SAN JOSE, California - June 07, 2012 -- (EON: Enhanced Online News)--With prescription drug abuse near epidemic proportions and the FDA’s initiative to educate medical providers on the use of opioids, EK Health Services is well ahead of the curve.
“They were paying huge medical costs on cases that had been open for years, especially those involving chronic pain and costly medications with high dependency risks.”
A national leader in medical and disability management services, EK Health− through its Next Step Medical Advisory Program℠ − has created a track record for successfully transitioning injured employees from drug dependency to recovery.
The proprietary program has shown measurable success in helping injured workers reclaim functionality and a productive life, while helping payers save substantial dollars in one of the most costly components of workers’ compensation medical claims – drug expenditures.
EK Health created the exclusive program to resolve stagnating workers’ compensation claims, especially those that are complex, costly and involve poly-pharmacy and potentially addictive pain medication.
The program’s approach helps insurance carriers, employers, injured workers and medical professionals by converting patients to less costly treatment alternatives that follow evidence-based medical guidelines, including ACOEM's Practice Guidelines, considered the gold standard in effective treatment of occupational injuries and illnesses.
“We developed the program in direct response to clients who asked for help with claims that plateaued and showed no progress towards maximum medical improvement, permanent and stationary status, and settlement,” said Pamela Otto, Director of EK Health’s Next Step Medical Advisory Program℠. “They were paying huge medical costs on cases that had been open for years, especially those involving chronic pain and costly medications with high dependency risks.”
The program is a collaborative approach involving senior EK Health physicians, case managers, and project coordinators to provide a comprehensive review and recommendation. Through file review, round-table discussions with all stakeholders, and peer-to-peer physician communication, this team effort helps move a case to closure and settlement.
Since creating Next Step Medical Advisory Program℠, EK Health has documented success stories. One case involved OxyContin in which a payer saved $249,000 in a three-year-old case of a worker with complex regional pain syndrome of an upper extremity with no documentation of increased function.
In this real life case, medication costs for one year, per California DWC pharmacy fee schedule, was $21,178. Through Next Step's intervention, which included file review recommendations, plan of action and multiple peer-to-peer conversations with the primary treating physician, the carrier secured a compromise and release settlement saving over $200,000.
Among the cases the program targets are those with prolonged Temporary Total Disability (TTD) greater than one year, medical costs that exceed $25,000, unanticipated medical care and costs beyond original injury and long term cases with no expected closure date.
ABOUT EK HEALTH
Founded in 1998 and headquartered in San Jose, CA, EK Health Services is a URAC accredited leading national workers’ compensation managed care company specializing in case management, utilization, peer and bill review services for insurance companies, employers, for-profits and public entities.
For EK Health
Mary Estes, 813-839-3324