How Common is Illegal Drug Use Among Pain Patients?

At the American Pain Society’s 35th Annual Scientific Meeting in Austin, findings were released on the use of illicit substances among chronic pain patients. Of 450,081 patients included in a study by Baltimore-based pain medication monitoring firm Ameritox, 10.4% of urine samples tested positive for the use of at least one illicit substance.

How Many of Those Identified Were Workers Comp Patients?
Workers compensation was the primary payer for 22,525 of the 450,081 patients in the study, conducted between January 2013 and July 2015, which showed the use of illicit substances 8.4% of the time in workers comp patients. The group with the highest level of detection, at 16.4%, was Medicaid patients. The lowest: Medicare at 8.1%. Commercially insured individuals were detected at 8.4%, and patient paid tests at 12.5%, respectively. Of those receiving opioid pain treatment drugs, the use of illicit substances was detected at the following rate:

• For patients prescribed Hydrocodone – 10.9%
• For patients prescribed Codeine – 10.7%
• For patients prescribed Oxymorphone – 8.2%

Risk Mitigation and Pharmacotherapy Review
With the use of highly addictive opioids in the treatment of pain, a lack of utilization and/or awareness of risk mitigation strategies is a common driver for poor outcomes. Often times the potential for addiction or the existence of past drug abuse and even behavior consistent with drug abuse are over looked. When this happens the quality of treatment and life in large loss workers compensations claims are severely compromised while associated treatment costs continue to rise.

At ANS, our highly credentialed Legal nurse consultants develop actionable treatment recommendations to enhance the quality of life of injured workers while also ensuring optimal financial outcomes through:

• Comprehensive, holistic medical records reviews and treatment assessments.
• The identification of at-risk individuals and dangerous or deadly drug interactions.
• Uncovering of unnecessary opioid treatment regimens and baseless dosage increases.
• The recommended use of equally effective, less risky, alternative treatment methods where applicable.
• Compliance protocols for monitoring the usage of habit-forming medications, such as opioids.
• Opioid tapering/weaning programs to curb the risk of opioid addiction.

Improve outcomes and reduce costs with the most effective pharma cost containment strategies in the industry. Contact http://www.ans-solutions.com today.

Content was originally published at  http://ans-solutions.com/how-common-is-illegal-drug-use-among-pain-patients/.

Opioids Still the Top Prescribed Drug in California

Using data derived from the 10.8 million workers comp prescriptions dispensed between January 2005 and December 2014, a recently released report by the California Workers’ Compensation Institute identified opioids as the number one prescribed drug in California’s workers’ compensation system.

Report findings indicate that opioid prescriptions accounted for 27.2% of total prescribed pharmaceuticals. In addition, the average cost of opioid prescriptions rose by 85% from $61 to $113. In comparison, other prescription drugs within the same time frame experienced only a 39% increase, from $94 to $131. The report also indicated the proportion of injured workers prescribed opioids within the first 24 months following injury increased from 22.4% in 2005, to 27.9% in 2010.

Some positive trends were revealed however - in 2014, opioids dispensed to injured workers in the state dropped to 27.2%, from a 2009 peak of 31.9%. Also, the impending implementation of a statewide formulary is expected to contribute to reduced opioid use.

At the end of the day however, opioid use is still excessive. While prescription drug monitoring programs have been a focus of California state regulators, other California Workers’ Compensation Institute studies of utilization review have shown that medical management resources in California have been disproportionately directed to the review of requests for opioids and pain management drugs.

In workers’ compensation pain management, opioids continue to be prescribed in situations where their use may not be entirely appropriate, increasing the patient’s risk of addiction or overdose. ANS’s pharmacotherapy review program has been highly successful in uncovering overprescribing and ineffective management of patient treatment plans not just in California but across the country. The work of our legal nurse experts lays the ground work for pain treatment regimens that reduce the financial costs of large loss claims, while improving quality of care and life for injured workers.

To learn more about are success rate in California, contact ANS Solutions today.

This content was originally posted at http://ans-solutions.com/opioids-still-the-top-prescribed-drug-in-california/

Sources:

Hayes, Steve, Swedlow, Alex. “California Workers’ Compensation Institute: Trends in The USE of Opioids in California’s Workers’ Compensation System,” May 2016.

Medical Cost Containment Does Not Mean Compromised Care

The existing way that the workers’ compensation industry handles large loss claims has been contributing to diminished quality in care for injured workers, increased costs associated with treatments, and poorly coordinated care. Care delivery within workers’ compensation programs is arguably even more inefficient than in general healthcare but it does NOT have to be this way. Payers can have the best of both worlds with medical cost containment strategies that provide quantifiable outcomes that positively impact the patient’s health while also driving down associated treatment costs.

How does Medical Cost Containment Improve the Quality of Care for Injured Workers?

Interventions with prescribers can be instrumental in improving the quality of life and treatment for patients. ANS PharmaIntervention is designed to help treating physicians detect and correct underlying problems, promote functional improvement and reduce narcotic usage. Our legal nurse experts conduct comprehensive reviews of a patient’s medical history often uncovering risk factors and other considerations that can be overlooked by treating physicians. They are then able to collaborate with treating physicians to improve the current treatment plan based on actionable, evidence based recommendations. The benefits to the injured worker include but are not limited to:

• Reduced risk for prescription opioid painkiller addiction.
• A modified treatment program based on recovery.
• A modified treatment program based on the availability of alternative treatments and therapies that may be more effective, and have fewer side effects.

All of which contributes to measurable improvements in quality of care and life for the injured worker- even increasing the likelihood of returning to work sooner.

How Does Medical Cost Containment Positively Impact Your Bottom Line?

Ensuring injured workers receive the right care at the right time from treating physicians, minimizes the financial impact of catastrophic injuries. The goal of ANS PharmIntervention is to improve quality of care by applying expert clinical knowledge and experience to recommend, where appropriate, alternative treatments and therapies. The financial benefits of the ANS PharmIntervention strategy stem from its ability to aid treating physicians in:

• Improving opioid painkiller practices.
• Avoiding unnecessary or inappropriate pharmaceutical and medical treatments.
• Avoiding duplicate therapies in the event of multiple treating physicians.

When done correctly, medical cost containment ensures that patients receive the highest quality of care balanced with the necessary cost controls.

Care without Compromise

ANS Legal Nurse Consultants provide comprehensive reviews of large loss claims while delivering optimized financial results and quality of care for injured workers. To learn more about our medical cost containment strategies visit our website at www.ans-solutions.com.
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The Medical Legal Nurse Consultant – A Jack of All Trades

Medical legal claims typically involve complicated, long-term medical issues and represent an enormous financial burden for Payers. In order to mitigate this financial exposure it is crucial for Payers to accurately assess the true value of alleged damages. But this is no small task and it often requires extensive investigation and expert interpretation. Let’s be honest, mitigating financial exposure can only effectively be done by a highly credentialed few, those with a hybrid skillset of healthcare expertise, specialized legal training, and first-hand experience in complex liability matters such as GL, toxic exposure, personal injury, and malpractice. 

With qualifications in both medical and legal fields the Legal Nurse Consultant is perfectly poised to aid insurance companies who want to optimize their results and settle large claims once and for all. By definition, a Legal Nurse Consultant is an individual with healthcare expertise who has taken additional specialized legal training so that they can consult as an expert on medical cases, but this is just the tip of the iceberg.

Medical Legal Nurse Consultant Litigation Support

In litigation support, the data and reporting generated by legal nurse consultants can provide an extraordinarily powerful legal instrument in the negotiation of a claim. At ANS, our strategy for mitigating and defending medical legal claims involves a host of strategic activities including:

·         The critical analysis and review of initial complaints, supporting medical & legal documentation and pricing to allow for an accurate assessment of true damages.   

·         Review of medical causation and exposure to effectively gauge merits of alleged injuries while identifying any missing medical information that may prove valuable to the claim.

·         Generating an expert assessment and opinion based on a detail of record and all documented encounters with medical systems. 

·         Uncovering causation, mitigating factors, unreasonable medical charges, inappropriate/red flag patterns of care, and unnecessary and unrelated care issues are exposed

·         Providing a counter analysis in the event that a plaintiff future cost of care report is submitted.

Medical Class Action & the Medical Legal Nurse Consultant

Navigating a medical claim involved in a class action is difficult to say the least. Class actions are very large in scope requiring the dissection and digestion of thousands of pages of legal and medical documentation. Fortunately, medical class actions are another area of support fielded by ANS’s legal nurse consultants.  We have extensive experience in handling class action and large tort cases. If you have a medical legal claim involved in a medical class action case, our medical legal nurse consultants can assist by providing:

• Initial screening for merit and damages.
• Analysis of massive amounts of data quickly and accurately creating a snapshot of the case.
• Recommendation for appropriate next steps based on medical review.

At ANS, our team of nurse experts, are highly credentialed and wield an average of 25 years in specialized nursing experience. In addition, their scope of jurisdictional expertise yields unparalleled results. To find out more about ANS Solutions’ superior medical legal nurse consulting services visit us at http://www.ans-solutions.com.

This content was originally posted on http://www.ans-solutions.com.