Paladin Managed Care Services - Insights

August 2012 — Volume 2
In This Issue:
WorkCompWire: Tackling Prescription Drug Abuse by Tending to the Patient

Jeffrey D. Miller

July 31, 2012 – WorkCompWire

Jeffrey Miller, CEO of Paladin Managed Care Services, was invited to contribute a post to WorkCompWire’s “Leaders Speak” section, which features recognized thought leaders in the Workers’ Compensation industry. Here are excerpts from his article.

Prescription painkillers now outstrip cocaine as the country’s biggest drug problem.* Much of the attention is focused on opioids, synthetic narcotics with similar effects to opium derivatives. But all types of painkillers and psychotherapeutic drugs appear on workers’ compensation claims at questionable levels and frequency rates, and often without a pain management strategy in place. This leaves an entire industry wondering what to do.

At Paladin, we favor a progressive and forward looking approach to prescription management — one that addresses both the business and human impact of prescription drug excesses. Through early intervention by Paladin physicians, our goal is to influence the prescription before it can damage a claimant’s health and send medical costs soaring. Read the entire article.

* “Rise In Pill Abuse Forces New Look at U.S. Drug Fight”, New York Times, July 17 2012

Doctors in the Mix Continue to Produce Impressive Results for GUARD Insurance

GUARD Insurance Group GUARD Insurance has been using Paladin’s Medical Bill Review service for the past 18 months, and Dan Brennan, RN, MSN, Senior Vice President of Claims, Guard Insurance, says the initial results were impressive. "While the first quarter was good, I kept thinking; these kinds of results are not going to hold." Now, over a year later, he notes, "I have been pleasantly surprised. You get 100% better response when a doctor picks up the phone and contacts the treating physician." Just as important, he says, "the estimates for future costs are rarely disputed."

Because of the results GUARD has seen with Paladin’s Medical Bill Review service, they are currently expanding their Pharmacy Benefit Management program to include Paladin’s Rx Utilization Management service. The same peer-to-peer physician review goes into this Paladin service, including the use of physicians to review prescriptions — before they're filled — including Class II and III drugs, special requests, and prescriptions that have been flagged by Paladin’s proprietary triggers, and Brennan expects to see similar results for his clients including better care for injured employees.

The Aging Workforce and its Impact on Workers Compensation

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Dr. Paul Wakim, DO, FAAOOS, former Chief Medical Director of Paladin Managed Care Services, recently conducted a 45-minute CE webinar for One Call Medical University entitled, “The Aging Workforce and its Impact on Workers’ Compensation.” More than 400 healthcare and insurance professionals attended.

During the session, Dr. Wakim examined conditions that develop naturally as workers age, and the different job-related injuries that occur in older workers than younger ones. With knowledge of these differences, companies with aging workers can take steps to address and minimize injuries. Dr. Wakim focused on the areas most vulnerable to injury such as shoulders, discs and knees, and discussed how proactive prevention along with quality care not only protects the aging worker but significantly reduces the cost of a claim. You can view Dr. Wakim’s full presentation on our website.

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