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How CMS's Behavioral Health Strategy Can Help With Claim Management

Behavioral health assessments provide a proactive approach to a claimant's long-term treatment, reduce their reliance on medications, and shorten the life of claims. 


Understanding the Hidden Risks

The clinical management of chronic pain is a biopsychosocial challenge in itself. However, when the pain occurs in the context of workers' compensation, there is even greater clinical complexity.


A review of the literature shows that patients being treated for chronic pain under workers' compensation are generally more distressed and have poorer outcomes, both clinically and vocationally, than non-compensated patients. 

How BRE Helps Adjusters

Mitigate Long-Term Costs

By identifying and addressing mental health issues early on, insurers can reduce the risk of long-term disability and ongoing medical expenses. This proactive approach can help control costs associated with extended treatment and rehabilitation.

Improve Claim Outcomes

When mental health issues are accurately assessed and addressed, injured workers are more likely to experience improved mental well-being, leading to better overall claim outcomes and a higher likelihood of successful return to work.

Accurate Claim Assessment

BRE assessments help insurers determine the validity and extent of a claim related to mental health issues. This ensures that only legitimate claims are approved, preventing potential fraud or false claims.

Facilitate Timely Intervention

Early identification of mental health problems through assessments enables insurers to intervene promptly. Timely access to mental health support can prevent the condition from worsening, promoting faster recovery and return to work.

Data Collection & Analysis

Insurers can use aggregated data from BRE mental and behavioral health assessments to identify patterns and trends related to workplace mental health. This information can help in developing targeted prevention programs and policies to improve overall employee well-being and reduce the likelihood of future claims.

Identify Appropriate Treatment

BRE can help identify the specific mental health condition an injured worked is experiencing. This allows insurers to recommend and approve the most suitable and effective treatment options, reducing the likelihood of unnecessary or inappropriate treatments.

Reducing Opioids Impact on Claims

The impact of opioids on workers' compensation claims can be significant, and BRE behavioral health assessments can play a crucial role in addressing this issue. The Behavioral Response Evaluation program can give adjusters, case managers, and attorneys early indications of potential problems and can help reduce the cost and length of the claim in several ways.

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Life and Death In Workers' Comp

Injuries severe enough to keep an employee home for at least a week almost TRIPLED the combined risk of SUICIDE and OVERDOSE DEATH among women and fifty percent among men.

Increased Suicide & Overdose Death With Workers' Comp 

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