Irrespective of overwhelmingly positive data published on appropriate UR decisions, the UR process becomes a target of criticism. Largely driven by a lack of understanding, a push to unravel this layer of protection for injured workers persists. The overutilization of unnecessary medical care is not a benefit, it is a risk. Here are my thoughts on how the King case may motivate this movement come next year’s legislative session.
California Workers’ Compensation
Tragedy has a way of spurring unexpected outcomes bringing people together from all walks of life and disciplines. Here are my observations on the paradigm shifts happening throughout workers’ compensation partly due to the global tragedy that is the opioid epidemic.
Another important July 1st deadline has come and gone for the California workers’ compensation community. As of mid-June, nearly half of California’s Utilization Review Organizations had yet to complete the accreditation process required by newly modified Labor Code section 4610(g)(4). Is the crawl to compliance due to a complacent system culture or a costly and complex accreditation process?
The crux of the opioid crisis is in unchecked, inappropriate prescribing habits. Absent of comprehensive medically responsible prescribing standards, today’s opioid issue has the potential to evolve into another prescription drug crisis. Are narrow legislative bills enough to keep injured workers safe and encourage a paradigm shift among prescribers?
Health care information technology may be making the world smaller in many ways, but wide divides remain in the care and claims continuum. Bridging the gaps in the workers’ compensation space requires a conscientious focus on collaboration, human to human. Collaboration effectively creates an interactive and adaptable system capable of delivering improved patient health outcomes.
The U.S. House of Representatives has held numerous information-gathering meetings. The divide that exists between state and federal government has never been more clear as the feds turn their focus on the success that state workers’ compensation systems are having in the war on opioid abuse. But, are all aspects of the crisis being considered?
The importance of the National Guideline Clearinghouse™ (NGC) cannot be validated by someone continuing the work. Its importance was established in 2008 by U.S. Congress. Without appropriate oversight in the development of this content, anything might be called “quality” imperiling the well-being of injured workers. Here is my take on why “WorkComp Needs Quality Measures for Clinical Practice Guidelines”.