It isn’t news to any claims professional that we’re in the midst of an addiction crisis triggered by the misuse and over-scripting of powerful opioid narcotics.
These powerful allies in the fight against pain and injury are becoming, too often, stumbling blocks on the road to a better tomorrow... That’s where Rx Profile from Gallagher Bassett comes in.
Rx Profile is a key tool for GB in addressing the epidemic through early identification of claimants at risk of becoming addicted to narcotics. In the hands of the GB Resolution Manager, it becomes a vital decision-support tool. Enabling the RM to identify injured workers who are at or above accepted guidelines for opioid therapy, dosage and duration. Those who fall outside the safe guidelines are discussed in a collaborative, engaged team meeting between Resolution Manager, Branch Manager and an experienced nurse. Together, they determine whether a Drug Utilization Assessment or Peer to Peer intervention is warranted to get treatment back on the best possible course.
Like Waypoint, Rx Profile takes into account various claim, claimant and clinical data to unlock and more precisely identify at-risk individuals. Scoring is the result of an algorithm that weighs multiple claim, prescription and provider utilization components.
We recently conducted an analysis to determine the impact of Rx Profile in cases where Rx Profile recommended P2P/DUA intervention. The impact was significant in terms of outcomes post intervention.
- 18% reduction in number of prescriptions
- 21% reduction in drug spend
- And critically, we also saw an 11% reduction in narcotics scripts and 15% reduction in narcotics spend.
Early identification and treatment can make all the difference in the trajectory of a claim. And in the life of a person suffering.