2017 overall cost and utilization trend
When analytics, clinical tools and expertise, network enforcement, and advocacy in government affairs harmonize, positive change is the result.
The 7.2 percent reduction in average prescription cost per claim highlight the ongoing importance of working collaboratively to control both cost and utilization. These metrics both declined over the period.
Note: An analysis of paid, in-network workers’ compensation prescription transactions managed during the twenty-four month period, 2015 - 2016, associated with more than 500,000 claims indicates average wholesale price inflation has returned to more historical levels.
For the last several years, Optum has been tackling the biggest challenges in workers’ compensation pharmacy benefit management by collaborating with our clients and other stakeholders throughout the system. These efforts are delivering promising results. Looking forward, we will continue to work together to help ensure claimants receive the right medications at the right time, throughout the claim lifecycle. Specific to the remainder of 2017 and into 2018, we are engaged in efforts addressing industry trends, including:
- opioid analgesic utilization management
- expanded use of statistical analysis in claim management
- state-based formularies and other regulatory changes
- applicability of alternative therapies in chronic pain management
- enhancement of claims management portal technologies
- stakeholder education
Through these and other efforts, we will continue to evolve our pharmacy care services and make a positive difference in the lives of those we serve.
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