New technology has just been released that provides early detection of questionable drug usage behavior to reduce payer costs and improve employee health outcomes.
Rising Medical Solutions’ Rx Intelligence technology targets the workers’ compensation industry’s opioid epidemic.
Claims with long-acting opioid prescriptions are costing 9.3 times more than claims without, according to the August edition of the Journal of Occupational & Environmental Medicine, the latest in a string of industry studies. When long-acting opioid painkillers are prescribed, workers’ compensation claims are nearly four times more likely to turn into catastrophic claims with costs tallying more than $100,000, the study also found.
The technology is intended to ensure injured workers receive appropriate meds, while curtailing narcotic overprescribing and overuse – narcotics represent roughly 25 percent of all workers’ comp drug costs.
Rising is using analytics to monitor an injured worker’s prescription drug activity and alert users to “at-risk” cases so that early intervention can take place to prevent costly drug misuse or abuse. Key functionality includes:
- Complete medical picture, in addition to prescription fill data
- Urine drug screening insight
- Prescription activity for multiple providers
- Identification of escalating or weaning patterns
- Utilization of any formulary (e.g. payer-specific, state-specific, blended)
- Tracking of any prescription drug, not just opioids
“In any pharmacy review, if a person is taking an opioid, they are likely taking many other drugs that could be problematic,” says Anne Kirby, Rising’s chief compliance officer and vice president of Medical Review Services. “That’s why we don’t just deal with opioids in a vacuum, as other drugs impact how opioids are used and influence their effect.”
Source: Rising Medical Solutions Inc.
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