Publications

12/01/2016
Danielle Lisenbey NYCA Claim Executive of the Year
ATLANTA (Dec. 1, 2016) – Danielle Lisenbey, Broadspire® president and CEO, has been named Claim Executive of the Year by the New York Claim Association, Inc. (NYCA). The 2016 NYCA Holiday Dinner Gala will be held in her honor Dec. 10 at the Harvard Club of New York.
09/30/2016
Medigram Vol 26
If you have been following the media, both mass media and medical sources, you have probably noticed an onslaught of research and articles casting doubt on the effectiveness of many medical interventions. Some of these studies have been highlighted in this very newsletter. Many "standard" and highly-regarded medications, procedures and surgeries have been cast into doubt, generating concern on the part of both patients and physicians. Why is this happening and how should we react to it?
09/29/2016
Safe Patient Handling White Paper
Healthcare organizations are now engaged in Delivery System Transformation (DST), whereby performance-based incentive payment programs are used to support and reward hospitals for investing in projects that advance care and population health while lowering costs. In these efforts, it becomes critical to understand causes of patient handling and mobility workers’ compensation injury claims. Until now, programs that are self-administered or utilize a Third Party Administrator (TPA) have differing, if any, codes to determine employee injury trends.
08/09/2016
Medigram Vol 25
Zika is a viral illness which causes mild symptoms resembling influenza in most individuals: fever, rash, joint and muscle achiness, headaches, conjunctivitis (red eyes), etc. Hospitalization is very rarely needed, and there is no specific vaccine, or treatment other than rest, fluids, and medications to bring down the temperature and relieve pain. Acetaminophen should be used for this purpose, but not aspirin or NSAIDs (Motrin, Advil, etc.). The condition is self-limited and typically resolves within a week. As with many other viral infections, a very few patients can develop a neurologic complication known as Guillain-Barre Syndrome (GBS), which can persist for a long time. Zika can be definitively diagnosed by blood or urine testing of suspected cases.
06/30/2016
Medigram Vol 24
It is generally-accepted, and evidence-based knowledge that it is important to return-to-work as soon as possible after an injury or illness, or even to attempt to stay-at-work throughout the healing process, if it is at all prudent and possible to do so.
06/06/2016
Medigram Vol 23
In the clinical practice of medicine, as well as in the medical management tools we apply to facilitate high-quality care and timely return-to- work (RTW), guidelines play an important role. This issue of the Medigram is dedicated to discussing various types of guidelines: how they are developed and applied, and the impact they may (or may not) have in the delivery of medical services.
05/13/2016
Medigram Vol 22
Practicing medicine, or making decisions about the appropriateness of treatment, and the presence and extent of disability, is not always a straightforward issue. How many times have you heard the "experts" change their minds about whether a certain vitamin is useful, or whether eggs and coffee are good or bad for you?
03/25/2016
Medigram Vol 21
In previous Medigrams, we have discussed the biopsychosocial model of pain, which essentially postulates that the perception of pain is modulated by psychological determinants as well as by social, cultural and even economic factors. This issue takes a closer look at the research defining how psychosocial factors have been found to influence very specific workers compensation and non-occupational conditions and outcomes.
02/24/2016
Medigram Vol 20
It seems appropriate, in this initial 2016 issue of the Medigram, to preview some of the medical initiatives that will be implemented, or enhanced, in the first quarter of the year. We are constantly identifying, and evaluating via outcomes analysis, new medical management products and programs that can contribute to improved quality and cost-effectiveness.
12/16/2015
Medigram Vol 19
The holiday season is upon us, with all the good feelings and happy events that surround it. However, it is also a time of particular risk from a health perspective. A considerable body of research has pointed to a heightened frequency of unfortunate medical events that seem to occur at this time of year. The evidence does not always pinpoint whether the culprit is the winter season itself (for those of us who live in cold climates) or the celebrations and lifestyle changes that happen in this period, or other less well-defined physical or social factors. But let's review some of the findings and some preventive measures that may be helpful.
12/15/2015
Medigram Vol 18
Drugs are Food and Drug Administration (FDA)-approved prescription medications which have specific clinical indications for therapeutic use, and have been rigorously tested/reviewed and found to be safe and efficacious at designated dosages.
11/19/2015
Medigram Vol 17
Broadspire is unique among third party administrators (TPAs), and most carriers, in having its own in-house Physician Review Services (PRS or peer review) unit. Currently our panel consists of 250 physicians in 45 different specialties and sub-specialties located all across the nation. A core group of 20 of these independent contractor physicians (and psychologists/physical therapists/chiropractors) performs its reviews on-site at our Sunrise, Florida managed care headquarters. The reviews span a wide range of benefit plans including workers compensation, auto and general liability, product recalls, short/long term disabilities and other absences.
10/08/2015
Medigram Vol 16
This issue will discuss tools that can be used to predict outcomes of a workers compensation claim, and specifically the likely duration of a claim from onset to return-to-work. Since this is one of the key objectives in claim management, it is useful to have a sense of how long this may take in any particular claim, taking into consideration some of the key demographic, occupational and clinical factors that pertain to that claim.
10/01/2015
On the Frontline: Inaugural OTF issue
On the FrontLine provides you with ‘ground-level’ insight from across the insurance industry, government and academia into the very latest in risk management thinking. Each edition aims to take you as close as possible to the threats we face by speaking to those hands-on in dealing with these on a daily basis.
08/24/2015
Medigram Vol 15
In this issue we will take a look at some causation issues. This will be approached from a clinical/scientific perspective, and will not address the complex jurisdictional regulations that may apply in causation and compensability determinations in various states. These considerations are certainly important but are well beyond the scope of this newsletter.
07/23/2015
Medigram Vol 14
We have all seen the statistics, so there is no need to repeat them here again. Controlled substances, and opioids in particular, are overused, abused, cost payers a great deal of money, are often detrimental to the health (and very lives) of our claimants, as well as to their timely recovery from injuries and return to work.
06/29/2015
Medigram Vol 13
Radiology studies play a major role in workers compensation, since diagnosis and therapy are determined in part on the basis of accurate visualization of bone and soft tissue structures which have been, or are alleged to have been, injured.
05/13/2015
Medigram Vol 12
In a previous Medigram (Vol 7, Nov 2014), we explored the definition and process of evidence-based medicine, beginning with well-designed research studies, filtered through expert consensus-driven evaluation and peer review, and then incorporated into the development of referenced clinical guidelines.
04/07/2015
Medigram Vol 11
The Workers Compensation Research Institute (WCRI) is an organization that "takes the pulse" of our industry in accordance with the following mission statement:
03/12/2015
Medigram Vol 10
The current measles outbreak in California, now rapidly spreading to at least 16 other states, is a reminder that infectious diseases still require vigilance, that vaccine-preventable infections may reappear if our compliance levels decrease, and that attention to adult immunization guidelines remains a priority in order to help prevent workplace disability.
02/11/2015
Medigram Vol 9
Low back pain (LBP) affects at least 80% of us some time in our lives, perhaps 20-30% of us at any given time. It is the fifth most common reason for all physician visits in the U.S. It is usually recurrent, and subsequent episodes tend to increase in severity. It is common in individuals who lead sedentary lives and in those who engage in manual labor. It can occur at any age but is most prevalent during the third to sixth decades of life.
01/10/2015
Medigram Vol 8
As you are well aware, pain is one of the issues we grapple with on a daily basis in the management of our workers compensation claims, and we face many challenges in doing so. Because this problem is multi-faceted and complex, the approaches to it need to be correspondingly diverse and customized. Broadspire has developed an array of pain-focused initiatives aggregated under the umbrella of our Comprehensive Assessment and Management of Pain (CAMP) program. Before focusing on two of the newer components of the program, let’s touch on the basic platform with which you are more familiar.
12/08/2014
Medigram Vol 7
We often reference the concept of EBM (or EBP: evidence-based practice) in this newsletter, but this time let’s dig a little deeper to define what it is, and illustrate it with a recent real-life example that demonstrates its importance to our company and industry. This is the process that Broadspire follows in evaluating medical practice issues.
11/07/2014
Medigram Vol 6
Back pain is the most common reason for filing workers compensation claims in the United States. After the common cold, back pain is the second most common cause of sickness leave and accounts for about 40% of sick absences from work. The American Academy of Pain Medicine reports that back pain in workers 40 - 65 years of age costs employers an estimated $7.4 billion per year with almost 72% of this cost due to workers with back pain exacerbations. It accounts for approximately 175.8 million days of restricted activity annually in the US. Medical costs have risen and questions by payers and patients about unnecessary treatment have become frequent. By some estimates, Americans are spending billions every year on unnecessary surgery and other medical care.
10/07/2014
Medigram Vol 5
An occupational illness is any abnormal condition caused by exposure to environmental factors associated with employment. Determining a medical condition’s causal relationship to the workplace is a critical issue in occupational health, since this determination impacts treatment as well as the financial responsibility for the cost of treatment. This often includes medication management, repeated imaging evaluations, and follow-up visits. These are chronic illnesses which require both short term and long term treatment. The causality determination must take into consideration three key factors:  Objective clinical findings  Specific workplace exposures  Evidence-based-medicine supportive of (or not) the exposure of concern and the condition Are diagnoses such as chronic obstructive pulmonary disease (COPD), asthma and migraine causally related to work?
09/16/2014
Accountable Care and Workers Compensation: Are They Compatible?
First let’s review the acronym glossary. Accountable Care Organizations (ACOs) were stimulated by the Patient Protection and Affordable Care Act (PPACA). A cousin of the ACO model is the patient‐centered medical home (PCMH) model. And these, and similar delivery systems, are often described as valuebased healthcare (VBH) models.
09/10/2014
Medigram Vol 4
We often think of workplace injuries as impacting an individual’s ability to fully function at home or at work and we often overlook the emotional impact an injury has on an individual. Injuries that linger may often be due to the claimant’s perception of the recovery process. Attempts to treat pain and increase functionality often include escalating doses of opioids, and/or long term use of muscle relaxants and sleeping meds which can result in dependence or addiction. Routine use of opioids for treatment of chronic non-malignant pain is not recommended. There is no evidence of benefit from long term use. The 2012 Hopkins-Accident Research Fund Study found “Workers prescribed even one opioid had average total claims costs four to eight times greater than claimants with similar claims who didn’t get opioids.” In many cases prolonged use of opioids increases the risk of adverse reactions such as constipation, balance issues, hormone problems, sexual dysfunction, memory and concentration problems and an actual increase in pain due to an interaction between the drug and the brain. What can we do about this?
08/07/2014
Broadspire Medigram Volume 3
As of June 2014, 22 states and Washington, DC permit the use of marijuana as a viable medical treatment option for select patients. Laws in certain states allow individuals to grow their own marijuana at a specified quantity, while other states require purchase in controlled amounts through a dispensary. Two states, Colorado and Washington, have legalized marijuana for recreational use and many others have decriminalized the substance to varying degrees.
01/10/2014
Transitional Duty Return-to-Work
Working with doctors to place recovering employees as local volunteers can have a big impact on a company’s bottom line. Discover how Broadspire’s outside-the-box solution helps employees, employers, and the community.
01/10/2014
Senior Nurse Reviewer: Delivering Value in WC
Because every organization is unique in its priorities and complexities, having an over-arching approach to the management of employee injury is essential in addressing the current quality of medical care and escalating costs in the workers compensation segment of the healthcare arena. When appropriately utilized, Senior Nurse reviewers can help overcome these obstacles.
11/15/2013
WorkSafe
Whether your realm is in human resources, safety, medicine, insurance, public service, law, or elsewhere, regardless of where you live in the United States, let this free guidebook be your go-to resource. A co-sponsored publication by Broadspire and Concentra.
08/13/2013
The Latest in Pain Management
According to a survey conducted by Johns Hopkins Bloomberg School of Public Health, 100 million adults in the U.S. are affected by chronic pain, with total healthcare costs attributable to chronic pain estimated as high as $635 billion. Broadspire’s industry-leading Comprehensive Pain Management Program delivers demonstrable results – 72% of the participants enrolled in our roundtable process showed a significant reduction (23.6%) in average monthly medical and pharmacy costs.