Article

The rising retirement rate is changing the U.S. workforce

… disrupted the supply chain and inflated prices. - Loss of talent and expertise: Baby boomers account for a huge percentage of the U.S. workforce, and their approaching retirement was already …
Author

Dr. Mitch Freeman, Pharm.D.

… for the strategic direction for the clinical product and programs and leads the division’s account management organization. Dr. Freeman has been recognized as a leader in innovative …
Blog

Specialty Medication Trends in 2018

… to their significant costs. Although they represent approximately 1% of drug utilization, they account for nearly 7% of prescription drug costs and represent the fastest-growing segment of the …
Blog

A Look at the Foundation of Work Comp Pharmacy Trends

… which was driven mostly by the drop in average wholesale price (AWP) for brand drugs, and an increased focus on drug-mix management by our clinical team. Double-digit declines in …
Blog

Price Opportunists - Compound Kits and Combo Packs

… scripts per claim) in each of the last 5 years and overall use of both categories continues to account for less than 1% of total script volume and costs. However, this past year did see an increase in cost per script due to a shift in mix of compound kits used. This includes the … 2018. In regard to combo packs, usage decreased 2.4% compared to 2018 but this was offset by an increase in cost per script of 2.5%, which resulted in the cost per claim increase of less …
White Paper

A Personalized Approach to High-MED Opioid Management

… Successful opioid management includes a tailored strategy that takes into account: Each injured worker’s current medication regimen The patient’s medical history and …
Podcast

Quality Assurance in Case Management

… This next one is for Linda Wolf, what are good case managers trained to look for during an initial assessment? … Genex has an ongoing internal focus and commitment to quality. This includes our initial and ongoing … Thanks, ladies, for sharing your insight. In our next Inside Workers’ Comp, we’ll begin an in-depth series on mental health. Until then, thanks for listening. …
Article

New York Workers' Compensation Board says NO to Medicare hold harmless language in Section 32 Waiver Agreements

… of the claimant’s failure to safeguard the funds in a self-administered Medicare set-aside account established pursuant to the agreement. The Board indicated that it believes these hold harmless provisions to be unfair, unconscionable and without place in an agreement settling a claim for workers’ compensation benefits. The current publication of …
Article

New York Workers' Compensation Board says NO to Medicare hold harmless language in Section 32 Waiver Agreements

… of the claimant’s failure to safeguard the funds in a self-administered Medicare set-aside account established pursuant to the agreement. The Board indicated that it believes these hold harmless provisions to be unfair, unconscionable and without place in an agreement settling a claim for workers’ compensation benefits. The current publication of …
Article

The Rise of Fentanyl in the Midst of an Already Troubling Opioid Epidemic

… stories of the individuals and the families who have been impacted by the opioid epidemic. In an attempt to address this crisis, more aggressive clinical intervention and opioid management … opioid use has steadily decreased for workers’ compensation patients; however, according to an NSC survey , 75% of employers are being directly impacted by employee opioid misuse. In another  study  of workers’ compensation claimants who were initially treated with an opioid prescription, approximately 30% continued to fill opioid prescriptions beyond 90 days …
News Release

Changes to the ODG Drug Formulary Impact Opioid Class

… formulary as stated above. If you have any questions about this update, please contact your account manager or client services manager. …
News Release

Changes to the ODG Drug Formulary Impact Opioid Class

… formulary as stated above. If you have any questions about this update, please contact your account manager or client services manager. …
News Release

Puerto Rico Governor Declares State of Emergency

… in how injured workers can access care, and Mitchell Pharmacy Solutions has been configured to account for these changes. The emergency declaration will allow impacted injured workers to fill …
News Release

Enlyte Drug Trend Report: Migraine Med Use Soars in Comp Despite Overall Drop in Scripts

… of opioid usage in workers’ comp, which decreased by 7.8% in 2024. However, opioids remain the top-prescribed drug class in 2024, followed by NSAIDs, anticonvulsants, muscle relaxants, and … classes represent the majority of total scripts (54.4%) and costs (53.5%). While most of the top 10 drug classes saw drops in overall prescriptions, migraine medications and topical … in workers’ comp. Enlyte’s data shows that claims open for more than two years account for 92.1% of the total drug spend, while those open 0-1 years account for less than 8%. …
Podcast

Closing Loopholes: Tackling Drug Price Inflation in Work Comp

… happen. Rebates have a safe harbor exemption right now from the kickback statutes. And there’s an effort underway in Congress to remove that safe harbor and to make kickbacks or make the … the drug spend per person increased in this country. So, direct‑to‑consumer advertising has an impact on the kind of drugs that people buy, and there’s a lot of that out there. There’s been some talk among some circles in Congress …
Article

Modernizing Claims Management: Streamlining Workflows With Integrated Negotiation Solutions

… adjusters settle a claim accurately, quickly and efficiently. Integrating PrecisionDirect into an adjuster’s workflow introduces a path to give adjusters their time back. Enlyte owns the … Craft an Open-Ended Settlement Release: …
Article

Navigating Future Medical Costs: Forecast Claims Costs with Precision

… adequate capital reserves requires a precise prediction of the medical care and services an injured employee will need throughout their lifetime. This strategic foresight is pivotal not … projections are vital for preparing for long-term needs and ensuring that every aspect of an individual’s future medical care is thoroughly accounted for. Life care plans are … Medical cost projections and life care plans are not merely financial tools; they are an extension of a claims professionals’ commitment to the well-being of injured employees over …
Article

WCF Insurance Proves that Doing the Right Thing is Good for Business

… WCF recognized that injured workers who were receiving opioids early and often after an injury also had claims that stayed open longer with poorer outcomes relative to returning to … since restoring function and quality of life becomes much more complicated when there is an added layer of chronic opioid use. It’s not about saving money, it’s about saving lives. … abuse. With that in mind, their first goal was to reduce the unintended consequence of using an opioid when alternative non-opioid therapy is appropriate. Their secondary goal was to ensure …
News Release

Genex Earns URAC Reaccreditation for WCUM and CM

… clinical care. Companies holding URAC's Case Management accreditation are among an elite group of managed care organizations that maintain and measure an essential set of performance standards. These care protocols are designed to reinforce the … employees and 47 service locations throughout North America.  The company serves 381 of the top Fortune 500 companies in the U.S. today. In addition, Genex is the only company that delivers …
News Release

Decrease in Used Electric Vehicle Prices Coincides with an Increase in Total Loss Claims

… —Mitchell, an Enlyte company and leading technology and information provider for the Property & Casualty … its Q1 2024 trends report: Plugged-In: EV Collision Insights . This quarter’s report provides an update on EV total loss frequency, which has risen since late last year as the price of used … EVs has fallen. In the U.S. and Canada, EV total loss rates were 9.93% and 7.48% respectively—an increase of approximately 8% from Q4 2023 and 30% from Q3 2023 in both regions. Despite the …
Blog

At the eye of the storm: An opioid overdose epidemic and a viral pandemic converge

… a life changing public health and personal response for us all. For those struggling with an opioid use disorder, it no doubt contributes to the daily challenge of managing that … period and early data from a national tracking system at the University of Baltimore point to an 18% increase in suspected drug overdoses in this same period. 3 While these trends are very …
Article

When Good Intentions Misfire in Workers’ Comp Pharmacy

… introduced atypical strengths (e.g., 300 mg) at exorbitant prices. Prescriptions written for an odd strength can prevent pharmacists from substituting to a lower-cost equivalent, even when the daily dose is subtherapeutic relative to over-the-counter products. This results in an extraordinary unit price for a common, typically very inexpensive drug. … acquisition cost (NADAC) or similar acquisition-cost benchmarks. Out-of-network prescriptions account for 84% of abusive drug pricing in workers’ compensation, while in-network prescriptions …
Article

Plugged In: EV Collision Insights Q4 2022

… to lag behind vehicles with internal combustion engines (ICEs), ending the quarter at 19.18% (an increase from 18.83% the previous quarter). The average number of mechanical labor hours on EV … a proper and safe repair. EV Q4 2022 Statistics EV Average Repairable Severity By the Numbers Top North America EV Markets Based on Repairable Claims Frequency Top EV Model Frequency by Region   Subscribe Now To subscribe to future issues of Mitchell's …
Article

Plugged-In: EV Collision Insights Q4 2022

… to lag behind vehicles with internal combustion engines (ICEs), ending the quarter at 19.18% (an increase from 18.83% the previous quarter). The average number of mechanical labor hours on EV … a proper and safe repair. EV Q4 2022 Statistics EV Average Repairable Severity By the Numbers Top North America EV Markets Based on Repairable Claims Frequency Top EV Model Frequency by Region …
Article

Understanding Compliance and Regulatory Trends in Workers’ Comp Costs
Article

Reduce Cost and Complexity in Workers’ Comp Ankle and Foot Claims

… teams with unnecessary touchpoints. Proactive Oversight Drives Outcomes   Sprains and strains account for 50–60% of all foot and ankle claims. While a Grade I sprain (mild, with a small …
News Release

Overview of California Closed Formulary Draft Rules

… by law, the formulary must be implemented on July 1, 2017.  The information provided below is an overview of the proposed rules and subject to change based on further changes to the rules by … July 1, 2017 formulary start date, the formulary should be “phased” in so no harm is caused by an abrupt change to the course of treatment. No definite date has been set forth by which all … For additional information, please consult your Coventry Account Manager. About Coventry Coventry offers workers' compensation, auto and disability care- …
Virtual Event

Webcast: Michigan No-Fault Reform-An Expert's Guide to the New Utilization Review Administrative Rules

… under No Fault 500.3157a(6) , defines utilization review as “the initial evaluation by an insurer or the association created under section 3104 of the appropriateness in terms of both … but not a determination. That being said, utilization review organizations will release an explanation of benefits with the recommendation, but no determination document is required. …