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Artemis Emslie, Tampa, Florida-based CEO of pharmacy benefit manager Matrix Healthcare Services Inc., has served in her role since 2012 and has nearly 25 years of experience in both the workers compensation and group health industries. Her firm, which does business as myMatrixx, was founded in 2001 and continues to grow. She said myMatrixx leverages technology to bridge the gap between the clients it serves and the needs of injured workers. She spoke recently about trends and issues in workers comp with Business Insurance reporter Louise Esola. Edited excerpts follow.
Q: A buzzword in workers comp right now is advocacy. What is being done to improve service for injured workers and why?
A: We can start with the why, because the why is really simple in the fact that we are firm believers in really championing the message of kind of changing the face of workers compensation from an adversarytype model to an advocacy-type model.
And we’re doing that for the simple reason that if you think about all the money that a company deploys to retain and engage their workforce and then somebody in that workforce gets hurt on the job, all of a sudden this really odd environment can be tricky to navigate. And it feels like, or it has felt like in the past, that people are just going to say "no" or are just going to reduce cost by denying the claim.
And we feel pretty strongly that “no” is not necessarily always the right answer. The right answer is to help them navigate through their claim and educate them and engage with them for a positive impact. And what we do see is that when you do that, people are more likely to get involved themselves in helping — in our case, medication therapy — but also helping close that claim, helping them get back to work quicker. And not to lose sight, they are less likely to call an attorney because they’re mad or because they feel like they’re not being treated fairly.
Q: What are some of the areas for improvement in workers comp as you see them?
A: I think we have a long way to go educating on patient advocacy. I think we have to start being more conscious about how do we integrate and collaborate with each other and all of the different stakeholders. There’s a sense of, “if I hold the data, I have the power.” And I think that as an industry, if we come together and collaborate, we’re going to achieve better outcomes. Thinking about the patient as a whole — not just the physical injury, but the mental and the spiritual aspect of the patient — is what we have to consider. Again, patient advocacy is a part of that, but I believe (education) is the next direction we’re going in.
Q: Opioid prescribing is under attack by way of state legislation and formularies. How do you view this shift?
A: I think it’s long overdue. I think workers compensation is way behind the eight ball on opioid management. And not to say that opioids used in the right scenario for the patients that they help are a bad thing.
When I think about workers compensation, I think that we as an industry accept that if the medication’s related to the injury in some vague way, it’s OK to dispense with not having a little bit more control over that. I believe that this is not a new topic.
This is a relatively old topic that now is getting the right amount of press, the right amount of attention to actually reduce (overprescribing). And we’ve seen opioid reduction occur in our population. I think overall you could claim that opioid reduction is occurring in workers compensation. And I think that comes from the increased visibility from the states, the increase in visibility just from the nation. I think that we’ve made really good progress on that. I think that as the states are starting to look at opioids, they shouldn’t just be looking at opioids, but they should be looking at the bigger picture, which is: What’s the right legislation to put in place that helps payers and/or their partners manage medication therapy as a whole? There’s a lot more that we could do from a legislation (standpoint).
Q: What's being done to reduce prescription drug costs in comp?
A: Workers compensation drug costs have already come down significantly. And the industry as a whole, through the payers contracting with PBMs and the competitive nature of that marketplace, has already closed the gap. So there was this old belief that a drug in workers compensation was so much more expensive than a drug in a commercial plan, and that was absolutely the truth. But as soon as you allowed competition and as soon as you gave payers the ability to negotiate, price became highly competitive.
Q: What are the key technological innovations that you're seeing in workers comp claims handling at the moment, and how are they being used to restrain costs and improve service for injured workers?
A: I think the biggest area of technological advancement is using mobile technology to engage with patients.
Everybody has a smartphone. People are used to it. They interact very easily on their phones. And allowing stakeholders to touch a patient via a mobile app with really quick bites of information, or video, or a picture helps increase engagement for the patients and ultimately, hopefully, (creates) overall better outcomes.
Q: MyMatrixx is growing and celebrating its 16th year in business. Can you talk about what is driving the company's strategy and what’s to come?
A: We were founded on the core principles of making managing a patient or an injured worker’s medication therapy easy for anybody — for the patient, for the claims handler that might be handling the claim. We do that with leveraging technology and providing really quick, actionable data. If you treat the people that you work with correctly and right and you keep them happy and engaged in the workplace, that extends to the client base. There’s a ton of different ways we get there, but at the core, making it simple for somebody to manage their medication therapy and doing it with a smile and being happy about going to work every day is definitely driving that success.