During our time at RIMS 2017, we had Workers’ Comp industry stakeholders participate in WorkCompWire’s “RIMS Review” series, focused on what to look for this year, and key takeaways from the conference! Here’s what Mark Farrell Senior Vice President, Sales and Account Management at Coventry Workers’ Comp Services had to say:
What do you believe will be the most significant development in the Worker’s Comp industry this year?
I think the most significant development in the Workers’ Compensation industry this year will be adoption of the various Telehealth tools that have been launched in the healthcare markets … virtual physician visits, virtual access to nurses as well as remote patient monitoring.
Late last year, Coventry expanded its national PPO to include virtual provider networks (Telemedicine) to offer 24×7 access to care for workers immediately following an injury on the job… by implementing Telemedicine through our nurse triage service (NT24) we ensure the most appropriate use of Telemedicine at the right time… this is a simple way for employees to get the care they need without leaving their work site.
Injured workers and their employers all benefit from immediate access to licensed providers trained in telemedicine and workers’ compensation injury care who always bring a return-to-work focus to this first visit. Expanding access to immediate and appropriate care represents a very positive forward step to improve the workers’ comp experience for the injured worker which can engender the trust that leads to more positive outcomes.
What is the top challenge you and your organization are currently working on?
The opioid epidemic has dramatically impacted our workers’ compensation system. Coventry is taking an integrated approach to fighting the epidemic, using all its available resources.
Our triage nurses (NT24) educate on the use of narcotics at the point of injury and before any treatment is rendered. Through our PBM (First Script), we immediately outreach to prescribers, injured workers and adjusters when a narcotic is first prescribed to establish a plan for care that is within the most current evidenced based guidelines.
If narcotic utilization continues, we monitor risk through our integrated data, considering all medications regardless of where they were dispensed. When emerging risk is identified, we leverage a variety of intervention tools including Drug Utilization Assessments with Peer to Peer outreach and Urine Drug Testing and Monitoring to complete the clinical assessment of the injured worker’s individual risk. Through this approach, we are able to proactively intervene with those at risk for overdose. We have specific interventions to mitigate overdose risk including the opioid overdose reversal agent naloxone.
Adjusters channel injured workers into Coventry’s Outcomes-based Network (OBN) where providers have demonstrated prescribing practices within evidence base medicine. As a quality network manager, we also outreach to our network prescribers to educate and collaborate on improving injured worker care as needed.
In addition, we have developed a highly successful specialty nurse program (‘RxRN’) to work closely with at risk injured workers. They educate and coach injured workers and collaborate with prescribers to promote a healthier pathway to recovery. The RxRN may continue to work with the injured worker to address addiction and recovery through appropriate inpatient and outpatient settings.
What was one major takeaway for you from this particular RIMS Conference?
For us, the key to a successful RIMS ties directly to thoughtful pre-planning…we schedule meetings well in advance of the conference with our current customers and prospects to cover those issues and potential solutions most meaningful to them. Understanding what matters to them, we are best positioned to bring the right people to the table. Coventry aligns its product, operations, sales and account management experts with customers to collaborate around program designs and improvements.
This approach proved highly successful at the 2017 RIMS Conference. We identified several opportunities for product development which we will vet for investment this year.
What is one thing you’d like to promote?
As a full service managed care organization, we have made significant product development investments to aggressively promote a focus on delivering outcomes vs a more traditional focus on unit cost containment.
For Coventry, this means increased access (24×7) to providers whose treating and prescribing practices are within evidence based guidelines as well as engaging injured workers to actively participate in their own recovery. To this end, we have enhanced our network, pharmacy and clinical offerings not only to recognize the injured worker as an individual within our data but to overcome all medical and non-medical barriers to a positive outcome through our interventions.
Through our integrated data, we can identify risk acuity from the onset of injury and throughout the life of each claim. We respond immediately through physician and pharmacist outreach as well as through nurse interventions. Our nurses are trained in behavioral and health coaching and armed with decision-support tools to help injured workers having outcome risk based on attitude, drug dependence, co-morbid conditions as well as health challenges associated with aging.
By bringing injured workers back into the center of their claims and by supporting them through network and clinical services tailored to their unique challenges; we are successfully delivering upon our promise to return people to work, to play and to life.
Mark Farrell is responsible for overseeing Coventry’s sales and account management efforts. He is accountable for setting the sales and retention strategies that lead to continued growth and profitability of the Workers’ Comp division. Mark’s sales and account management teams are responsible for selling all Coventry products to the workers’ compensation and auto industries through employers, third party administrators, and insurance carriers.