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Where are the other insurers?

Noticeably absent from the Rx Drug Abuse Summit are non-work comp or Medicaid payers.  The third-party payer track is dominated by workers’ comp PBMs, payers, and researchers.  Sessions are well-attended, well-done, and worth while.

One wonders if private insurers selling group health or individual coverage don’t have problems with abuse of prescription drugs, or perhaps more precisely, don’t think it’s a problem for their business.

Well, it is.

Kudos to work comp for taking the lead on this critical issue.  Here’s hoping the rest of the world follows your lead; the chances for success are going to be much greater, and that success will come much faster, if private and public health insurers get involved.

One thought on “Where are the other insurers?”

  1. I administer a Taft Hartley plan and in the past worked for a Taft Hartley TPA and also managed corporate benefits for employers with 1000 to 5000 US employees. The abuse of prescription drugs varies depending on the population but for many plans it is a significant issue. I know administrators of construction trade Taft Hartleys who tell me that in some rural areas that as much as 50% of the adult population may have some form of addiction to both legal and illegal drugs. I know firsthand that the opoids can destroy lives and even entire families. But there are two constraints (whether real or perceived) that have deterred more aggressive intervention – first, the impact of HIPAA definitely makes many benefits professionals reluctant to more actively address individuals who may be abusing drugs and/or the doctors who feed the addiction. The other problem is that there is a veritable wall between workers’ comp and employer benefit plans and therefore, little coordinated effort or information sharing – even with many organizations the management of workers’ comp and the employee benefits plans is bifurcated.
    You are one of a few who understand the magnitude of this problem.

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Joe Paduda is the principal of Health Strategy Associates




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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