Are Primary Care Physicians Leaving Opioid Deaths to Chance?

A recently released study from the Journal of Addiction Medicine has uncovered an alarming trend. Patients with opioid addiction, also referred to as opioid use disorder (OUD), experience an alarmingly high death rate – one 10 times higher than those not suffering opioid addiction. Not surprisingly, the study has raised some tough questions about the existing treatment infrastructure, and the system’s failure to identify and aid such at-risk individuals.
The Sobering StatsUsing electronic health records from a major university healthcare system from more than 2,500 patients ranging in age from 18 to 64, all identified as having an OUD, 465 deaths were observed during the eight-year period studied, 2006-2014. Drug overdose and disorder was the leading cause of death (19.8%), with deceased patients commonly experiencing other substance abuse disorders (tobacco, alcohol, cannabis, cocaine). Other causes included cardiovascular disease (17.4%), cancer (16.8%) and infectious disease (13.5%, of which 12% had hepatitis C). Alcohol abuse and hepatitis C were identified as primary markers. Compared to the general population, the deceased were more likely to be male (41.7% vs 31.6%), uninsured (87.1% vs 51.3%), and older at the time of initial OUD diagnosis (48.4 vs 39.8 years).
Unintended EffectsThough health care reforms (Federal Mental Health Parity, Addiction Equity Act, and the Affordable Care Act) were intended to lead to an expansion of services for substance abuse disorders in primary care, shifting them from previously isolated treatment centers, there appears to be a significant portion of the population slipping through the cracks. This suggests multiple issues within the current healthcare delivery system in identifying and addressing patients battling addiction:

• Ignorance of the true risks of opioid abuse and corresponding treatments.
• A lack of timely and sufficient screening for identifying patients with addiction.
• Identification of addiction issues too late to provide appropriate/effective interventions.
• A lack of addiction specialists on-site, as well a as a lack of outside resources for treatment.

The healthcare industry must find a better way to identify and treat patients suffering substance abuse disorders – before they pay the ultimate price. Clinicians in the primary healthcare setting could be a driving force – provided they receive proper training and assistance. For the worker, an effective pharmacotherapy review program ensures that recommended prescription treatment plans are necessary and appropriate and can help eliminate the potential for addiction.
This was originally posted on http://ans-solutions.com/are-primary-care-physicians-leaving-opioid-deaths-to-chance/

How Technology Is Shaping The Workers’ Compensation Industry

The technology now used within today’s workers’ comp industry is remarkable compared to what was available just a few decades prior. A dominant component of advocacy, claims, and treatment, technology is helping employers and insurers work the bugs out of the process, producing amazing results and the promise of even more unbelievable advancements on the horizon…

How is Technology Reshaping the Workers Compensation Industry?

• Paper Falls by the Wayside
  • NOW: Endless forms and lost paperwork are no longer, replaced by automated forms, electronic signatures and correspondence that is both faster and easily trackable.
  • LATER: Lengthy, written legalese explanations will be replaced by clearer video demonstrations. Avatars, virtual assistants, and chat will become more commonplace.
• “Smart” Tech Takes Over
  • NOW: Smartphones and mobile devices empower injured workers, offering personal claims reporting, teledoctor consultations and referrals, status and payment checks, virtual correspondence examiners/case managers, and easy access to information via chat/messaging. This faster reporting and assessment speeds treatment, lowering pain severity and costs, and boosting network penetration.
  • LATER: Wearable Tech will become increasingly common in the workplace, from high-tech safety vests and helmets to watches that identify fatigue, repetitive motions, and even alert employees of dangerous situations. For the injured, mobile self-service tools will encourage a more active role in recovery and return-to-work, and the introduction of digital wallets will offer more convenient access to prescriptions.
• Automation Moves Things Along
  • NOW: Triggered by specific claims events, automated correspondence speeds the process with real-time text/email notifications, boosting productivity and claimant satisfaction.
  • LATER: Tech driven by “empathetic” artificial intelligence will aid claimants, further reducing workloads.
• Video Trumps Phone Communication
  • NOW: Employers, claims professionals, nurses, and attorneys can more easily communicate remotely and interactively.
  • LATER: The transition to a more personal video telepresence will boost efficiency and improve interactions, making them more personable.
• Analytics Provide Greater Insight
  • NOW: Predictive analysis through text mining is granting ever-faster access to previously unknown variables, identifying cost triggers (opioid use, comorbidities), and unearthing previously unidentified information.
  • LATER: Prescriptive analytics will come into play, implementing new tech that prescribes successful and actionable intervention techniques.

Exciting Times, Amazing Opportunities

The industry and employers are capitalizing on this wave of technological change. When was the last time you initiated change in your workers’ compensation medical cost containment strategy? ANS Solutions’ streamlined Pharmacotherapy Review program has a proven track record for improving efficiency, reducing costs by over 25% with a success ratio of 94%, yielding a guaranteed return-on-investment of 20-to-1 through our Guarantee Program. Centered around maximizing treatment outcomes for injured workers, our unique, multi-faceted approach delivers cost-effective, proven treatment solutions that make a lasting, positive impact on the overall employee workers’ comp experience. Blaze a new trail in this innovative era. Contact http://www.ans-solutions.com today.

Original content posted on http://ans-solutions.com/how-technology-is-shaping-the-workers-compensation-industry/

The Position of Workers Compensation in 2017

With the election of a new president who is ushering in a new era for the government, the trickle-down effect to the workers’ compensation industry just might sweep you off your feet. Prepare yourself with the industry knowledge you need, and avoid being overtaken by the tsunami…

The 2017 Workers’ Compensation Industry Issues to Watch:

• The Affordable Care Act (ACA)
  Like a rogue wave, changes to the ACA may pop-up with little notice. These changes will influence the industry, including claims frequency, claims shifting, and cost shifting if/when private insurance is lost by injured workers, potentially shifting the industry back into the role of “medical insurance for the uninsured.” Preparing for engagement and rapid response to proposed legislation will remain integral as ACA changes are ironed-out in the coming year.
• Nationwide Physician Shortages
  America is projected to be short an estimated 12,000 to 31,000 primary care physicians by 2025, according to the Association of American Medical Colleges. Surgeons are also expected to be in short supply. Though effects will vary based on geographic location, coupled with population growth, the aging Baby Boom population, Affordable Care Act instability, and the nationwide opioid crisis, this single phenomena could converge in a myriad of issues within the workers comp industry.
• Changes to the Workforce
  As the economic current in the U.S. changes, the manufacturing industry may re-emerge, detracting from what is currently a service-based economy. The mobile workforce will also continue to evolve, such as remote and telecommuting positions. Workforce changes aren’t simply labor-related, however, the aging American workforce across the country will also play a large role.
• Prescription Drug Abuse
  The overuse and abuse of prescriptions drugs, particularly opioids, continues to be a turbulent issue in the industry, driving workers’ comp costs and leaving opposing forces facing-off at a line in the sand. As federal and state lawmakers continue to bandage this issue across the medical industry, claims management teams and attorneys will need to move forward in addressing this issue in claims, monitoring prescriptions, recommending “drug contracts,” and better engaging with physicians regarding the risks of abuse, where permitted. On the flipside of the drug abuse coin, the consequences of injured workers medical marijuana scripts influencing on-the-job risks will continue to be a sticky wicket.
• Profit & Loss Scenarios
  Though the workers’ comp industry saw their first underwriting profits in 2013, the trend is not expected to continue. Falling rates and increasing exposures, particularly over the long term, point to a negative outlook overall, with combined ratios of 100% projected for the coming year. Medical providers still continue to increase reimbursement rates to offset costs from lackluster Medicare and Medicaid payments, and medical and pharmaceutical advancements increase the risk of loss. Maintaining proper reserves, conducting timely settlement reviews, and utilizing appropriate resources over the course of the year will be key.

Make Progress in Managing Risks & Costs

No matter how fast the tide rushes in, ground yourself in facing this year’s obstacles with positive change, putting yourself in the best position to avoid being washed out in the chaos. With the transparent, mutually beneficial workers compensation cost containment services of ANS Solutions and our medical cost containment strategies, you can support both financial savings and positive outcomes, with a program that actively engages workers compensation patients with a positive experience, gaining unmatched results via true, face-to-face interactions between all involved parties for a complete team approach to care. Ride the wave of the future, contact http://www.ans-solutions.com today.

Sources:

http://www.wci360.com/news/article/how-to-fix-the-primary-care-physician-shortage

http://www.beckershospitalreview.com/hospital-physician-relationships/15-things-to-know-about-the-physician-shortage.html

Original content posted on http://ans-solutions.com/the-position-of-workers-compensation-in-2017/

Naloxone (Narcan): What Workers Comp Payers Need to Know

Though it has been on the market since 1971, this year is expected to be a landmark year in Naloxone (Narcan) sales nationwide, and this trend is expected to continue due not only to the opioid epidemic sweeping the nation, but the fact that opioids still remain the most frequently prescribed category of medication used in workers’ comp pain management.

Preventing Death from Opioid Overdose

In its hallmark form, Naloxone was approved for injection by the FDA in 1971. An opioid agonist, it was used in hospital and emergency settings to temporarily reverse the dangerous effects of overdose, including sedation, low blood pressure, and potentially fatal respiratory depression. However new outpatient options have recently entered the market, putting this potentially life-saving drug in the hands of the general public.

• Evzio (2014)
  The first FDA-approved naloxone auto-injector available in the U.S., this small, portable device, similar in nature to an Epi-pen, can be used by patients or family members in the event of overdose. (Holds a significantly higher average wholesale price than Narcan and traditional injectables.)
• Narcan (2016)
  A single-dose, ready-to-use nasal spray that requires the patient to be lying on their back for proper administration.

Not a Magic Bullet
Reversing the effects of opioids at the receptor site and blocking further binding, naloxone takes effect in 3 minutes, wearing off in about 30-to-90 minutes depending on the opioid taken. Though it reverses the clinical and toxic effects of overdose, it only displaces opioids for a short time.

Access Expanding
Despite its short-term effects, legislative and regulatory reforms are making naloxone increasingly available nationwide as states struggle to combat the opioid epidemic. Anesthesiologists, PMR physicians, physician assistants, nurse practitioners and pain management specialists are writing the majority of prescriptions for patients undergoing opioid treatment therapies. Civil liability protection has been expanded for First Responders employing its use. Some states have even made naloxone available for sale as an over-the-counter medication.

Turn the Tide
Due to opioid over-prescription and abuse in our country, Naloxone is unfortunately a necessary medication. However, at ANS Solutions, we believe the best way to prevent opioid overdose is by circumnavigating its use with the patient-doctor education and equally effective, scientifically-proven alternative medical treatments that protect the outcome of injured workers, and reduce unnecessary opioid treatments and associated costs. With our medical cost containment strategies, safe, efficacious cost-effective care is possible. Discover more at http://www.ans-solutions.com today.

Sources: http://helioscomp.com/docs/default-source/continuing-education-2016/072816-optum-naloxone-use-in-wc-ce_final.pdf 

Original content posted on http://ans-solutions.com/naloxone-narcan-what-workers-comp-payers-need-to-know/

Landmark Reforms Hoped to Aid New York in the Fight against Opioid Addiction

It is hoped to be a happier new year for Empire State residents suffering from opioid abuse. In a landmark legislative package that took effect January 1st of this year, health insurance plans will now be required to cover treatment services to New Yorkers suffering opioid addiction. In a state plagued by the effects of opioids and heroin, whose overdose death rates are far outpacing nearly every state in the union, legislators are hopeful those grappling with the effects of these drugs can finally gain access to the help they need in overcoming addiction.

The Plan to Expand Access to Opioid Addiction Care

Signed into law by Governor Andrew M. Cuomo, the reforms are expected to remove burdensome treatment access barriers, help expand prevention strategies from within communities, and limit opioid over-prescriptions statewide. What is the governor’s Heroin and Opioid Task Force plan to stamp out abuse?

• Insurance-Related Protections
  • Insurance pre-authorization no longer required for immediate access to inpatient care and (emergency) drug treatment medications when needed.
  • Utilization review (insurance) cannot become involved until after 14 days of uninterrupted treatment.
  • Insurers must use objective, state-approved criteria when making coverage determinations.
  • Opioid-reversal medication coverage is mandated.
  • Requirements apply to small, large group, and individual plans regulated by the DFS.
• Addiction Treatment Services Enhancements
  • Individuals incapacitated by drugs can now receive 72, not 48 hours of emergency treatment and evaluation.
  • Hospitals are now required to provide follow-up service at discharge, connecting at-risk patients with nearby treatment options for continuous care.
  • Trained professionals no longer risk licensure when administering naloxone in emergencies.
  • Wraparound services (legal, support, transportation, childcare) have been expanded to support long-term recovery.
• Community Prevention Strategies
  • Prescription limits reduced from 30 to 7 day supply maximum (with exceptions).
  • Required continuing education for all physicians/prescribers on addiction/pain management.
  • Pharmacists must provide materials on addiction risks and nearby treatment services.
  • Opioid overdoses and overdose medication use must be reported quarterly.

Ensuring Appropriate Treatment Options For Opioid Addiction 

Much like the measures put forth by the state of New York, ANS Solutions’ Pharmacotherapy Review Program strives to uphold appropriate treatment options for patients, offering protection against opioid dangers with a three-stage approach to injury recovery that far-surpasses drug utilization review. Comprehensive and effective, it both protects against unnecessary expenses and safeguards patient treatment outcomes. Utilizing personal, face-to-face communication and integrative case-management methods, over-prescription of dangerous narcotics and potentially deadly drug-to-drug interactions commonly experienced with multiple prescribers can be prevented, success achieved with evidence-based treatment protocols and cemented by written proposal to achieve maximum results.

Don’t stand on the sidelines of the epidemic. Take part in the solution. Reinvent the way you handle claims with the help of ANS Solutions today.

Original content posted on http://ans-solutions.com/landmark-reforms-hoped-to-aid-new-york-in-the-fight-against-opioid-addiction/

Comorbidities Compound Workers Comp Costs & Recovery

Underlying Conditions Complicate Workers’ Comp Injury Rehabilitation

New research from a Harbor Health Systems study demonstrates the significant impact of underlying conditions on workers’ comp claims. Commonly associated with higher costs and increased duration, this latest research illustrates an undeniable link between patients with comorbidities and undesirable claims outcomes.

A Problematic Pile-Up

Analyzing data from more than 7,000 workers’ comp claims, encompassing seven common comorbidities: Obesity, hypertension, diabetes, mental health, addiction, tobacco use, and combination comorbidities, claims associated with comorbid conditions were found to have incurred an array of undesirable side effects…

• Higher medical costs
  • Multiple comorbidities increased total costs a whopping 341%
• Longer claims duration
  • 76% increase with multiple comorbidities
  • 67% increase with addiction
  • 55% increase with obesity
• More temporary total disability days (TTD)
  • Significantly higher overall in all groups
  • 285% higher with multiple comorbidities
  • 274% higher with addiction
• Increased surgery rates
  • Up 123% with multiple comorbidities
  • Up 140% with obesity
• Increased litigation
  • 147% higher with multiple comorbidities
  • 224% higher with addiction
  • 248% with mental health-related claims

Overall Outlook

While tobacco use had little effect on claims, multiple comorbidities and obesity had the greatest impact on overall, followed by addiction, mental health, and hypertension. Relationships between comorbidities were also found further complicate health and financial risks, with worker age throwing yet another wrench in the works.

Changing Direction

Given these research findings, it is obvious a more comprehensive, systemic approach to workers’ comp claim management is essential to improving treatment results, from a more thorough intake data analysis and the management of multiple health issues addressed by numerous providers and prescriptions, to identifying and finding alternative treatments to those that could result in narcotics abuse.

Quality Matters

Minimizing these risks and providing optimal outcomes for injured workers while controlling workers’ comp costs is no easy feat, and requires a tried and true strategy. ANS Cost Containment Programs work uniquely to address these issues with the only true face-to-face, end-to-end pharmaceutical cost containment program in the industry that genuinely puts patients first while minimizing claims costs through personalized relationships and in-depth case knowledge and review.

Rapid treatment progress and reduced claims costs are possible. Achieve maximum all-around results. Discover how with http://www.ans-solutions.com today.

 

- See more at: http://ans-solutions.com/comorbidities-compound-workers-comp-costs-recovery/#sthash.qGeIjMn9.dpuf

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Incorporate These Improvements to Frame an Effective Medical Cost Containment Strategy

Medical cost containment program is an end to end pharmaceutical cost containment programs which puts the patient first while reducing the cost of settlement in large loss workers comp claims. Today, businesses are challenged to control workers compensation cost and improve the income. Only framing an effective cost containment strategy focuses on different areas and provides possible tricks to avoid any mess.

Using comprehensive and well-coordinated medical cost containment strategies helps you to combat multiple lines of cost escalation. Incorporate the following useful options to your medical cost containment strategies while seeking improvements at your company.

Medical Provider Network

Medical provider network is a combined group of the most experienced workers' comp physicians, doctors, hospitals and specialized providers who have a prearranged relationship with the company to treat employees who are injured on the job. They deliver consistent quality care and work closely while minimizing paperwork and treatment time and maximizing the results of quick, effective care. The major benefits of instituting a medical provider network are:

* Fewer lost workdays

* Lower medical costs

* Lower litigation rates

Nurse Case Management

Nurse case management requires an active coordination of medical services and communication among the injured employee, employer and physician. The nurse case managers play a major role in improving the patient’s outcome and have deep experience in managing catastrophic and complex injuries. They also keep the employer and the claim representative well-updated on the physical improvement of the injured employee and his ability to return to work.

Rehabilitation Networks

Rehabilitation networks are destined to offer specialized care for helping injured people recover from specific injuries. Like medical provider network, they also play a major role in stabilizing the injured person’s medical condition and maximize the medical outcome.

Utilization Review

Nowadays, utilization review is an integral part of most public and private health plans and is associated with a reduction in bed days and growing hospital costs. Utilization review is considered as the primary cost prevention tool and includes both precertification reviews and concurrent reviews. The process involved in utilization review also includes:

* Guiding patients to cost effective facilities

* Referral co-ordination

* Managing hospital admission and medical appointments

* Pre-certification

* Monitoring patient’s ongoing treatment process

* Planning patient discharge

* Coordinating follow-up appointments and more.

Utilization review managers also act as liaisons between insurance companies, service providers and the injured employee.

Chronic Pain Management

Chronic pain has a huge impact on the life of the injured worker in both monetary and personal fronts. Using data mining and virtual online “check-ins” to monitor and evaluate the physical, psychological and social impacts on the injured employee. This process of evaluation helps in reducing the impact of chronic pain and improves employee health.

Establishing these standards help companies to easily manage their complex claims and ensure the best possible medical outcomes for injured workers.

ANS Solutions, LLC, the fastest growing medical cost containment companies in the USA puts forward a comprehensive suite of programs to minimize the cost of settlement in large loss workers comp claims. Visit http://ans-solutions.com/ for more information.