White papers

As thought leaders, we pursue better, healthier, more sustainable outcomes. Here you’ll find research findings and analytical insights shared by the dedicated experts at Optum.

  • Working Together to Achieve Better Outcomes: How Using State-Specific and PBM Formularies is a Benefit

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    August 2015
    ​With many states implementing state-specific closed formularies for the workers' compensation industry, the question is often asked, "What is the difference between a state-based formulary and a Pharmacy Benefit Manager (PBM) formulary?" This white paper discusses the differences and how the best of both worlds is when they work together. Click here to read more.

  • Common Comorbidities: How Comorbid Conditions Impact Workers' Compensation Claims

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    Hypertension, Diabetes, Insomnia, Depression, Workers' Compensation, Comorbidities

    July 2015 
    ​Following our blog series on common comorbid conditions found in workers' compensation, this white paper provides information on how conditions such as hypertension, heart disease, insomnia, obesity, depression, arthritis, diabetes, substance use, and aging can impact claims and their influence on medication therapy. Click here to read more.

  • Shining a Light on MEDs: Understanding Morphine Equivalent Dose

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    Opioids, MED, Morphine Equivalent Dose

    July 2015
    ​In the workers’ compensation industry, 60.2% of claimants utilize opioid analgesics for the treatment of pain caused by a workplace injury. But with the use of opioids also comes inherent risks, such as addiction, tolerance, dependence, misuse, abuse, and even death. Because of this, it is important to understand the potency of the medications being prescribed and when additional caution and monitoring is warranted. That is what the morphine equivalent dose (MED) helps provide. This paper explains what MEDs are, how they are used in workers' compensation, and provides case studies on determining calculations. Click here to read more.

  • Ensuring Payer Compliance with Mandatory Insurer Reporting Requirements

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    Mandatory Insurer Reporting, Workers' Compensation

    May 2015 
    ​Section 111 of the Medicare, Medicaid and SCHIP Extension Act of 2007 (MMSEA) establishes Mandatory Insurer Reporting (MIR) as a requirement for group health, liability, no-fault, and workers’ compensation insurers/plans. But the MIR process is complex and requires specialized expertise. Learn what to look for when selecting a partner to achieve compliance. Click here to read more.

  • Coding Systems: Understanding NDC and HCPCS Codes

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    Durable Medical Equipment, Ancillary, Workers' Compensation

    January 2015
    ​The standard coding systems used in workers' compensation can be daunting and confusing. This white paper answers questions about the coding systems and how you can better navigate their use. Click here to read more.