AmTrust battles impacts of opioid crisis on workers’ comp

Since the inception of the program, the company has seen a significant drop in prescription opioid claims

AmTrust battles impacts of opioid crisis on workers’ comp

Workers Comp

By Alicja Grzadkowska

Despite increased attention from the media and government, the opioid crisis continues to plague the United States, and in turn has implications for workers’ compensation insurance. To address the risks associated with employees’ overuse of opioids, AmTrust Financial Services has partnered up with pharmacy care management company Optum Workers’ Comp and Auto No-Fault to implement processes that have driven down overall opioid prescriptions to insureds’ injured employees.

“The longer that an injured employee is treated with opioids and they’re masking their pain, the less likely it is that they’ll go back to work, and if they do go back to work, it’s not a safe environment,” said Melissa Burke, head of managed care and clinical at AmTrust. “We are very focused on making sure that they’re returning to work with a personalized approach that allows them to be safe in the workplace. Opioids have side effects of drowsiness and dizziness, and they create confusion. They’re not the answer because they are not addressing the pain.”

Since the inception of the program with Optum a year ago, AmTrust has seen a significant reduction in the percentage of prescription opioid claims, which dropped from 60% in Q4 of 2017 to 25% in the same quarter in 2018, according to the company’s “Opioid Prescription Risk Report.”

There have been other improvements, too, with drops in both the average daily supply of opioids and the average number of transactions per claimant.

“The partnership with Optum allowed us to bring nurses to the front lines – nurses that have pharmaceutical knowledge to be able to identify when medication is appropriate or not,” said Burke, adding that within the program, “We have those nurses dedicated to reviewing claims as soon as they come into the pharmacy.”

While awareness among employers about the dangers of opioids is growing, there is still room for improvement. Companies can provide random drug testing, and be aware of their employees’ impairments. Besides getting employees back on their feet faster, addressing opioid use can also help bring down the costs associated with injuries over the long-term.

“When pain is addressed appropriately and treatment is provided, we get off of the opioid escalation and stop the focus on pain,” said Burke. “Our drive is to get to the right treatment, not just continuing down that opioid road.”

With its Optum partnership and ongoing work addressing opioid use, AmTrust has thought outside of the box, and set itself apart from competitors.

“We know our customer. We spend time understanding them, and we value that small business since that is our customer base,” explained Burke, adding that those businesses can be especially impacted by injured employees since they already have a small number of staff to begin with. “It’s important that we’re able to focus on the needs of our customer and bring those injured employees back to work as soon as medically appropriate and as soon as they can be successful in the workplace.”

She continued: “We are on the front lines in many ways of the opioid epidemic. I think that we’re being as proactive as we can be and that makes us different.”

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