Liberty Mutual Enhances Program Managing Workers Comp Pharmacy Costs
Posted on: Monday, 25 July 2005, 15:00 CDT
The first-of-its-kind approach to managing workers compensation prescriptions. Direct pharmacist involvement. And even deeper negotiated discounts.
These are the latest ways Liberty Mutual helps risk managers overcome one of their greatest challenges: controlling prescription costs for work-related injuries.
"Soaring medical costs - especially pharmacy - are now the biggest part of total wc expenses, surpassing wage payments," notes Mark Sidney, who manages claim operations for the area of Liberty Mutual that services large businesses. "To better control these, we recently fine-tuned our wc pharmacy program, adding and expanding tools that hit the drivers of pharmacy costs: the drugs prescribed and their price."
These enhancements include:
-- A new approach to managing wc drugs - Liberty Mutual is the first insurer to design drug strategies: medicines approved to treat specific injuries or body parts. Because some drugs are more appropriate right after an injury and others months later, Liberty Mutual built strategies for two distinct phases of treatment: acute (within the first 89 days of an injury) and long-term (90 + days from the injury). Other insurers rely on traditional formularies - a single broad list of medications for any work-related injury at any point in the claim. Filling a prescription under Liberty Mutual's drug strategy model requires it match one of the medicines approved for the claimant's exact injury type or body part and treatment phase. Drug strategies benefit risk managers twice. First, the right medicines are used at the right times, assisting the recovery of an injured worker while controlling costs. Second, only prescriptions for work-related injuries are covered. A claimant with a sprain could likely fill a prescription for an antibiotic under a formulary model. Why? Because antibiotics could be on a list of approved medications, since they're appropriate for certain work-related injuries. But Liberty Mutual's drug strategies would not automatically allow an antibiotic prescription to be filled for a sprain, since the medication wouldn't be appropriate for this injury, unless there's a break in the skin. -- Direct pharmacist involvement in managing claims - Now Liberty Mutual's managed pharmacy program links claim managers with registered pharmacists. This helps improve outcomes and control costs by quickly raising and resolving: -- Concerns about drug therapies. Should a claims manager question the effectiveness of a particular prescription, they can review the issue with a clinical pharmacist -- Dangerous drug interactions, addiction and fraud. Claim managers are notified anytime a claimant has prescriptions from multiple physicians. Working together, claim managers and pharmacists look for any alarming duplication, usage patterns or potential interaction -- Expanded discounts - While negotiated discounts were a key part of Liberty Mutual's earlier pharmacy management effort, the enhanced program now boosts the savings available by capturing prescription rates often below retail and state fee schedules. More than 55,000 pharmacies countrywide are now in the program, including most of the major national pharmacy chains"Good got better," is how Sidney describes the updated program. "And while these enhancements help our policyholders better manage a key expense, we'll continue to build new tools for controlling all of the costs of workplace injuries."
About Liberty Mutual:
Managing a business is challenging. Protecting that business doesn't have to be. So for more than 90 years, Liberty Mutual Group (LMG) has protected companies and families from the risks they face: from providing for injured workers to safeguarding homes, and everything in between.
And as the complexity of our clients and their risks grew, so did we. Today, we're a leading global insurer. With more than 38,000 employees in nearly 900 offices throughout the world, LMG offers a full range of products and services, including commercial multiple peril, commercial automobile, general liability, workers compensation, global specialty, group disability, assumed reinsurance, fire, surety, personal automobile, and homeowners.
$19.6 billion is one measure of our success in using these to meet the insurance needs of companies and individuals. That's our consolidated 2004 revenue, which earned us spot 111 on Fortune's ranking of the largest 500 U.S. companies.
Source: Business Wire
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