When we talk
about the costly nature of large loss Workers’ Comp claims, it is sometimes hard
to think beyond the financial impact.
Further to this point, when medical cost containment strategies are
discussed they are often geared toward addressing the clinical and
pharmaceutical treatment programs for injured workers from a financial
perspective. What about the less tangible side of medical cost containment-the
human costs which are equally as significant and damaging?
Addressing Human Costs in Medical Cost Containment
When we talk
about the human cost of large loss claims, we are really talking about the
effect a case has on the quality of life for an injured worker and their family.
While all medical cost containment strategies focus on financial cost drivers,
not all strategies address human costs. There are many drivers that can
contribute to compromising an injured worker’s quality of life. These human
cost drivers include, but are not limited to:
·
Pain treatment through highly addictive opioids, coupled
with a lack of patient education on the risks and dangers of these drugs,
subjects injured workers to a path of drug addiction which may hinder or
prevent their recovery.
·
Lack of appropriate physician monitoring and/or patient
compliance to a prescribed medical treatment regimen can contribute to a longer
recovery period.
·
Lack of monitoring patient’s treatment program and
progress results in missing the warning signs of drug abuse and addiction,
missed opportunities to modify a treatment program based on patient’s recovery,
lost opportunities to modify treatment based on
the availability of alternative treatments and therapies that may be more
effective, and have fewer side effects.
·
Lack of coordination between multiple treating physicians
can attribute to greater increase for drug abuse or unnecessary or
inappropriate pharmaceutical and medical treatments.
ANS Cost Containment Strategies
The ANS PharmacotherpyReview Program is the most advanced and results-oriented cost containment
strategy in the industry. At the first of three stages, we assess the existing
treatment program using evidence based reviews to assess medical necessity. We
also identify duplicate therapies, excessive dosages and alternate medication
regimens. Our experts then make actionable treatment modification
recommendations that ensure optimal outcomes for the patient. This includes
consolidating and coordinating drug therapies between multiple
prescribers. In the second stage, our
nurse experts work with treating physicians to obtain commitment on a modified
future course of treatment. For a positive therapeutic outcome, we move to
stage three where an ANS Clinical Liaison Officer proactively manages each case
to ensure physician and patient compliance with the revised 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 www.ans-solutions.com.
