Insights
Aggregate Top Therapeutic Classes by Age of Claim in 2018
August 12, 2019
1 MIN READThe 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
1 MIN READIn 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
2 MIN READAs 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
3 MIN READIn 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.
What is an MCO?
July 16, 2019
3 MIN READMore often than not clients will ask the question: What is an MCO? Well isn’t that a loaded question? If we take it at face value, a Managed Care Organization (MCO) is an organization that manages care. Like Coventry, who manages all types of “care” injured workers seek to get on the road to recovery. However, usually the question has more to do with State Certified Managed Care Programs, commonly referred to as MCOs. From there it gets clear as mud. While the general category of state certified programs may be commonly referred to as MCOs, when you get into the state specifics you won’t find it to be that easy.
Investigating the Top Therapeutic Classes
July 8, 2019
2 MIN READFirst Script saw a decrease in opioid utilization across our retail and mail-order programs in 2018. In 2017, opioids made up 29.7% of total prescriptions, dropping to 26.9% in 2018, and representing a 2.8% decrease in utilization year over year.
Morphine Equivalent Dose (MED) Continues to Decline
July 1, 2019
3 MIN READIn 2018 Coventry’s pharmacy benefit management solution, First Script®, saw a 7.8% decrease in average MED per prescription for its retail and mail-order channels. This was the largest decrease in the last 5 years across First Script’s retail and mail-order programs. In addition, there was a reduction in the percentage of opioid scripts with greater than or equal to 90 MED. To better understand why this is important let’s answer a few questions.
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Genex helps injured employees return to their jobs in a safe and efficient manner through compassionate case management while reducing total claim cost.
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