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Healthesystems is a leading provider of Pharmacy Benefit Management (PBM) & Ancillary Benefits Management programs for the workers' compensation industry.
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.
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.
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.
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.
The range of medical products and services needed for injured worker recovery is broad and the opportunities for fraud, waste, and abuse in workers’ comp healthcare are many.
Comorbid obesity can complicate recovery, and new drugs create new pharmacy considerations.
Better metrics for physical medicine
10 Best Practices in Medical Claim Management
Older patients and fewer physicians in workers’ comp
Effective monitoring strategies can help curb nonadherence and its impact on patients and payers.
Innovative analytics tools provide better, more actionable data for improved opioid management.
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