Clinical Pain Management

Early Identification of Patient Risk in a Complex Claim

Treatment of pain requires specific rather than subjective management – management beyond a single prescription. Narcotics account for more than one-fifth of workers’ compensation total pharmacy costs, due to the healthcare industry’s reliance on prescription drugs as a quick fix for pain. By shifting the modalities of patient care from one that diagnoses and reactively treats individual symptoms to a methodology that looks at the patient as a whole, employees can return to work faster.

CorVel’s comprehensive clinical pain management program offers a solution for workers’ compensation cost drivers. As part of our program, both physiological and psychological treatment are at the forefront, utilizing multiple therapy options to afford the patient a chance at a better life through medical interventions, psychological support, and different treatment and functional modalities. Through wellness intervention, which includes the patient taking responsibility for their treatment, CorVel’s self-management model can return injured workers to work faster and at a fuller capacity, saving employers time and money.

Case Synopsis

A patient sustained a shattered left femur and knee after being involved in a car accident while on duty.

The patient’s claim was identified as complex and flagged for peer review after it surpassed thresholds within our Clinical Modeling program. These results indicated several red flags demonstrating the patient’s risk for problematic use of prescription drugs.

As a result of medication review, a pain questionnaire was issued to the patient. CorVel obtained approval from the patient’s treating physician agreeing to proceed with a revised treatment plan. A team of interdisciplinary specialists was assembled, including a Case Manager, a Physical Therapist and a Psychologist Pain Specialist, to assist with the patient’s holistic treatment – incorporating the biopsychosocial care model.

When the Case Manager identified the patient was struggling with depression, the team recommended psychological help for the patient. A wellness intervention was conducted and cognitive behavior therapy commenced, helping the patient shift her thoughts toward recovery rather than her pain.

Once the patient’s behavior and attitude toward her injury changed, she was able to make progress in her physical recovery. Within three months of physical therapy and her revised prescription, she experienced improved range of motion.

Additionally, the medical management team increased the patient’s physical independence with everyday activities and addressed her fear avoidance of car transfers and driving by enabling her with self-management tools. As a result of CorVel’s patient-centered approach and the team’s constant communication with the injured worker’s employer, the patient was able to return to work at a modified position.

Conclusion

Our Clinical Pain Management Program is centered on our integrated, interdisciplinary model. Potentially problematic patients are identified early. By working with all aspects of the patient’s injury, including comorbidities and other risk factors, and utilizing a team of diverse pain specialists, CorVel’s program delivers patients complete, quality care, instead of limiting them to the traditional managed care model. In doing so, CorVel simultaneously combats the industry’s growing dependence on narcotics and increases awareness of the impact of biopsychosocial modality of treatment in workers’ compensation.