April 24, 2017

Art Lynch: Defining ‘Value-Based Contracting’ Requires More Than A Few Words

Art Lynch

Value-based contracting is one of the most talked-about topics at conferences, in stewardship meetings and in workers’ compensation requests for proposal (RFPs). But for all the discussion around the term, one thing seems missing: a common definition. Value-based contracting seems fairly straightforward to most observers and that might be part of the problem…[Continue Reading]

Eric F. Patten: Strategies to Manage the Pandora’s Box of Comorbid Conditions

Eric Patten

Originating from Greek mythology, the phrase “to open Pandora’s box” calls to mind how a seemingly innocuous act, such as opening a box, can unleash a plethora of negative consequences. That’s how many workers’ compensation (WC) program managers feel about covering injured workers who incur relatively minor workplace injuries that quickly spiral out of control…[Continue Reading]

Kevin Glennon: Use of Medical Marijuana in Workers’ Compensation: Where Are We Today?

Kevin Glennon

If marijuana has been shown to effectively treat pain, why should injured workers be denied access to or reimbursement for it? This question isn’t easy to answer. Controversy exists because of the conflict between state and federal laws. Some medical evidence shows marijuana is effective in treating pain, but these clinical trials have been small in scale. In the workers’…[Continue Reading]

Dr. Steven Feinberg: Why Claims Go South, and How to Avoid It

Dr Steven Feinberg

In my previous post, I discussed the importance of injured workers’ empowerment and taking responsibility for their health and well-being and rehabilitation through a biopsychosocial functional restoration education approach. While this concept has been around for as long as I can remember (I learned about it during my PMR residency in the early 1970s), it is only in the last few years…[Continue Reading]

Dr. Steven Feinberg: What is the Best Approach to Preventing and Managing Chronic Pain?

Dr Steven Feinberg

The treatment of injured workers with chronic pain conditions throughout the United States is at best problematic and at worse a disaster. We continue to see individuals overtreated by well-meaning physicians with excessive opioids and psychotropic medications while undergoing numerous passive invasive interventions but with at best transient and little, if any, lasting benefit…[Continue Reading]

Thomas D. Johnson: Antifragile: How WC Organizations Can Benefit from ‘Disorder’

Tom Johnson

Volatility, disorder, uncertainty, and randomness are conditions we dislike and try to avoid. However, in his 2012 blockbuster book, Antifragile: Things That Gain from Disorder, author Nassim Nicholas Taleb paints a different picture. If something is fragile, it breaks easily. Think of a crystal goblet or Fabergé egg — neither would do well if dropped onto a concrete floor…[Continue Reading]

Mariellen Blue: California Legislation May Elevate UR Processes for All

Mariellen Blue

California Senate Bill 1160 (SB 1160) is slated to bring major reforms to the California workers’ compensation system. Its provisions aim to eliminate both delays in the utilization review (UR) process and inappropriate denials of care for injured workers. In addition, it will help prevent billions of dollars in workers’ compensation billing fraud. Depending on how effective…[Continue Reading]

Joe Guerriero: Patient Advocacy: A Key Driver of Value-Based Care

Joe Guerriero

The value-based care conversation has finally made its way to the Worker’s Compensation landscape, and stakeholders are Investigating new models aimed at improving outcomes and lowering costs. Now, as this change is occurring, industry leaders increasingly point to the need for expanding strategies to hone in one key tactic: patient advocacy. The “more is better” mentality of past…[Continue Reading]

Carlos Luna: It’s About Time – Value-Based Care Comes to Workers’ Compensation

Carlos Luna

With the total annual cost of lost productivity attributable to health-related conditions exceeding $225 billion in the United States, employers are looking for ways to get the best medical results at the best prices for injured workers. In fact, more than 40 percent of employers are considering implementing value-based plan designs or high-performing networks in the coming…[Continue Reading]

Dan Anders: New Tricks for New Claims

Dan Anders

As discussed in last week’s article, old dogs can be taught new tricks. A proactive settlement initiative can not only get legacy claims off the books, but it can also dramatically reduce costs and improve patient care. In one case, a man who suffered a minor back injury at work more than 25 years ago was weaned off fentanyl, hydrocodone, and several other drugs. The claim’s pharmacy…[Continue Reading]

  • RSS
  • Twitter
  • LinkedIn