In her session, Best Practices to Restrain Rising Medical Costs, Gillen-Algire, an MBA, registered nurse, and practice leader for Integrated Health & Productivity Management will outline strategies that are helping some employers reduce their medical costs. With continuing increases in workers' comp medical spend, she says companies need to become more savvy in their actions.
"A lot of companies are doing pharmacy benefit management, nurse case management; they are doing the networks and all of those different programs and components, but they're not really seeing the true value of their investment," she said. "There are some key things they need to do that companies/payers that are seeing the best results are doing."
Data overload. One thing companies can do is better utilize their data. "I think one of the big mistakes [companies make] is that we collect a lot of individual data points. Workers' comp is rich in data. But how do we look at that across your program design?" she said. "Companies are looking at pharmacy benefit management and durable medical equipment and issues for things that are paying in or out of network -- we have this flurry of data -- what do we actually do with it operationally? How do we connect this data to actually affect, in a meaningful way, my operation?"
Just collecting data in and of itself does not help a company reduce its workers' comp costs, she said. Instead, employers need to understand how to consolidate and use it to reduce costs.
Data collection is not the only area where companies can improve their efforts to reduce medical costs. "One of the biggest mistakes is many companies are still operating in a silo," Gillen-Algire said. "They say they're integrated, but they're really not. They are still looking at pharmacy, networks, bill review, utilization review, early intervention separate and apart from each other."
Some of the solutions to reductions in workers' comp medical spend can be made in the contractual language companies have with their medical providers. Gillen-Algire will discuss that and offer tools to control pharmacy spend. Additionally, she will discuss when and how to deploy medical management in a particular claim.
Informal medical management discussion.
Later in the conference, Gillen-Algire will facilitate an informal roundtable discussion on medical management. The "real-time open chat room forum, a gathering of brain trust" as she describes it, will give attendees the opportunity to share and hear ideas from their fellow attendees about unique approaches some companies are taking to achieve cost savings.
Read more at the WorkersComp Forum homepage.
October 24, 2011
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