White Paper

The Injured Worker Patient in 3D: Driving More Personalized Care Through Strategic Formulary Design

With an effective formulary strategy, PBMs can ensure injured worker patients receive the most appropriate care and create better outcomes.

White Paper Summary

In today’s evolving workers’ compensation landscape, the shift toward more personalized, outcomes-driven care is not just aspirational – it’s essential. That’s because injured worker patients are not one-dimensional – they are nuanced, living, breathing beings with complex characteristics and needs. For Pharmacy Benefit Managers (PBMs), formulary design and management are powerful levers to drive toward more personalized care for these patients.

An effective formulary strategy is not a set-it-and-forget-it approach. Just as each injured worker is a three-dimensional being living in a dynamic environment, your formulary design should be agile, too. Nimbleness, in addition to configurability, is crucial to keeping up with changing regulations, emerging therapies, evolving prescribing behaviors and workers’ comp populations, and payer needs.

Many factors come into play to determine what medication and dosage is appropriate for each injured worker: those inherent to injury type or occupation, injured worker-specific factors such as age, safety factors, and more – and some of these factors continue to evolve over time.

The beauty of strategic formulary design is that we can take all of these factors into account and implement formularies that are personalized to meet the three-dimensional needs of every injured worker. By partnering with a PBM that offers this multi-layered capability, payers can ensure each injured worker receives the most appropriate and safe drug therapies – and provide better outcomes for all.

 

For more content like this from Healthesystems visit their RxInformer clinical journal website.

Healthesystems is a leading provider of Pharmacy Benefit Management (PBM) & Ancillary Benefits Management programs for the workers' compensation industry.

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