The Road Ahead for Auto Medical Cost Management
Auto medical costs are showing encouraging signs of stability after several years of rising severity, but maintaining that progress may be the bigger challenge. In the latest Enlyte Envision podcast, Ed Olsen and Michele Hibbert explore findings from the auto casualty section of the Enlyte Envision Trends Report and what they mean for insurers.
Fewer Prescriptions, Bigger Price Tags
Prescription utilization in workers’ comp continues to decline, but that doesn’t mean drug costs are no longer a concern. In fact, the latest Enlyte Drug Trends Report finds a small number of high-cost prescriptions are creating an outsized impact. In today’s Enlyte Envision podcast, Brian Allen explores what’s driving these costs, how some providers are exploiting gaps in the system and what states can do to rein in abusive pricing.
Key Implementation Considerations from Kentucky's New PIP Fee Schedule
For decades, Kentucky's no-fault auto system operated without a dedicated Personal Injury Protection (PIP) medical fee schedule. That changed with the enactment of House Bill 627, which established a new reimbursement framework for PIP medical benefits by incorporating Kentucky workers' compensation fee schedule rates.
In-Network and Out-of-Network Trends
4 MIN READ
This analysis provides a comprehensive examination of prescription utilization across both in-network and out-of-network channels including retail pharmacies, mail-order services, and paper-based medical bill submissions. This dual-lens approach captures the full prescription landscape that extends beyond traditional pharmacy benefit management reporting, revealing critical cost and utilization patterns across all jurisdictions. While in-network channels demonstrate the real-time effectiveness of integrated clinical controls and cost management strategies, out-of-network data, often representing acute treatment episodes captured through medical bill review, exposes significant cost management opportunities and pricing anomalies. Together, these perspectives illuminate where pharmacy dollars are spent, how prescriptions are managed, and where targeted interventions can drive the greatest impact on both clinical outcomes and costs.
What Causes Bodily Injury Claim Overpayments and How to Prevent Them
12 MIN READ
Learn why bodily injury claims are overpaid and how consistent demand evaluation improves negotiation outcomes and reduces claim leakage
5 Ways to Double Your Productivity Gains from Referral Engine
Double-digit productivity gains in claims operations are achievable, but rarely fully captured. The difference comes down to execution. Referral Engine is the foundation, but performance gains are driven by intentional configuration and workflow alignment. Here are five simple configurations that will instantly boost your team’s productivity.
Is Workers’ Comp’s Golden Era Transitioning to a New Normal? Three Threats that Could Reshape the Market
Workers’ compensation has enjoyed a prolonged period of profitability, but new challenges may be on the horizon. In this Risk & Insurance article, Enlyte’s Dave Torrence discusses key threats facing the market, including rising medical costs, workforce changes and economic pressures that could reshape claims, profitability and risk strategies in the years ahead.
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