Insights
The Sounding Board
Ideas and inspirations for the managed care industry
Embracing Technology: Old School vs. New
September 2, 2019
The learning curve difference for adopting technology is skewed among four generations: Millennials, Gen Xers, Baby Boomers and the Silent Generation. The three older categories are still skimming the surface of how to use technology to positively impact their lives. Think about the Silent Generation – our Baby Boomer parents whose exposure to cell phones began in their sixties. I know it took my parents months to figure out how a new phone works.
Top 5 Opioid Medication Trends in 2018
August 26, 2019
Overall, 2018 showed favorable trends for opioid use with declines in both utilization and cost. Understanding the top opioid medications being filled and impacting spend can help guide decision-making and aid in identifying opportunities for intervention particularly through formulary controls, utilization management strategies, and through insight into regulatory changes and juris-specific rule application.
Legal Nurse Review Explained
August 19, 2019
Legal Nursing is defined as a registered nurse with specialized knowledge and experience in nursing as well as education and experience in medical-legal issues. These professionals assist in providing direction on a file through their knowledge, education and experience. The Legal Nurse will interpret the information in the records, provide insight and education to the referral source and develop a report designed to mitigate the claim.
Aggregate Top Therapeutic Classes by Age of Claim in 2018
August 12, 2019
The types of medications utilized by ill or injured workers can vary depending on the age of the claim and differences in claim population. Understanding the most-utilized types of medications in younger vs. older claims can help guide decision-making and aid in identifying opportunities for intervention that can lead to better overall outcomes.
Aggregate Trends for the Top 10 Therapeutic Drug Classes in 2018
August 5, 2019
In 2018, the top 10 therapeutic classes accounted for 77.1% of all scripts and 81.0% of all costs. An understanding of the most-utilized or highest-ranked classes of medications by cost can help identify intervention opportunities and benchmark targeted efforts for pharmacy program management. Year-over-year trend changes can also guide decision-making and recognize drug class utilization and cost outliers that may warrant further evaluation for appropriateness and safety.
Virtual Connections: Utilizing Technology to Build and Deepen Relationships with Injured Workers
July 29, 2019
As the telemedicine industry continues to boom we’re seeing more and more new forms of telehealth emerge in the marketplace. Variations including tele-rehab, remote patient monitoring and even “avatar-like” nurses being utilized by hospital systems and providers. In this new world of telehealth we need to constantly be looking for innovative modes by which triage and telephonic case managers can connect with the individuals they serve and engage them on their road to recovery. At Coventry we are piloting two new types of Virtual Connections designed to support our clinical staff in the establishment of trust and engagement with injured workers – Virtual Triage and Video-Telephonic Case Management.
Understanding Brand & Generic Utilization and Cost
July 22, 2019
In 2018, First Script realized a 0.6% increase in generic utilization.1 Generic medications contain the same active ingredient and approved indications as their brand name counterparts. An increase of 0.6% might not seem like a lot; however, when the difference in cost per script is considered, it is easy to see why a shift in favor of generic use is a win and can be a big cost saver.
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