20 JANUARY 2014 60th Anniversary Claims Magazine PropertyCasualty360.com
cal costs, it will be important for insurers
to pay close attention to state specific ef-
forts to combat prescription abuse. With
the right amount of actuarial research and
advanced analytics, workers’ compensa-
tion insurers can develop a better under-
standing of their opioid exposed popu-
lation and the prescribing habits of the
physicians treating their injured workers.
To the extent insurance companies can
leverage the above strategies in combina-
tion with their own analytics, physician
educational efforts, evidence-based pain
diagnoses, utilization reviews, and tort re-
form efforts (e.g., In 2011, the 79th Texas
Legislature adopted a closed formulary
system which led to a 70 percent decrease
in Schedule II narcotic costs), we believe
insurers can move the needle on reducing
opioid abuse and addiction.
In the end, these opioid risk management strategies may not only generate
dollar savings to workers’ comp insurers
as workers return to work sooner, but will
also help improve the quality of life for the
injured worker and his or her family.
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Kevin M. Bingham is a principal at Deloitte Consulting LLP in Hartford, CT and
leader of Deloitte’s Claim Predictive Modeling and Medical Professional Liability
practices, immediate past chairperson of
the American Academy of Actuary’s Medical Professional Liability Committee, and
an official Academy spokesperson.
Alix C. Michel is an attorney at Michel
& Ward in Chattanooga TN specializing
in the defense of all types of healthcare
professionals, hospitals, long term care
facilities, and educating society on the
dangers of RX Drug Diversion and strategies to help in the fight against same.
David J. Ward is an attorney at Michel
and Ward in Chattanooga TN defending
and advising physicians, healthcare providers, long term care facilities and other
professionals in professional malpractice
litigation, professional licensing investigations and healthcare practice issues.