U.S. Able MCO
IAIABC: Please provide a description of your organization.
E. Ann Shelnutt, Product Manager, U.S.Able MCO: USAble MCO is a wholly owned subsidiary of USAble Mutual Insurance d/b/a Arkansas Blue Cross and Blue Shield. We are the first managed care organization to be certified by the Arkansas Workers’ Compensation Commission (AWCC). While our mother company currently has 3,370 employees, USAble MCO is managed by two employees at Arkansas Blue Cross and Blue Shield. We work in tandem with an Arkansas company called Systemedic, which provides many services to our customers. Systemedic has twenty-eight employees, including certified professional coders and nurse case managers. Our mother company’s mission is to improve the health, financial security, and peace of mind of the members and communities we serve. At USAble MCO, we bring those same values to the realm of workers’ compensation.
AS: To be a certified MCO in the state of Arkansas, certain requirements must be met. These requirements include providing medical case management, preauthorization for certain procedures and hospital stays, access to a PPO with discounted rates, and other services. Through Arkansas Blue Cross and Blue Shield, we can offer the largest, most comprehensive PPO in the state of Arkansas with excellent savings below the AWCC fee schedule.
IAIABC: What do you see as some of the major challenges the industry is facing, and how can we as a community address them?
AS: The Covid-19 pandemic left the entire medical community with new challenges, including a rise in the number of addicts in our country. This includes addictions to prescription medications, “street” drugs, or alcohol. A lingering effect of the physical health pandemic is a continuing mental health pandemic, and the use of addictive substances is often the means for those suffering to emotionally escape their stresses. As a community, we need to stop ostracizing mental health and addiction and make more effort to identify and reach out to those in need.
IAIABC: Are there any projects/programs/initatives going on at your organization that you are particularly excited or enthusiastic about?
AS: In 2023, Arkansas Blue Cross and Blue Shield added their first peer counselor for addiction. A peer counselor is someone with lived experience who has successfully recovered from addiction and/or mental illness. The peer support specialists at Arkansas Blue Cross and Blue Shield are non-clinical credentialed and trained with the state of Arkansas and will provide support, education, and resources for members with mental health or substance use needs within our communities.
According to a study published by the NIH’s National Library of Medicine in 2016, “peer support groups included in addiction treatment show much promise in potentially reducing substance use, improving engagement, reducing HIV/HCV risk behaviors, and improving substance-related outcomes”. This is something that could be effective if incorporated into workers’ compensation programs.
IAIABC: Why is your organization a member of the IAIABC?
What would you tell others about the benefits of membership?
AS: USAble MCO has been a member of the IAIABC since 2008. We joined because we were looking for opportunities to expand our knowledge about the workers’ compensation system outside of the state of Arkansas. We remain members because of the comradery we enjoy with others in our industry and the knowledge that we gain through committee membership and live events. In recent years, we have been able to create an interest in this organization for members of our state and local governments by suggesting that they broaden their workers’
compensation knowledge and share their specialized knowledge with other IAIABC members.