Opioid use is most certainly a pandemic societal concern. Far too many individuals are suffering from the unintended consequence of addiction as a result of an accidental work place injury. The cost of misused medications is staggering, in both financial and health terms and as a result, the workers' compensation industry is abuzz regarding the punitive aspect of narcotic misuse and abuse. But it doesn't have to be this way. Ensuring that the injured worker receives the right drug, in the right quantity, at the right time -- every time -- is achievable.
Progressive Medical, a workers' compensation and auto no-fault pharmacy benefit manager and ancillary services provider located in the Columbus, Ohio suburb of Westerville recognizes that as individuals and as an organization each and every action impacts clients and injured parties. "If we deliver more control beginning with the first prescription and intervene when warranted throughout the course of therapy, there will be better outcomes -- both financially and clinically," states Barry Jarnigan, Chief Marketing Officer.
To help bring this philosophy into focus, Progressive Medical introduced "Claim Your Impact," a nationwide initiative that shares individual acts of innovation and ethical professionalism in support of injured workers at the National Workers' Compensation and Disability Conference & Expo held in Las Vegas, Nevada last month. Their exhibit unveiled an 8'x12' wall, which displayed the company's impact on the industry at both the individual and enterprise levels, as well as a virtual wall online at www.claimyourimpact.com. During the show, attendees were asked to join the movement by sharing their impact. Every impact shared resulted in a $2 donation to Kids' Chance, a national organization that focuses on bringing educational opportunity to the children of individuals seriously or fatally injured on the job. To date, close to 1,000 impacts have been collected representing a donation of $2,000.
Pleased with the response to the initiatives, the impacts themselves are particularly impressive to Sarah Berger, VP of Marketing. Some favorites Berger cites are: 'I listen with my heart.'; 'Limit the life interruption'; 'Provide excellent patient care at the highest level on a daily basis'; 'I help people be normal again' and 'Reduce costs through effective network discounts and efficient processes.' "Simple words that speak volumes - all having a positive influence on our industry," she said. Another aspect that was unexpected was the relative alignment of the message. Whether a bill review company, nurse case manager, insurance executive, PBM service specialist, attorney or claims professional, those participating in the initiative share a commitment to improving the industry as well as helping to make work place injuries a little easier to bear.
But what does Claim Your Impact have to do with narcotic use and ensuring that the injured worker receives the right medication in the right quantity, at the right time? In a word: Everything. Narcotic prescribing and use has risen exponentially over the last ten years. The use of these powerful, potentially addictive agents in the treatment of pain has dramatically increased the associated risks of misuse, abuse and addiction for claimants taking these medications for long-term chronic pain conditions. It is critical that these medications be used only when appropriate. While most people do use these agents as indicated, there must be measures in place to know when to intervene. That's why Progressive Medical is utilizing a patent-pending process, which aligns clinical innovation with advanced analytics. This process not only identifies potential issues earlier, but promotes a stronger collaboration between our clinical team and claims professionals. The additional insight gained from using advanced analytics affords more opportunity to act and better positions claims professionals to prevent what could become a longer term issue. This, combined with the highest retail pharmacy network penetration in the industry, rigorous evidence-based medication plans and a commitment to operational excellence are producing the lowest total program cost through more control and better outcomes.
"It comes down to consistently executing the basics on a daily basis and that means doing what's right for both clients and injured workers. Taking this approach to our business has resulted in some impressive outcomes," Jarnigan said, including:
-- 42% reduction in the number of claims with active drug use one year after injury. As claims age, more drugs are prescribed and more dollars are spent. The benefit of deeper analytical insight and earlier clinical intervention help claims close faster. When claims close faster, we all win.
-- 32% reduced total cost of pharmacy benefit management programs.22% average reduction in morphine equivalence per claim. A focus on transaction costs can be misleading. Clients embracing our program are experiencing both hard dollar savings and improved clinical outcomes.
-- Up to 98% pharmacy retail network penetration. The ability to apply network discounts and medication plans starting with the first fill not only results in dollar savings, but gives the payor more control over the pharmacy-related claims expense. Progressive Medical has the highest retail pharmacy network penetration in the industry and is uniquely positioned to drastically reduce, if not completely eliminate, the collection calls and unexpected paper bills from third party billers. This vast interconnected network also helps to ensure that the injured worker receives the right medication, in the right quantity, at the right time.
-- 95% of calls answered within 20 seconds. Committed to delivering excellent customer service, our team of experienced client service specialists is available to help. In addition to being efficient, the team is dedicated to working hard to do what is right and can be relied upon to offer guidance and assistance when needed.
Progressive Medical believes that as individuals and as an organization we can inspire change to the betterment of our industry and the injured workers we serve by doing what is right. We claim our impact. When will you claim yours?
To read some of the many impacts collected or to claim your impact, visit www.Claimyourimpact.com.
For more information on how Progressive Medical can help your organization, visit www.workcomptransformation.com.
To learn more about Kids' Chance, visit www.Kidschance.org.
(The above piece is part of our continuing Insights series designed to highlight key products and services to our readers. This paid-for Insights was written and edited by Risk & Insurance®
on behalf of our marketing partner. Additional Insights can be found on our Web site at www.riskandinsurance.com.)
December 12, 2012
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