee has been receiving opioids for more than 60 days, and the employer has a Wellness Program, the employee should be referred to the Employee Assistance Program. While the employee may be initially reluctant to seek assistance with their use of opioids (as many addicts will lie to themselves to justify their addiction), the employee needs to be educated about the long-term negatives of opioid addiction. The Employee Assistance Program will provide the employee with positive support, behavioral modification, encouragement and guidance on how to break the opioid addiction. This can include counseling, information on alternative treatments and if needed, drug rehabilitation.
 
 
Author Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher.  www.reduceyourworkerscomp.com.  Contact: mstack@reduceyourworkerscomp.com.
 
©2013 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional about workers comp issues.

How You Can Prevent Pain Medication From Causing More Pain

Opioid-Induced Hyperalgesia

 

Anytime I discuss medical issues I always clarify that I am in no way a medical physician.  Whether it is to a claimant, or an attorney, I can only interpret medical in my own opinion based on training and years of experience in this business. I do also clarify to people that I always try to stay up to date on new medical issues, since they can have a direct application on the handling of workers compensation insurance claims. 

 

There has been some talk of late about a new issue involving opiate medications, coined “Opioid-induced Hyperalgesia” or “OIH” for short.  Oftentimes a claims adjuster has a file where a claimant is taking a large amount of opiate medications for pain.  Every time the adjuster reviews the medical records, or talks to the claimant, the injured party seems to be in more pain than before, despite the presence or even increased dosage of strong narcotic medications.  How is this possible?  If Oxycodone is doing nothing for pain control, then what other steps could you take for pain control?

 

In the past, an adjuster worried about narcotic pain medication causing addiction issues, dependence issues, and increased medication tolerance issues. In addition to that, these medications are costly, and they seem to be prescribed on every claim no matter what the severity. But OIH has raised new concerns about longer-term chronic pain issues and what to do before these claims get out of control. 

 

 

The Cause of OIH:

 

The exact cause of why OIH occurs is currently under medical investigation.  The leading theory continues to be the excitation of nerves through chemical pathways by certain types of narcotics.  Research has shown that some narcotics may have a higher propensity to cause OIH than others.  These are mainly known as the “phenanthrene opioid” class of medications, which includes codeine, hydrocodone, oxycodone, and hydromorphone.  In patients where OIH could be the culprit, switching to a non-phenanthrene medication such as meperidine or tramadol often times leads to adequate pain relief, much to the surprise to those involved.

 

In simpler terms, OIH may be caused by the narcotic itself increasing the level of pain that the patient may be experiencing.  Almost out of the blue, this medication that is supposed to be used as a pain reliever is actually worsening the pain, thus requiring larger and larger doses of medication for adequate pain relief.  As these doses increase, so do the risks for the more well-known issues with pain medication which include central nervous system issues, depression, addiction, drug-seeking behavior, and the risk of overdose. Even more, the financial costs of these medications begin to dominate the claim more than anything else, including wage loss.

 

 

What to Watch For:

 

Some common characteristics of OIH include:

 

  • Worsening pain over time despite increased dosages of opiate narcotics used for pain control.

 

  • Pain that becomes more diffuse in and around the area of injury.

 

  • Sensitivity to touch around the injured area specifically.

 

  • Subjective setbacks in the progression to MMI without diagnostic objective findings.

 

 

The Future of OIH

 

Although this is a newer phenomenon, the study of OIH can change the way physicians diagnose and treat chronic pain cases.  To date, if a patient’s pain in not controlled by whatever medication they are taking, it is common to step the dosage up to the next level, and re-evaluate pain at the next doctor appointment.  Because increased doses are used, the patient also has increased tolerance for pain medication, and at that point the dose must increase again. But if OIH were to be present early on, but not addressed specifically, then who knows if that medication would have ever helped this person’s pain, no matter what the dose?

 

There is a large potential for work comp claimants to experience OIH symptoms since narcotic pain relief is often used early on, usually at the first visit to the clinic.  When reviewing your comp files, especially those longer-term files where a person has had chronic pain symptoms of an escalating nature without any exacerbation of the injury, those files should be sent for an OIH evaluation by a medical professional.

 

 

Summary

 

I believe it is a safe assumption that OIH could be responsible for a significant percentage of claims dollars spent within the workers compensation system.  Cost drivers that can occur if this is not diagnosed will be increased medication costs, medication side-effect management, and addiction treatment.  These three issues alone can be responsible for large amounts of money spent on the claim.  The ability to identify OIH very early on in the life of a claim can save massive amounts of claim money, and also benefit the claimant who would not have to deal with the strong side effects of the long-term use of these dangerous medications. The ability to identify and treat OIH correctly will lead to better claim outcomes, earlier returns to the workplace post-injury, and an overall decreased burden on the work comp system as a whole. 

 

 

 

Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50%Contact: RShafer@ReduceYourWorkersComp.com.

 

Editor Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher.  www.reduceyourworkerscomp.com Contact mstack@reduceyourworkerscomp.com

 


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Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.

 

©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.

 

New Opioids Being Developed to Decrease Abuse, Save Work Comp Costs

Prescription Drugs Major Expense in Insurance Claims

 

Recent trends in auditing the expenses within insurance claims point to prescription medication as being one of the major expenses involved in these insurance claims.  Within these costs, opioid pain medications tend to lead the way as some of the most expensive medications out there.  It seems that physicians can be rather quick to prescribe Vicodin and OxyContin for the general strain injury, and of course the prescription of these medications can lead to a ton of problems, namely addiction and overall general misuse, which can complicate a claim tenfold.

 

 

Drug Manufacturers Looking for Answer to Addictive Side Effects

 

Faced with intensive scrutiny, drug manufacturers have been scrambling to come up with alternatives to lessen the side effects of these very strong pain relievers. Probably the most common new tactic being created are ways to “disable” the medication when crushed, so when the actual tablet is tampered with it will lessen the potency, thereby making any misuse less attractive to the drug abuser, which also should decrease the overall street demand for the drug. [WCx]

 

In addition to Vicodin and OxyContin, which have lead the way in the newspaper headlines, insurance carriers started to see an increase in the prescription drug Opana, which generally has effects similar to those of OxyContin.  To refresh your memory, this certain classification of medication is used for treating severe breakthrough pain in acute injuries.  Other medications that have stereotypically had a negative connotation within the insurance claim world include Valium, Xanax, Ambien, and to a lesser extent Ultram, Flexeril, Percocet, and the like.  All will fall within a class of benzodiazepines and/or opioid medication used to treat severe and chronic pain complaints. Certainly when an adjuster sees any of these medications being prescribed, a red flag goes up and the adjuster will start an aggressive track of working with the prescribing doctor in an attempt to try alternative, less addictive medications that may be more reasonable to treat short-term injury pain relief. 

 

Instead of these stronger medications being used very sparingly, and often times very early on in the work comp claim as a means to control pain, it is also becoming more common to see these medications prescribed over and over again, even after the acute stage of the claim has long since passed.  This is when the real cost starts to set in, as you can imagine if a claimant is being prescribed a handful of these medications month after month, and sometimes year after year. 

 

 

Overly Prescribed

 

If a claimant is still complaining of pain and states they are no better, then why are these medications being prescribed again and again?  You would think that if the medication were actually not working, that a change would set in sooner or later, and the doctor would start to try to utilize other means of pain relief such as decreasing and tapering the dose, or switching to anti-inflammatory medications instead of opioids. Sadly, this is not often the case.  You could blame this on anything, maybe sometimes just general laziness of the doctor, but really only the doctor knows the real reason.  This is why adjusters, nurse case managers, and pharmacy benefits managers will intervene early on in an attempt to shift the prescriptions into safer, less expensive waters.

 

 

New Drug Alternatives

 

Whatever the reason, there are a few new drugs being marketed out there that you should be aware of.

 

Butrans—A topical patch that delivers relief for moderate to severe chronic pain.

Abstral—A tablet designed to address breakthrough pain in cancer patients.

ConZip—An extended release tablet engineered to address moderate to moderately severe chronic pain.

Lazanda—Delivered in an intranasal spray also for breakthrough pain in cancer patients.

 

These 4 medications will probably only be the tip of the iceberg.  In the past, I would estimate it to be common to see a new drug or two over the course of a year being introduced to treat pain.  As the negative press continues, I would guess you will start to hear more and more medications branded as the “next greatest thing to treat pain while limiting harsh and addictive side effects.” 

 

In addition to new medication, the FDA is also making pharmacists and doctors work more closely together by having more stringent registration requirements once these drugs are prescribed.  I guess the threat of more paperwork and possible penalties may deter doctors from casually prescribing these strong medications when the common injury presents itself.  Whether or not this will work we have yet to find out. [WCx]

 

 

Summary

 

There is an air of change in the world of insurance claims, with the costs of prescribed medication being the main culprit of overall increased costs of long-term injuries, as well as short-term.  But there are changes being made, and it is important to be aware of these changes and the hopeful cost reductions that they hope to achieve. 

 

Saving money on claims affects us all, since in one way or another we all have to compensate for increased costs in the form of increased premiums across the board, no matter what classification the injury claim may be.  Cost reduction starts one claim at a time.  It is never too late to become involved and make these doctors explain why claimants remain on these expensive, oftentimes dangerous opioid medications in long-term use situations.  Make these physicians defend their actions, and don’t let it pass you by and slip through the cracks.

 

 

 

Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50%Contact: RShafer@ReduceYourWorkersComp.com.

 

Editor Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher.  www.reduceyourworkerscomp.com Contact mstack@reduceyourworkerscomp.com

 


WORKERS COMP MANAGEMENT MANUAL:  www.WCManual.com

VIEW SAMPLES PAGES

MODIFIED DUTY CALCULATOR:  www.LowerWC.com/transitional-duty-cost-calculator.php

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.

 

©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.

 

Workers Compensation News From Around the Net

Input Needed in Providers Opioid Audit
 
The Texas Department of Insurance, Division of Workers’ Compensation (TDI-DWC) acknowledges that prescription drug abuse and misuse, including opioids, is a serious issue in all health care delivery systems, including workers’ compensation.
 
 
The TDI-DWC seeks input and suggestions regarding the development of a new Plan-Based Audit for health care providers prescribing opioids. The Plan-Based Audit sets the scope, methodology, selection criteria, and program area responsibilities as laid out in the Medical Quality Review Procedure. A copy of the proposed Health Care Providers Pain Management Services (Opioid) Plan-Based Audit can be viewed at the TDI website here. [WCx] 
 
 
Broadspire Launches BOLD® Rx Network
 
Broadspire, a Crawford Company and TPA of workers compensation claims, liability claims and medical management services, has launched its BOLD Rx Network to help control the medical costs associated with WC claims. See here for more information.[WCx]
 
 
According to Broadspire, the BOLD Rx Network uses a multi-leveled strategy to achieve superior penetration rates and savings compared to the rest of the industry. “Rather than just partnering with one pharmacy benefit management (PBM) company, as is traditionally seen in the marketplace, Broadspire leverages multiple partners based on the value they bring to clients, creating a stronger pharmacy program,” they write.
 
Federal Court Rejects NLRB Authority to Force Posting of Employee Rights Notice
 
According to a well-written newsletter from McGuireWoods, a world-wide lawfirm with 900 lawyers, in Chamber of Commerce of the U.S., et al. v. NLRB (Dist. S.C., April 13, 2012), a South Carolina federal district court held that the National Labor Relations Board (NLRB or the Board) does not have statutory authority to force employers to post notices that the NLRB claims are designed to inform employees of their rights under the National Labor Relations Act.
 
 
McGuireWoods writes, “The Court’s decision directly conflicts with a recent decision from a separate federal court in the District of Columbia. These developments place all employers covered by the Act in a very difficult position.”
 
 
The regulations are to take effect April 30, 2012. “The conflicting court cases make it unclear whether employers will be required to post the NLRB notices on the current April 30, 2012 deadline. (Click here for more),” they write.
 
 
Columbus Dispatch Notices Lawsuits Against Doctors on Decline
 
Columbus Dispatch reporter Alan Johnson writes here that Ohio’s tort-reform law has reduced closed claims by 41 between 2005 and 2010. He discovered average payments for medical malpractice cases have declined 38 percent over that period.
 
 
Johnson writes, “The legal fight over curbing lawsuits and settlements in medical malpractice cases reached a tipping point in 2003 when the General Assembly passed and Gov. Bob Taft signed Senate Bill 281. The law capped non-economic damages, commonly known as ‘pain and suffering,’ at $500,000 per occurrence.”
 
 
Johnson reports that Tim Maglione, of the Ohio State Medical Association says doctors’ medical malpractice rates have dropped more than 26 percent. “It’s not only good news and a good trend, but it is proof that tort reform accomplished what it set out to do — slow the growth of what we thought were runaway lawsuits and to stabilize the market for physicians,” Maglione said. The numbers have also gone down, he said in the article, because doctors and hospitals are working harder to improve safety and cut down on mistakes. “The best error is the one that never happens.”
 
 
Progressive Medical Releases Annual Workers’ Compensation Medication Trends Report
 
According to Progressive Medical, Inc., WC medication spending declined in 2011. Their annual analysis, found here, reveals changes to medication expense patterns in workers’ compensation claims from 2010 to 2011 for Progressive Medical clients, as well as key factors that may influence future expenditures, such as chronic pain, product mix and government activity.
 
 
Key highlights from the 2012 Workers' Compensation Medication Trend Report include:
  1. Although medication AWP inflation was 5.8 percent in 2011, data shows a 1.3 percent reduction in total medication spend per claim.
  2. There was an overall 3.3 percent decrease in utilization per injured worker from 4.3 percent fewer prescriptions and a 1.1 percent decrease in average days of medication supply received.
  3. Across the industry, narcotics account for 35 percent-40 percent of workers' compensation medication spend while Progressive Medical showed a 3.9 percent decrease in total spending per claim in this drug category. Progressive Medical believes this is due to an emphasis on conducting interventions earlier in the lifecycle of a claim.
 
 
Note: If your company has any developments you'd like to share, please send them to us at: RShafer@ReduceYourWorkersComp.com

 

 

Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact: RShafer@ReduceYourWorkersComp.com.

 


WORKERS COMP MANAGEMENT MANUAL:  www.WCManual.com

MODIFIED DUTY CALCULATOR:  www.LowerWC.com/transitional-duty-cost-calculator.php

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.

 

©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.

Small Number of Calif Comp Doctors Prescribe 80 Percent of Narcotics

A small percentage of doctors are responsible for prescribing close to 80% of Schedule II opioids for workers compensation injuries, according to unveiled research from the California Workers Compensation Institute (CWCI).
 
 
BusinessInsurance.com reports that Schedule II opioids include “major narcotics LIKE oxycodone, fentanyl, morphine and methadone, which have limited FDA-approved medical uses and carry a high potential for addiction and abuse,” according to the CWCI. (WCxKit)
 
 
The study reports that 10% of doctors prescribing Schedule II opioids for injured California workers accounted for approximately 80% of all workers comp prescriptions for the drugs and 88% of the associated payments.
 
 
The CWCI reviewed 233,276 prescriptions dispensed to 16,890 California workers from the period of January 2005 to December 2009. It discovered that nearly half of all Schedule II opioid prescriptions went towards minor back injuries.
 
 
Yet the American College of Occupational and Environmental Medicine claims the use of these drugs is “typically not useful in the sub acute and chronic phases,” according to the. (WCxKit)
 
 
Previous CWCI research discovered the use of the drugs in California workers comp cases had ballooned, with their costs accounting for 3.8% of workers comp prescription drug costs in 2005 but growing to 23.6% four years later.
 
 
Author Robert Elliott, executive vice president, Amaxx Risks Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers Compensation costs, including airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. See www.LowerWC.com for more information. Contact:Info@ReduceYourWorkersComp.com or 860-553-6604.
 
 
 
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
 
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.

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