…Court Orsborn, president of Donn & Co. in San Francisco, said most of the managed care advisory firm’s clients are concerned about opioids, and many are expanding their efforts to address the issue. “This is definitely something all payers should look at,” Orsborn said. “It’s one of the clearest win-wins in comp, where more active management both significantly improves medical outcomes and well-being, and reduces medical/indemnity costs.”
Meaningful opioid management is a team effort between claim examiners, PBMs and utilization review organizations, Orsborn said, and requires all parties to work actively with injured workers and physicians as early as possible to prevent opioid dependency. Passive approaches typically don’t work, he said.
Drug formularies that have been implemented in some states make the task easier for payers by giving them explicit discretion to deny inappropriate medications, including opioids, Orsborn said.
A drug trend report from Coventry last month also found decreased workers’ comp spending on opioids.