The Courage to Create
When I think of the courage to create, and the accompanying traits of passion and perseverance that define Risk All Stars, I can’t help but think of Renee Crow of Kimpton Hotels and Restaurants.
Like a number of our Risk All Stars winners, Crow manages risk at a company that is experiencing rapid growth. Rapid growth brings opportunity. But rapid growth, as we know, carries risk.
When Crow joined Kimpton, the company owned 24 properties. Now, it owns more than 60.
Although customer service underlies so much, there is a laser focus on it in the hospitality business. Much is expected and very little is forgiven.
The organizations these professionals manage risk for are stronger because of their courage.
According to Crow, Kimpton sets high customer service standards, but it was also facing legal snares from guest and employee interactions gone bad. She devised a training program that enabled Kimpton staff across the country to re-enact various customer service scenarios and learn from them.
Crow humbly states that she did what she did because she’d seen enough bad training approaches to know better. But I say what she did was innately brilliant.
She took a risk, or a negative, and created employee engagement across the board in seeking solutions. This is an era when employee disengagement is reported to be at high levels across many industries. The cost of risk at Kimpton has plummeted as a result.
The creative courage of Risk All Stars winner Kris Finell of Rytec Corp. also comes to mind. Finell possessed not merely the courage to create, but also the moxie to confront.
Rytec, another fast growing company, is a manufacturer of high-speed industrial doors. You can easily see the risks and the results when something goes wrong.
Rytec salesmen were in the habit of removing industrial door safety features at the behest of customers. Finell, practically brand new in her role as risk manager, put a stop to it.
Waivers that allow customers to remove safety features on Rytec doors are now a thing of the past.
Finell also had the courage to remove a broker that was friends with one of her supervisors. The relationship wasn’t working for her vision, so she vetted a number of candidates and chose one with the right fit for her.
Talking to these Risk All Stars reminded me that it’s not enough to see something; you have to say and do something. The organizations these professionals manage risk for are stronger because of their courage.
2015 Risk All Stars
Angeli Mancuso: On a Mission to Revitalize (+Responsibility Leader)
Manager, Employee Health & Safety, Cottage Health System
By getting the board of directors behind a goal to decrease patient-handling injuries, Angeli Mancuso has improved employees’ quallity of life.
Timothy Fischer: With Military Precision (+Responsibility Leader)
Tim Fischer was given nine months to address the risk implications of a sizable spin-off.
Tim Kirsch overhauled his company’s safety mission, protecting drivers on the road while slashing workers’ comp claims costs.
The urgent need for a creative solution inspired one Risk All Star to create a unique excess casualty program with benefits on several levels.
Jennifer Cable’s degree is in opera performance. She is also a risk management maestro.
Tracey Gasper: Service Centered (+Responsibility Leader)
This risk manager’s savings for her company can be measured in the millions.
Elizabeth Queen: Building a Unified Travel Program (+Responsibility Leader)
With an existing program now spread enterprise-wide, traveling employees have an improved experience, while the company enjoys lower costs and reduced risk.
One Risk All Star took on the daunting challenge of quickly relocating a sprawling headquarters, and without a single moment of down time.
David Brooks quantifies and manages risks across every industry and product offered by XL Catlin.
Brent Cooley: Shakespeare Minus the Tragedy (+Responsibility Leader)
A series of potentially high-severity events drove the push to launch a safety organization that will help keep theater students safe for years to come.
New to her position in risk management, Rytec’s Kris Finell set about correcting just about everything she could get her hands on.
Albert Fierro: The Fruits of Long, Hard Labor (+Responsibility Leader)
With decades of expertise in captive insurance, Albert Fierro was the ideal person to help AARP rein in its rising workers’ compensation costs.
Adding role playing to training efforts helped Kimpton Hotels’ risk manager teach employees how to avoid mistakes that drive up the cost of claims.
Treasury now drives risk management throughout Meritor’s business units, thanks to the efforts of Todd Chirillo.
Florida’s insurance pool members can rest easy that, thanks to Jeannie Garner’s initiative, they can bounce back in the face of severe storms.
When staff reductions and organizational change made strong leadership imperative, Amanda Lagatta rose to the challenge.
Compounding: Is it Coming of Age?
The WC managed care market has generally viewed the treatment method of Rx compounding through the lens of its negative impact to cost for treating chronic pain without examining fully the opportunity to utilize “best practice” prescription compounds to help combat the opioid epidemic this nation faces. IPS stands on the front lines of this opioid battle every day making a difference for its clients.
After a shaky start cost-wise, prescription drug compounding is turning the corner in managing chronic pain without the risk of opioid addiction. A push from forward-thinking states and workers’ compensation PBMs who have the networks and resources to manage it is helping, too.
Prescription drug compounding has been around for more than a decade, but after a rocky start (primarily in terms of cost), compounding is finally coming into its own as an effective chronic pain management strategy – and a worthy alternative for costly and dangerous opioids – in workers’ compensation.
According to Greg Todd, CEO and founder of Integrated Prescription Solutions Inc. (IPS), a Costa Mesa, Calif.-based pharmacy benefit manager (PBM) for the workers’ compensation and disability market, one reason compounding is beginning to hit its stride is because some states have enacted laws to manage it more effectively. Another is PBMs like IPS have stepped up and are now managing compound drugs in a much more proactive manner from an oversight perspective.
By definition, compounding is a practice through which a licensed pharmacist or physician (or, in the case of an outsourcing facility, a person under the supervision of a licensed pharmacist) combines, mixes, or alters ingredients of a drug to create a medication tailored to the needs of an individual patient.
During that decade, Todd explains, opioids have filled the chronic pain management needs gap, bringing with them an enormous amount of problems as the ensuing addiction epidemic sweeping the nation resulted in the proliferation and over-consumption of opioids – at a staggering cost to both the bottom line and society at large.
As an alternative, compounded topical cream formulations also offer strong chronic pain management but have limited side effects and require much reduced dosage amounts to achieve effective tissue level penetration. In fact, they have a very low systemic absorption rate.
Bottom line, compounding provides prescribers with an excellent alternative treatment modality for chronic pain patients, both early and late stage, Todd says.
Time for Compounding Consideration
That scenario sets up the perfect argument for compounding, because for one thing, doctors are seeking a new solution, with all the pressure and scrutiny they’re receiving when trying to solve people’s chronic pain problems using opioids.
Todd explains the best news about neuropathic pain treatment using compounded topical analgesic creams is the results are outstanding, both in terms of patient satisfaction in VAS pain reduction but also in reduction potentially dangerous side effects of opioids.
The main issue with some of the early topical creams created via compounding was their high costs. In the early years, compounding, which does not require FDA approval, had little oversight or controls in place. But in the past few years, the workers compensation industry began to take notice of the solid science. At the same time, medical providers also were seeing the same science and began writing more prescriptions for compounding – which also offers them a revenue stream.
This is where oversight and rigor on the part of a PBM can make a difference, Todd says.
“You don’t let that compounded drug get dispensed when you’re going to pay for it without having a chance to approve it,” Todd says.
Education is Critical
At the same time, there is the growing, and genuine, need to start educating the doctors, helping them understand how they can really deliver quality pain management to a patient without gouging the system. A good compounding specialty pharmacy network offering tight, strict rules is fundamental, Todd says. And that means one that really reaches out to work with the doctors that are writing the prescriptions. The idea is to ensure that the active ingredients being chosen aren’t the most expensive sub-components because that unnecessarily will drive the cost of overall compound “through the ceiling.”
IPS has been able to mitigate costs in the last couple years just by having good common sense approach and a lot of physician outreach. Working with DermaTran Health Solutions and its national network of compounding pharmacies, IPS has been successfully impacting the cost while not reducing the effectiveness of a compounded prescription.
In Colorado, which has cracked down on compounding profiteering, Legislative change demanded no compound could be more than $350.00 period. What is notable, in an 18-month window for one client in Colorado, IPS had 38 compound prescriptions come through the door and each had between 4 and 7 active ingredients. Through its physician education efforts, IPS brought all 38 prescriptions down 3 active ingredients or less. IPS also helped patients achieve therapeutic success (and with medical community acceptance). In that case, the cost of compound prescriptions was down to an average of $350, versus the industry average of $788. Nationwide IPS has reduced the average cost of a compound prescription to $478.00.
Todd says. “We’ve still got a way to go, but we’ve made amazing progress in just the past couple of years on the cost and effective use of compound prescriptions.”
For more information on how you can better manage your costs for compound prescriptions, please call IPS at 866-846-9279.
This article was produced by the R&I Brand Studio, a unit of the advertising department of Risk & Insurance, in collaboration with IPS. The editorial staff of Risk & Insurance had no role in its preparation.