Combating Prescription Abuse

Florida Drug Monitoring Program Promising

By: | January 21, 2014 • 2 min read
Nancy Grover is the president of NMG Consulting and the Editor of Workers' Compensation Report, a publication of our parent company, LRP Publications. She can be reached at [email protected]

Deaths caused by prescription drugs are down, prescriptions for two of the most harmful drugs have fallen, and doctor shopping has been reduced in the first years of the Florida prescription drug monitoring program, according to a new state report.

Florida’s Legislature adopted the program in 2009 with a mandate to establish a “comprehensive database system that collects controlled substance prescription information from health care practitioners within seven days of dispensing controlled substances to a patient,” according to the report. “Its use is not mandatory.” The Electronic Florida Online Reporting of Controlled Substances Evaluation, or E-Force, became operational in September 2011.

The annual report is required by law and focuses on the program’s effects on the following outcomes:

  • Reduction in the rate of inappropriate use of prescription drugs through the state Department of Health’s education and safety efforts.
  • Reduction of the quantity of pharmaceutical controlled substances obtained by individuals attempting to engage in fraud and deceit.
  • Increased coordination among interested parties participating in the prescription drug monitoring program.
  • Involvement of stakeholders in achieving improving patient health care and safety and reduction of prescription drug diversion.
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“Florida has seen promising results since the implementation of E-Force,” according to the 2012-13 annual report. “The effectiveness of the prescription drug monitoring program is reflected in the Drugs Identified in Deceased Persons by Florida Medical Examiners 2012 report which shows that deaths caused by oxycodone plunged by almost 41 percent in 2012 and overall drug deaths fell by 9.9 percent. In the same period, the prescription drug monitoring program documented a 51 percent decrease in the number of individuals receiving prescriptions from five or more prescribers and five or more pharmacies in a 90-day period.”

Additionally, prescriptions for oxycodone and methadone — two of the four most harmful prescription drugs — fell by 24 percent and 8 percent respectively, according to a message from Dr. John H. Armstrong, Florida’s surgeon general and secretary, that accompanied the report.

There are currently more than 87 million prescription dispensing records for controlled substances in the database, according to the report. In the first two years, physicians and pharmacists made more than 6.4 million requests to view their specific patients’ controlled substance dispensing history. In the last year, physicians and pharmacists queried these records more than 3.7 million times, a 61 percent increase over the prior year. Law enforcement has requested and received more than 33,000 investigative reports from program staff to assist in active criminal investigations involving controlled substances.

“Evidence of the value of the PDMP as a clinical decision-making tool to reduce prescription drug abuse, misuse and diversion is supported not only by the increased usage but also by a 28 percent increase in health care practitioner registration,” the report noted. “Additionally, 82.8 percent of 2,000 PDMP users surveyed this year thought all prescribers and dispensers should use E-Force to inform their controlled substance prescribing and dispensing clinical decisions.”

4 Companies That Rocked It by Treating Injured Workers as Equals; Not Adversaries

The 2018 Teddy Award winners built their programs around people, not claims, and offer proof that a worker-centric approach is a smarter way to operate.
By: | October 30, 2018 • 3 min read

Across the workers’ compensation industry, the concept of a worker advocacy model has been around for a while, but has only seen notable adoption in recent years.

Even among those not adopting a formal advocacy approach, mindsets are shifting. Formerly claims-centric programs are becoming worker-centric and it’s a win all around: better outcomes; greater productivity; safer, healthier employees and a stronger bottom line.

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That’s what you’ll see in this month’s issue of Risk & Insurance® when you read the profiles of the four recipients of the 2018 Theodore Roosevelt Workers’ Compensation and Disability Management Award, sponsored by PMA Companies. These four programs put workers front and center in everything they do.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top,” said Steve Legg, director of risk management for Starbucks.

Starbucks put claims reporting in the hands of its partners, an exemplary act of trust. The coffee company also put itself in workers’ shoes to identify and remove points of friction.

That led to a call center run by Starbucks’ TPA and a dedicated telephonic case management team so that partners can speak to a live person without the frustration of ‘phone tag’ and unanswered questions.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top.” — Steve Legg, director of risk management, Starbucks

Starbucks also implemented direct deposit for lost-time pay, eliminating stressful wait times for injured partners, and allowing them to focus on healing.

For Starbucks, as for all of the 2018 Teddy Award winners, the approach is netting measurable results. With higher partner satisfaction, it has seen a 50 percent decrease in litigation.

Teddy winner Main Line Health (MLH) adopted worker advocacy in a way that goes far beyond claims.

Employees who identify and report safety hazards can take credit for their actions by sending out a formal “Employee Safety Message” to nearly 11,000 mailboxes across the organization.

“The recognition is pretty cool,” said Steve Besack, system director, claims management and workers’ compensation for the health system.

MLH also takes a non-adversarial approach to workers with repeat injuries, seeing them as a resource for identifying areas of improvement.

“When you look at ‘repeat offenders’ in an unconventional way, they’re a great asset to the program, not a liability,” said Mike Miller, manager, workers’ compensation and employee safety for MLH.

Teddy winner Monmouth County, N.J. utilizes high-tech motion capture technology to reduce the chance of placing new hires in jobs that are likely to hurt them.

Monmouth County also adopted numerous wellness initiatives that help workers manage their weight and improve their wellbeing overall.

“You should see the looks on their faces when their cholesterol is down, they’ve lost weight and their blood sugar is better. We’ve had people lose 30 and 40 pounds,” said William McGuane, the county’s manager of benefits and workers’ compensation.

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Do these sound like minor program elements? The math says otherwise: Claims severity has plunged from $5.5 million in 2009 to $1.3 million in 2017.

At the University of Pennsylvania, putting workers first means getting out from behind the desk and finding out what each one of them is tasked with, day in, day out — and looking for ways to make each of those tasks safer.

Regular observations across the sprawling campus have resulted in a phenomenal number of process and equipment changes that seem simple on their own, but in combination have created a substantially safer, healthier campus and improved employee morale.

UPenn’s workers’ comp costs, in the seven-digit figures in 2009, have been virtually cut in half.

Risk & Insurance® is proud to honor the work of these four organizations. We hope their stories inspire other organizations to be true partners with the employees they depend on. &

Michelle Kerr is associate editor of Risk & Insurance. She can be reached at [email protected]