Getting public school police officers the care they needed meant taking on the risk of visiting emergency rooms during the pandemic.
Utilization review requirements in California are in a state of limbo, with mandates from a 2016 reform bill now in effect while the industry await
Meet Dana Schwartz, RN, CCM. One of the unique advantages a case manager brings to a workers’ comp case is a holistic approach to treatment. This focus on the person, rather than the injury, is how Dana Schwartz has managed to return injured employees back to their jobs safely and efficiently throughout her exceptional 22-year career as a case manager.
Field Case Management Meet Theresa Martin, RN, BSN, CCM Theresa Martin, RN, BSN, CCM, is a second-
The types of medications utilized by ill or injured workers can vary depending on the age of the claim and differences in claim population. Understanding the most-utilized types of medications in younger vs. older claims can help guide decision-making and aid in identifying opportunities for intervention that can lead to better overall outcomes.
New automation capabilities are now available in the DecisionPoint bill review platform.
In 2018, the top 10 therapeutic classes accounted for 77.1% of all scripts and 81.0% of all costs. An understanding of the most-utilized or highest-ranked classes of medications by cost can help identify intervention opportunities and benchmark targeted efforts for pharmacy program management. Year-over-year trend changes can also guide decision-making and recognize drug class utilization and cost outliers that may warrant further evaluation for appropriateness and safety.