Ineffective Intervention Results in Less Than Optimal Outcomes

Workers’ compensation payers industry-wide have relied on pharmaceutical cost containment measures in one form or another as a means to manage escalating costs. But as everyone has learned, not all strategies are created equal. In fact, most are limited in scope and effectiveness.

A Holistic Approach to Medical Cost Management

At ANS, we take a holistic, collaborative approach to managing medical costs. When a comprehensive analysis is conducted on a pharmaceutical regimen, it reveals the bigger picture, thus uncovering points of concern that may impact the pharmacy plan. Quite often we uncover opportunities for modifications that improves patient efficacy while decreasing costs. Conducting an extensive review of a patient’s medical history can avoid missing crucial factors that are all too often overlooked by other programs.

Nurse Experts Apply Advanced Pharmaceutical and Jurisdictional Knowledge

ANS’ advanced program includes a national network of highly credentialed legal nurse consultants. Utilizing experts to employ a collaborative environment with the physician and integrating a holistic approach to medical cost containment results in successful, optimal outcomes for both the injured worker and the carrier:

ANS Solutions

We offer an industry-leading suite of Workers’ Compensation Medical Cost Containment Services designed to lower costs, improve loss ratios, and enhance the claimant’s quality of care. For more information contact us today or visit www.ans-solutions.com

This content was originally posted at http://ans-solutions.com/ineffective-intervention-results-in-less-than-optimal-outcomes-2/

3 Elements of Successful Medical Cost Containment Strategies

Medical cost containment is a complex game as there is a level of responsibility that needs to be acknowledged. These strategies need to do more than just address the obvious financial costs of large loss claims as often factors driving financial costs also correlate to effects on an injured workers quality of life. In short, medical cost containment strategies need to take into account the injured workers course of treatment and quality of life including the following:

• Physicians are sometimes employing treatment regimens that prescribe expensive pharmaceuticals and medical treatments when lower cost alternatives may be available that would maintain or improve patient efficacy.
• Pain management via highly addictive opioids runs increases the risk of patient addiction or increased tolerance and subsequent need for refills or a stronger dose at a higher cost.
• Lack of compliance to a treatment regime lengthens potential recovery time for injured workers and increases associated treatment costs.
• Lack of coordination between multiple treating physicians can drive up costs with duplicate and/or inappropriate pharmaceutical and medical treatments while leaving the patient open to dangerous drug interactions, addiction, or even death.

Medical Cost Containment Strategies

ANS’ medical cost containment solutions have been honed to perfection for the past decade. Our strategies consistently yield hard dollar savings while also ensuring optimal outcomes for the injured worker. In our experience, there are three parts to our approach that ensure the success of our cost reducing strategies:

• Comprehensive and holistic review of a patient’s entire medical history – with a clear understanding of the bigger picture ANS often uncovers issues and concerns that can impact the medical treatment plan and the patient’s chances of recovery.
• Harnessing expert knowledge – ANS legal nurse consultants boast extensive medical and legal experience and expert knowledge of catastrophic injury, cutting edge medical and pharmaceutical therapies, and jurisdictional nuances.
• Collaboration - Multiple parties must be engaged from managing patient adherence to our legal nurse consultants and the treating physician(s) for optimizing medication therapy, determining a modified course of treatment, and ensuring compliance to the new course of treatment.

ANS Solutions

Our approach to cost containment was uniquely developed to simultaneously ensure a medically appropriate and cost effective treatment program and enhanced quality of life and care for the injured worker. For more information on our industry leading cost containment strategies visit us at www.ans-solutions.com.

This content was originally published at http://ans-solutions.com/3-elements-of-successful-medical-cost-containment-strategies/