Pharmacy Benefits Management

A Breakthrough in Pain Management: Inside the Promise of Journavx

Enlyte’s Nikki Wilson offers a fresh take on a promising alternative to opioids, a first-of-its-kind FDA-approved non-addictive medication for pain.

Trends That are Paving the Way for Successful Managed Care Programs in 2025

Workers’ Compensation PBMs: What They Do and What to Look For

Why Pharmacy Staff with Varied Backgrounds Are Key to a Successful PBM Clinical Program

5 Workers’ Comp Pharmacy Trends to Watch in 2024

Recently in Pharmacy Benefits Management

Selected Sessions for Friday, Nov. 13

We highlighted these sessions for today’s NWCDC attendees.

The Elephant in the Room

A progressive goal attainment program can help injured workers overcome psychosocial risk factors.

Predicting Claims Severity

Models analyze variables at intake and afterward to identify claims that may become adverse.

Shaping the Future of Workers’ Comp

Boeing is innovating to improve both its workers’ comp outcomes and the quality of health care delivered to its workers.

Selected Sessions for Thursday, Nov. 12

We highlighted these sessions for today’s NWCDC attendees.

Managing Service Providers

Quality assurance programs prevent talented claims adjusters and supervisors from jumping ship.

Focus on Behavioral Issues

Technology is helping to transform medical services, but employers and providers need to focus more on socioeconomic factors.

Selected Sessions for Wednesday, Nov. 11

We highlighted these sessions for today’s NWCDC attendees.

Welcome!

Tested solutions for the toughest challenges.

Theodore Roosevelt Workers’ Compensation and Disability Management Award Winners

Teddy Award winners will be honored on Thursday at “Steal These Ideas! Award-Winning Employers Share Their Successes,” beginning at 8:30 a.m.

Commitment to Care

The Theodore Roosevelt Workers’ Compensation and Disability Management Award honors exceptional programs that innovate to produce the best results.

NM Proposes Marijuana Reimbursement Rules for WC Payers

Despite ongoing controversy, the New Mexico Workers’ Compensation Administration is attempting to provide reimbursement guidance on medical marijuana.

The PBM Evolution

Pharmacy benefit managers are becoming a greater force in clinical case management, adapting to higher customer expectations. 

Study Says Rx Fee Schedules Don’t Fully Explain Costs

NCCI’s latest findings reinforce the assertion that there are adverse effects when Rx fee schedules are set too high.

Data Key for Claims Control

Sophisticated pharmacy data allows workers’ comp payers to spot utilization red flags.

The Pharmacy Cost Creep

Spending on prescription drugs accounts for a large share of workers’ comp medical costs, but utilization can be controlled.

California Closed Formulary Legislation Heads to Governor

With California’s closed drug formulary nearly a done deal, other states including Tennessee and Louisiana are exploring the idea.

Long-Term Opioids Worsen Outcomes After Back Fusions

A new study found that back fusion patients fared significantly worse when receiving long-term opioid therapy.

Legislative Reform Goals Being Met in California

Studies have identified strong evidence that California’s SB 863 reforms are positively impacting workers’ comp costs.

Take a Proactive Approach to Reduce Opioid Liability Risk

Payers are increasingly being held responsible for addiction and overdoses related to opioid pain medications prescribed for occupational injuries.