Workers’ Comp Insurer Launches Narcotics Program for Injured Workers

Accident Fund Holdings, Inc. recently created a comprehensive narcotics program to help reduce the health risks associated with narcotics and provide a mechanism for injured workers to return to work sooner.

Opioid medications are now being prescribed at higher dosages in pure form and are routinely making their way into the hands of injured workers without the proper controls, regardless of the health risks.

Escalating problems such as overdose, addiction, and even death have reached epidemic proportions, according to the Centers for Disease Control (CDC), and are now commonly reported in association with workers compensation claims with 55-85% of injured workers across the country receiving narcotics for chronic pain relief.

“The growing public concern, the burden of this drug on insurers, and the health risks to the injured worker are a real and a major concern,” Donald Bearden, D.O., corporate medical director for Accident Fund Holdings, said.

Accident Fund Holdings has been monitoring the use of opioids to manage chronic pain for years and the results of a recent study completed in 2011 with the Division of Environmental and Occupational Medicine at Johns Hopkins School of Medicine has validated the scope of this problem.

“The extent of the issue was not fully realized until we linked our pharmacy data to our claims data,” Jeffrey Austin White, director of Medical Management Practices and Strategy for Accident Fund Holdings and the individual running point on the development of the over-arching strategy, said. “In hindsight, it appears we were focused primarily on monitoring drug cost, along with the rest of the industry, rather than the impact of the drug on the injured worker.”

The narcotics program has been under development at Accident Fund Insurance Company of America, a subsidiary of Accident Fund Holdings and will be expanded to all of Accident Fund Holdings’ companies including United Heartland, Third Coast Underwriters, and CompWest.

The primary components of the program include early detection software, activity driven workflows, and peer-to-peer intervention strategies.

“We are extremely happy with our preliminary results,” Paul Kauffman RN, director of Medical Programs for Accident Fund Insurance Company of America, said. “Over 70% of our providers have been willing to adjust treatment protocols and monitor the use of opioids by our injured workers. Of the over 200 injured workers that were touched by the program during the introductory period, over five percent have been weaned from narcotics and are already back to work.”

Failure to return to work as a result of opioid addiction is a major problem that the workers compensation industry faces in 2012 as state regulations lack controls and new drugs are being introduced to the market. Accident Fund Holdings hopes this program will help reduce the health risks of these drugs on our injured workers and ultimately provide a mechanism for them to get back to work sooner.

“There is no simple solution to this problem,” Patrick Walsh, vice president and chief claims officer for Accident Fund Holdings, said. “It requires a multidisciplinary approach that relies heavily on state of the art technology and a commitment to communication and learning which will drive continued improvement in our efforts.”