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Pinnacol Assurance Leads the Way in Curbing Opioid Overprescribing in Colorado's Workers' Compensation System

June 24, 2024
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Efforts yield a 23% reduction in the percentage of Pinnacol injured workers receiving an opioid prescription

DENVER – June 24, 2024 — Pinnacol Assurance, Colorado's leading workers' compensation insurer, today announced significant achievements in reducing inappropriate opioid prescriptions for injured workers receiving care covered by Pinnacol. Pinnacol's proactive initiatives, launched in 2018, have resulted in substantially improved outcomes for injured workers and positioned the company as a national leader in combating the opioid epidemic within the workers' compensation system.

Data from Pinnacol Pharmacy Benefits Manager show that Pinnacol injured workers receive far fewer opioid prescriptions and lower cumulative dosage quantities than those under the care of other workers’ compensation insurers. 

"Pinnacol recognized the potentially devastating impact of opioid overprescribing on injured workers and took decisive action years before state mandates were in place," said Tom Denberg, M.D., Pinnacol's Senior Medical Director. "Our comprehensive approach, combining innovative programs with strong medical provider partnerships, has not only curbed overprescribing but also improved the quality of care for injured workers across Colorado."

In limited instances, opioids can be prescribed relatively safely for temporary pain relief. When this is the case, Pinnacol supports their judicious use. On the other hand, the overprescribing of opioid medicines has been a widespread problem contributing to a public health crisis in Colorado and the nation. Opioids are highly addictive substances. When prescribed in medically inadvisable ways, patients can experience physical dependence, overdose, increased chronic pain and disability, reduced quality of life, and delayed recovery from injury and ability to return to work.

“The nation’s opioid overdose crisis is at critical levels and some industries and occupations are especially hard hit,” said L. Casey Chosewood, MD MPH, Director, Office for Total Worker Health®, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention. “We need all hands on deck to address this challenge. Efforts to improve the safety of our workplaces, reduce the risks of injury, and prevent work that predisposes to pain are paramount. Likewise, limiting the overprescribing of opioids and finding alternatives whenever possible are vital.”

Key Pinnacol Initiatives:

  • Mandatory Opioid Prescribing Education: Pinnacol required all of its network providers with DEA licenses to complete accredited opioid prescribing courses, a requirement later adopted by the state.
  • Proactive Provider Education: Well before the state established a similar program, Pinnacol developed clinic profiling reports to educate network medical providers about their opioid prescribing patterns and best clinical practices.
  • Unique Opioid Prescribing Surveillance Program: Pinnacol partnered with Optum and University of Colorado clinical pharmacy faculty to create a first-of-its-kind program that monitors opioid prescriptions at the point of pharmacy fills, allowing for immediate interventions including medication reviews, blocks, and dosage adjustments.
  • Early participation in the Colorado Consortium for Prescription Drug Abuse Prevention:  In 2017, Pinnacol's medical director joined the Colorado Consortium for Prescription Drug Abuse Prevention, an organization focused on helping to coordinate the state’s response to the abuse and misuse of prescription medications, including opioids.
  • Expanded Access to Substance Abuse Treatment: Pinnacol increased access to substance abuse treatment facilities for injured workers who developed opioid use disorder related to inappropriate prescribing.

Pinnacol's proactive efforts have yielded significant results, including:

  • As a result of Pinnacol’s ability to curtail unnecessary prescribing, from 2020 to 2023 there was a 23% reduction in the percentage of Pinnacol injured workers who received opioids.
  • By the end of 2023, a 21% lower likelihood that Pinnacol injured workers would receive an opioid prescription compared with injured workers in the rest of Pinnacol’s PBM’s Colorado book of business.
  • Significant improvements in average days away from work.

These achievements highlight Pinnacol's proactive and innovative commitment to the well-being of injured workers and demonstrate the company's national leadership in promoting responsible prescribing practices.

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