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Sep
9

If only Florida was like California

If only Florida (‘s commitment to patient safety and responsible prescribing and good workers’ comp medical care) was like California.

But…no.

The Sunshine State’s work comp regulators and legislators don’t seem to care about patient safety or employer/taxpayer costs – at least not when it comes to drugs.

 

If they did, payers wouldn’t have to:

  • pay an upcharge for physician-dispensed drugs,
  • argue that physicians aren’t pharmacists (yes, really),
  • argue that drugs dispensed by physicians should be evaluated for patient safety

Kudos to myMatrixx for weighing in on this and attempting to get insurers and employers involved. Alas if history is any indication, the vast majority of insurers won’t.

Neither will most employers.

I get workers’ comp premiums will continue to decline, leaving fewer and fewer dollars for administrative tasks, like, you know, government affairs.

I get workers’ comp is hugely profitable.

I also get that this will change – and when it does those insurers will be looking for nickels in the couch cushions – nickels (and dimes and dollars) they ignored when things were going great.

Right now, payers and employers need to weigh in and tell Florida regulators that Physicians are NOT pharmacies – and therefore patients don’t get to pick a physician to be their pharmacy.

This is a major patient safety issue; physician-dispensed drugs aren’t subject to many of the electronic edits that pharmacy-dispensed drugs are.

So, physicians are almost certainly giving patients drugs that:

  • duplicate patients’ other scripts
  • conflict with patients’ other scripts
  • aren’t appropriate for that patient.

What does this mean for you.

Fight your own battles. I’m not going to do it for you.

From a post way back in 2014…

There is NO reason, no rationale, no logic behind docs dispensing drugs to workers comp claimants.  

Proponents claim it is better care, leading to speedier recovery and lower costs.

We long suspected the opposite is true; that is, claimants getting drugs from docs get more treatment, incur higher medical costs, are out of work longer and run up bigger claim costs than claimants with the exact same injury who don’t get pills from their physicians.

Thanks to CWCI, we know that’s the real impact of doc dispensing.

Now, we know even more – we know that dispensing docs prescribe more opioids for longer times, thereby increasing the risk of addiction and drug diversion and overdoses and death.  Thanks to a research paper authored by Johns Hopkins University Medical School and Accident Fund, there’s clear and convincing proof that doc dispensing is a highly risky, very dangerous, and very expensive proposition.

Here is the money quote:

“we found 39% higher medical costs, 27% higher indemnity costs, and 34% higher frequency of lost-time days associated with physician-dispensed versus pharmacy-dispensed medication. We found even more striking differences related to physician-dispensed opioids versus pharmacy dispensed opioids. The effect was nearly doubled and revealed 78% higher medical costs, 57% higher indemnity costs, and 85% higher frequency of lost-time days associated with physician-dispensed versus pharmacy-dispensed medication. [emphasis added]


2 thoughts on “If only Florida was like California”

  1. Joe, say it ain’t so and don’t commingle non-opioid drugs with opioids when comparing CA to FL.

    You may want to review Fl Statutes, Sec. 465.0276:
    http://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&URL=0400-0499/0465/Sections/0465.0276.html

    FL was the first state to truly address the opioid crisis in 2011, when if created a PDMP and forbid the vast majority of physicians from DISPENSING opioids.

    CA us light years behind FL, when it comes to physicians dispensing opioids.

    1. Hello York and welcome to MCM.

      Thanks for the note. Unfortunately I have waaaaay too much experience in and with Florida.

      I didn’t “commingle” anything…the post was about physician dispensing and the shameful refusal of regulators and legislators – including Charlie Crist – to do the right thing. And laid out the research showing why it is not just expensive, it is bad medicine.

      But hey, if you want to talk opioids, let’s go.

      Re Florida and physician dispensing of opioids, the Sunshine State finally did something about opioids because its physicians were rampantly abusing patients and their right to dispense. This was in response to a crisis that was directly caused by the physician dispensing lobby co-opting regulators and legislators. Physicians should never have been allowed to dispense in the first place.

      Oh, and that PDMP? Well, not so fast. Florida’s PDMP was toothless until 2018; docs prescribing/dispensing controlled substances were not required to check the PDMP until 7/1 of that year. And they STILL aren’t required to check/report for kids under 16.

      That was a full 90 days sooner than California made PDMP usage mandatory – so there’s that.

      be well Joe

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Joe Paduda is the principal of Health Strategy Associates

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A national consulting firm specializing in managed care for workers’ compensation, group health and auto, and health care cost containment. We serve insurers, employers and health care providers.

 

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