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Proactive steps to monitor opioid prescriptions may help injured workers

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PHILADELPHIA — Without waiting for regulations to kick in to tell payers and providers when to monitor prescription medications and when to cut back, experts say companies can be successful in keeping injured workers off opioids and dangerous drug combinations by better keeping tabs on pills. 

That’s what is working for Lake Buena Vista, Florida-based Walt Disney Parks and Resorts U.S., a representative with its pharmacy benefits management program and its claims manager told attendees at the Risk & Insurance Management Society Inc. conference in Philadelphia on Wednesday. 

“(The industry is) starting to understand that we need to help with (opioid prescribing) from an employer standpoint,” said Brigette Nelson, Scottsdale, Arizona-based senior vice president of workers compensation clinical management at Express Scripts Holding Co. 

Barry Dillard, director of claims management of Walt Disney Parks and Resorts U.S., told attendees the key is to be proactive at the onset of an injury. He mentioned “compassion” and “triage” as important first steps.

Disney refers to its 70,000 employees who work in all the facets of the resort’s operations—from beverage management and acting to merchandise and theme park operations—as “cast members.” The company operates on-site clinics for injured workers, a step in ensuring the company has a grasp on the worker’s care at the onset, said Mr. Dillard of the company’s self-administered and self-insured workers compensation program. 

A key to Disney’s handling of injured workers is its pharmacy program’s clinical oversight, which includes a pharmacy task force to look at trends and outliers among injured workers. The company also has clinical roundtables and raises “red flag alerts” if a worker’s prescriptions are out of line with standard care.

“The first issue we tackled was opioids,” Mr. Dillard said of the company’s own monitoring of prescriptions among workers. 

Ms. Nelson, who works with Disney, said as a result, “opioids aren’t a problem with (Disney).” 
“(Their program) helps us understand what is happening with those injured cast members,” she added. 

She said that such a program, put in place before regulations began putting opioid prescribing under the microscope, gave Disney an early edge. “It’s really the outreach from the nursing case managers and the medical director that makes the difference,” she said.