Curbing the Opioid Epidemic

Opioid Strategies Net $20 Million in Savings

Changes implemented in Ohio over the last two years are successfully reducing opioid prescribing.
By: | March 7, 2014 • 3 min read

Ohio’s workers’ comp system has seen its total drug costs decrease by more than $20 million in the last two years, according to state officials. The finding was included in the latest update on the Bureau of Workers’ Compensation’s pharmacy program.

Pharmacy officials credit the savings to a variety of changes in recent years, including the establishment of a closed formulary. The BWC also stopped covering prescriptions from decertified prescribers, eliminated coverage of repackaged drugs, mandated compliance with U.S. Pharmacopeial Convention guidelines, and required all prescriptions in medical only claims to have prior authorization, among other changes.

Advertisement




The savings came despite increases in the cost of the average prescription and drug cost per injured worker. In addition, the system saw its opiate costs decrease by nearly $18 million.

The BWC also reported the following impacts on opioid prescriptions from the formulary changes:

  • Injured workers receiving opiates decreased by 22.5 percent.
  • Opiate prescriptions decreased by 27.8 percent.
  • Opiate prescriptions per injured worker decreased by 6.8 percent.
  • Opiate doses decreased by 26.2 percent.
  • Opiate doses per injured worker decreased by 4.8 percent.

Since 2010, BWC has experienced a reduction of 10.9 million opiate doses, the officials said.

The news comes just after the BWC instituted a rule in January requiring medical providers who write three or more controlled substance prescriptions for the same injured worker during a 12-week period to use the Ohio Automated Rx Reporting System drug database, or OARRS.

Going forward, the BWC said it will continue to manage drug utilization through formulary and relatedness list updates, manage the transition of the drug utilization review process to the managed care organizations, develop an automated process to identify high-risk medication regimens and trigger direct clinical staff contact with the prescriber, and implement a retail pharmacy-based medication therapy management program.

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]

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.

Advertisement




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.

Advertisement




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]