Workers' Comp

Are Demands for Spend Accountability Becoming More Complex?

Look to EHO’s PBM360 platform for integrated claims processing and real-time, detailed data reporting

EHO is dedicated to getting injured employees back to work with positive outcomes while controlling utilization and prescription drug cost. By understanding the client’s plan requirements, EHO is able to recommend immediate cost-saving adjustments during the benefit design setup process. Complete customization is offered at no additional charge. Using EHO’s proprietary, cloud-based PBM360TM claims processing platform, clients can view real-time metrics on a plan level or individual member basis. Alerts and notifications can be tailored to plan guidelines to control dosing, spending limits, step edits, and prior authorizations.

EHO is sensitive to the opioid crisis. Research on medical outcomes when opioids are used in workers’ compensation demonstrates that opioid use beyond the acute phase can impair function and be a barrier to recovery* EHO has partnered with Sure Med Compliance, the industry leader in opioid prescribing compliance, offering in-network providers a tool that helps ensure only patients that truly need opioids receive them and only for as long as needed.

EHO Caters to Workers’ Compensation Plans

  • State reporting
  • Injury-specific formularies
  • Detailed reports to account for spend
  • Cost management strategies
  • ePrescribing
  • 24/7 live call center
  • Real-time prior authorizations

A Commitment to Clinical Services

EHO effectively manages clinical utilization through a “real-time audit” of high-cost claims. All claims requiring a prior authorization are reviewed by clinical pharmacists with years of experience in the industry. Pharmacists review prescriptions before they are filled utilizing a live connection into the PBM360 claims processing system. The program has reduced clients’ annual pharmacy spend by between 15% to 20% through direct cost savings on existing medications and cost avoidance on newly prescribed medications.

* Source: https://www.nsc.org/Portals/0/Documents/RxDrugOverdoseDocuments/RxKit/EMP-How-Prescription-Opioids-May-Be-Affecting-Workers-Compensation-Program.pdf

Find a Pharmacy in Our Network