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Auto Casualty Article

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.

Auto Casualty Article

Retail and Mail Order Prescriptions

3 MIN READ

Overall cost and utilization by claim were down in 2025 even with 6 of the top 10 therapeutic classes experiencing rising cost per script. Migraine medications rose by nearly 10%, representing the largest script cost gains driven in part by increases in brand Average Wholesale Price (AWP) including brand AWP for migraine medications increasing 2.4%. Utilization per claim also jumped in the migraine medication class (up 9.6%), while every other class within the top 10 (besides topicals, which rose 2.5%) experienced decreased utilization.
Mitchell Article

Plugged-In: EV Collision Insights Q1 2026

The U.S. share of repairable collision claims involving battery electric vehicles (BEVs) held steady at 3.33% in Q1 2026, unchanged from Q4 2025. Although sales of new BEVs grew modestly quarter over quarter, they remain 28% lower year over year. Several OEMs have scaled back production following increases in import tariffs and the expiration of federal tax incentives. Despite this near-term slowdown, BEVs are projected to reach approximately 29% of new vehicle sales and just over 10% of vehicles in operation by 2035, driving a steady increase in collision exposure.
Workers' Comp Article

PTSD Presumption Claims are Rising. Workers’ Comp Needs a Stronger Clinical Response

5 MIN READ

PTSD presumption claims are rising. Learn how case management supports behavioral health care, treatment follow-through and return-to-work planning in workers’ comp.
Workers' Comp Article

Protect Your Program from Unnecessary Risk: Why Provider Agreements Matter More Than Ever

4 MIN READ

Discover how contracted provider networks help workers’ compensation payers reduce risk, improve claim outcomes, and deliver more sustainable savings.
Workers' Comp Article

Specialty Solutions Spotlight: How Adjusters Can Spot CRPS Early in Work Comp Claims

Complex Regional Pain Syndrome, or CRPS, can change the course of an upper extremity claim fast. What starts as a routine wrist, hand or arm injury can become a longer disability claim with delayed functional recovery, higher treatment intensity and growing return-to-work barriers. For adjusters, the key is to spot the warning signs early, understand what may be driving the claim off course and know when to seek added support.
Workers' Comp Podcast

What Really Drives P&C Policy Change: It’s Local

Ever wonder what really drives legislative decisions, and why some seemingly “no-brainer” policies don’t pass? We dig into the idea that all politics is local and what that actually looks like in practice, especially for those in the P&C space.
Workers' Comp Case Study

Driving Better Outcomes Through Total Program Integration

Explore how aligning telephonic case management and bill review helped reduce claim costs, improve efficiency, and deliver better outcomes.
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