Third Coast Underwriters Workers’ Comp: A Piece in Solving the Opioid Puzzle

Prescription opioid abuse is a widespread epidemic in the United States recognized throughout all levels of government as well as the by Center for Disease Control (CDC). The risk and prevalence of addiction, abuse, and the number of deaths associated with opioid abuse is something local governments, employers, insurance carriers, families, and communities face on a daily basis. As the risk of opioid abuse has risen, Third Coast Underwriters (3CU) has developed unique strategies to confront this growing epidemic.

While there is no quick fix or single solution to this problem, 3CU engaged in a multifaceted approach to steadily bring positive change to this complicated issue.

One approach developed by 3CU includes the use of a predictive analytic tool for early identification of claims with strong indicators for inappropriate prescription of opioids. When a case is flagged, nurse case managers can assess the situation and determine which intervention is necessary. In many cases, this early detection allows open discussions with the prescriber about the amount or duration of the opioid prescribed, and with the injured worker to educate them about the risk. Working with their on-staff pharmacist, the nurse also discusses other non-narcotic alternatives to pain management with the prescriber. The ultimate goal is to help reduce the risk of dependency and addiction in the future. Data from AF Group (parent company of 3CU) shows that from their interventions, there has been more than a 25% decrease in the number of opioid prescriptions since the programs inception in 2012.

While the opioid abuse problem is multi-layered, an encouraging new study shows that efforts in reducing addiction in the workers’ compensation industry are beginning to pay off. The Workers Compensation Research Institute (WCRI) recently released a study that observed noticeable decreases in the amount of opioids prescribed per work comp claim in a number of states. This report serves as a tool to monitor ongoing changes in opioid utilization in 26 state workers’ compensation systems.

“This research is certainly encouraging news,” said Paul Kauffman, director of Medical Management and Corporate Claims at AF Group. “After years of study and first-hand observation of the catastrophic effects opioids can have on an injured worker, the research supports the value of our commitment to minimize the detrimental effects of long-term opioid use to our injured workers. The opioid abuse battle is something we feel passionately about and we will continue our rigorous efforts to combat the issue and advocate for our injured workers and employers.”

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