CorVel Services Uncover Patient Risk
In this increasingly costly and complex healthcare environment, payors need to have tools and strategies necessary to govern an effective workers’ compensation program and provide the best quality care and outcomes for patients. CorVel brings a unique solution with the integration of Pharmacy Management and Medication Review Services. We are able to identify variances in patients’ drug usage, triggering our expert panel of pain management physicians to reach out to the treating physicians to address issues as soon as they are identified.
As a part of our Medication Review Program, we examine the patient’s entire drug history to determine medical necessity, consider alternative medications and treatments, and ensure best practices for pain management. The following is a case that illustrates the experience of a CorVel patient.
A patient with a history of low back pain and lumbar degenerative disc disease sustained a hip injury in the workplace after lifting a box. The patient was seen by a spine surgeon that recommended lumbar epidural steroid injections and conservative pain management. Instead, the patient’s primary care doctor prescribed several short-acting narcotic pain medications and muscle relaxers as the patient’s therapy plan.
Due to inappropriate narcotics usage, this case was selected for further evaluation. The Medication Review Report revealed that short-term narcotics were being used as long-term solutions to pain, and additional medications were being prescribed by alternative physicians. CorVel’s pain management physician determined that the patient’s drug therapy program was grossly unnecessary and recommended a gradual discontinuation of all pain narcotics. CorVel worked with the treating physician to begin an alternative treatment plan that consisted of physical therapy and medically necessary appropriate medications.
CorVel understands that managing medication usage is much more than just prescription utilization, it is also about ensuring appropriate care for an injured workers return to work. Not only did CorVel’s Medication Review result in a calculated medication saving of $62,000 over the life of the claim (Calculation based on National Vital Statistics Report), it also addressed issues of patient risk for inappropriate narcotic use and provided an alternative treatment plan appropriate for the injury.