Help Me Obi-Wan Kenobi…You’re My Only Hope!
I’m linking to my newsletter of October 29, regarding Zohydro ER, the pure hydrocodone just approved by the FDA.
Many of our clients and colleagues are rightfully concerned about this new narcotic, and the most often asked question is, “How do we address this new risk?”
I’m no Luke Skywalker, but we can help. Although it may be some period before the scientific literature and guidelines catch up with this new drug, you can assume it will hit the streets ASAP.
So what’s the answer? As usual, it’s the basic blocking and tackling fundamentals of aggressive UR/case management:
- Network – Does your network include every rogue/storefront clinic, or are you taking steps to limit approved providers?
- Early Intervention – Through UR, PBM report monitoring and risk triggers, it is key for the nurse case manager to become involved early in the claim.
- Communication – Are your claimants/patients fending for themselves, or do you have involved case managers who educate, motivate and cajole?
- Treatment Plan Accountability – Do your primary care physicians welcome your involvement? Will they consider alternative and non-traditional methods to improve outcomes?
- Peer-to-Peer Intervention – Will your physician advisors personally address/challenge the treating and specialty providers? Or do they just drop the report in the mail? Does your review vendor match physician credentials, or do they just send a pharmacist or pediatrician to challenge the neurosurgeon?
Call us. We can do better.