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Healthesystems is a leading provider of Pharmacy Benefit Management (PBM) & Ancillary Benefits Management programs for the workers' compensation industry.
Out-of-network pharmacy use in workers’ compensation drives higher costs, safety risks, and regulatory gaps; educating and engaging injured workers through digital outreach is a critical lever to increase network utilization.
How do PBMs help to manage the overall utilization, cost, and quality of workers’ comp healthcare?
With an effective formulary strategy, PBMs can ensure injured worker patients receive the most appropriate care and create better outcomes.
Weight loss drugs are surging in popularity and making their way into workers’ comp. Get the latest news on payer coverage, drug shortages, and costs.
A small percentage of claims are driving the majority of costs in workers’ comp. What are these “mega claims” and how can we mitigate them?
More complex and costly claims are a concern in workers’ compensation. Understanding the factors that drive longer claim duration and higher costs is the first step to detection and management.
Degenerative comorbid conditions are present in 19% of claims and can drive up claim costs and disability duration.
While the global cancer burden continues to rise, the risk and impact of occupational cancers can vary significantly. For payers who are impacted, the costs can be substantial.
PBMs are an integral piece of managing workers’ compensation healthcare and improving the experience for all stakeholders.
Recent industry data has shown that while more severe cases of Long COVID are uncommon, those cases can significantly impact claims costs in workers’ comp.
Migraine medications are making up a growing portion of pharmacy spend in workers’ comp, driven by an influx of new CGRP antagonist medications to the market over the last few years.
Let’s look at common complexities in workers’ comp claims – and how a combination of technology, data, and people can help address them.
A good customer service center can create an exceptionally positive experience for customers, claims teams, and injured workers.
How can clinical pharmacists use artificial intelligence to improve care for injured workers? Silvia Sacalis, VP of Clinical Services, weighs in.
Expanding presumptions in workers’ comp are making it easier for workers to qualify for benefits related to mental injury, including PTSD, as well as certain cancers and other conditions.
Hypertension and other cardiovascular diseases affect 128 million adults in the United States.
Healthesystems’ AVP of Information Security, Tony Brown, discusses how cyber threats affect workers’ comp organizations.
High-impact drugs represent proportionately low utilization compared to opioids or NSAIDs, but they can increase pharmacy spend exponentially on impacted claims.
Lawmakers look to regulate the U.S. drug supply chain in ways that could impact workers’ comp pharmacy management.
Infusibles and injectables are among the costliest medications in the specialty drug category. What is their place in workers’ compensation?
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