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Mind the Gap: Increasing Access to Behavioral Healthcare

According to the Kim Foundation, one out of four Americans experiences behavioral health issues. Of those, 60 percent are not receiving treatment.

Why are so many people not receiving treatment?

What does this mean for providers?

What more can be done to increase access to behavioral healthcare?

Learn more about this issue by downloading Magellan’s new infographic, “Mind the Gap: Increasing Access to Behavioral Healthcare.”




Value-Based Purchasing: Putting the Wheels into Motion

You’re buying a car. Before you hit the lot, you do your planning and research, establish a budget, figure out what features you want and what style you’re looking for. You probably search online for car and dealer reviews, prices and sales. Based on all of that work, you make a decision, negotiate and pay for your new car.

Your car research was relatively easy. But finding a healthcare provider? Not so much.

While you may know what you want in a provider, very little information is available about the services they provide, appointment costs, reviews and other important details to help you make an informed choice about your care. And if you ARE lucky enough to find someone who seems to fit your needs, you’re often still left wondering what kind of quality you can expect from your treatment experience.

The bottom line is that it’s easier to buy a car than it is to find a healthcare provider. Silly, right? We think so, too – which is why Magellan is bridging these information and quality gaps by employing value-based purchasing models.

Rewarding quality care yields informed choices

Value-based purchasing takes various forms. But it generally operates on the premise that aligning providers’ incentives and reimbursement with organizational and individual goals incents behavior and drives positive outcomes, ultimately benefiting all involved in the healthcare continuum. This includes consumers, customers and payers, in addition to the providers themselves, who also enjoy improved reputations through public reporting.

In fact, one of the key tenets of Magellan’s value-based collaboration and purchasing models is to ensure stakeholders become more informed as a result of these initiatives:

  • Customers benefit by knowing whom to partner with for network management;
  • Payers benefit by knowing whom to pay for value; and
  • Consumers, of course, benefit by having those online provider reviews become a lot less elusive, enabling them to make an informed decision about whom to choose for their care.

Magellan’s models also center on:

  • Engaging and empowering providers in compensation model evolution. We partner with provider leaders around compensation design, employ transparency to ease the compensation shift and create meaningful incentives for providers to encourage active engagement. (1)
  • Building provider compensation for an evolving healthcare market. Our priorities center on population management, team-based care and member access. We integrate new quality and efficiency standards into compensation, and remove compensation barriers to population goals. (1)

Why do we give value-based purchasing strategies the green light?

Take our Assertive Community Treatment (ACT) program as just one example. Through program data analysis and close collaboration with our ACT provider teams, we developed a three-tiered rate structure based on overall program goals to support recovery, wellness, and to improve community tenure. As a result, we saw a 21 percent decrease in inpatient admissions and a 24 percent decrease in the inpatient readmission rate.

Our drive for engagement continues

Providers nationwide are in different phases of readiness, so we keep our wheels in motion by providing a graduated maturity model to move them from the most basic stage—learning the behavior through activity incentives—to the most complex arrangements, which transform care delivery through outcomes-based incentives or other payment structures (2). We look forward to working with stakeholders, providers and consumers as we continue to expand this innovative and exciting model.

 

(1) Medical Strategy Group Council: “Next-Generation Physician Composition,” The Advisory Board Company

(2) Physician Quality Reporting Initiative: The Advisory Board Company




Using Technology to Help Individuals with Substance Use and Depression

Millions of people are challenged by drug and/or alcohol use, which may result in physical and emotional health concerns. Many individuals feel like they have lost control and struggle with depressive signs and symptoms, in addition to substance use – and only a fraction of these individuals receive care, according to a report on addiction released in November by the U.S. Surgeon General.

At Magellan Health, our clinical methodology for the management of substance use incorporates leading principles of care, involving appropriate assessment, evidence-based interventions, as well as close collaboration with other healthcare providers who are vital to the delivery of effective care. At the core of Magellan’s interventions for substance use is our suite of computerized cognitive behavioral therapy (CCBT) programs powered by Cobalt Therapeutics, as well as screening software, and optional wraparound telephonic support.

Magellan’s Cobalt platform includes online, well-studied programs proven to help individuals who are coping with various behavioral health conditions. Among our Cobalt CCBT programs is SHADE – a 10 session mobile and web-based program for individuals living with alcohol, and/or drug use and co-morbid depression. SHADE provides skills-building exercises, which include mood monitoring, problem brainstorming, pros and cons analysis, planning for change, identifying problematic thought patterns and developing effective drug refusal skills. SHADE helps participants control their substance use, alcohol use and low mood by promoting long-lasting skill-based changes in behavior and thinking.

Published in the journal Addiction, SHADE has been proven in randomized, controlled trials to:

  • Be comparable in efficacy to face-to-face therapy.
  • Reduce hazardous drug and alcohol use by 44-58 percent after 6 months.
  • Reduce hazardous use by 72 percent after 12 months.
  • Significantly reduced binge drinking.

SHADE was listed favorably among the technology assisted interventions highlighted by the surgeon general’s report as a tool designed to “(1) increase access to care in underserved areas and settings; (2) free up time so that service providers can care for more clients; (3) provide alternative care options for individuals hesitant to seek in-person treatment; (4) increase the chances that interventions will be delivered as they were designed and intended to be delivered; and (5) decrease costs” (see https://addiction.surgeongeneral.gov/ for more information).

You can learn more about Magellan’s Cobalt CCBT capabilities here:

 

Magellan’s self-guided Computerized Cognitive Behavioral Therapy from Magellan Health on Vimeo.




Five Ways to Live More Mindfully in 2017

As we pass from one year into the next with celebration, it can be a terrific time to reset, reframe and evaluate how we’ve been living. Do you feel run down on a regular basis? Do you feel unsatisfied with your career or personal relationships? Is there something that is weighing on your confidence? If enough dissonance exists between how we wish to live and how we’re currently going about our daily lives, the gap can begin to weigh on our happiness, health and sense of identity. It’s important to realize that to struggle with this dissonance from time-to-time is to be human, but there are a few simple tips you can take on to gradually reposition thoughts and make progress toward living a more satisfying, mindful life in the new year.

  1. Prioritize connecting with family and friends. While it’s easy to get consumed with shopping for just the right gift, making the house “just-so” and achieving an Instagram-worthy holiday or party scene, try to steal a few minutes in your day to press the pause button. Savor your coffee, close your eyes and think about the valued relationships in your life. Make time for a quality visit, phone call, or send a card, text message or social media message to someone you fell out of touch with – just to wish them well and ask how they are. Knock on an elderly neighbor’s door, or look up and notice someone in your path that may be in need of a connection, and offer a friendly conversation.
  1. Evaluate your self-care routine. When we think of healthy habits we aspire to adopt, we often look at the physical habits we can improve on – regular exercise, balanced diet, more water and sleep. Every year, many people begin with a resolution to finally tackle the mystical formula of being able to incorporate these habits into their daily life. While the holidays can be a great time to schedule that annual physical to check-up on your physical self, make sure you’re also scheduling in time to identify why it’s been difficult to achieve your goals and what you specifically need in order to feel strong and resilient. How do you feel about yourself? What are some negative influences in your life? Being honest about these questions can help you pinpoint how to move forward and incorporate ways to take care of your mental and emotional needs along with the physical. Your self-care routine will be unique to you, whether it’s recognizing that you need more quiet time in your day, or that your current situation leaves you feeling socially-isolated. Discovering what’s truly bothering you can feel very freeing, and offer a clearer picture of how to move forward.
  1. Talk to someone proactively. Whether it’s a friend, family member, or a professional therapist or coach, exploring your feelings and the way you react to life stressors with an objective third party can help you step back and observe your needs in a different light. We often limit ourselves unconsciously with thinking patterns, views and behaviors that we’ve built on through the unique experiences in our lives. Recognizing the ability to look at things from a different perspective before we find ourselves in a serious state helps us to build that mindfulness muscle – helping us to cope better with challenges, react in constructive ways and practice resiliency. If you’re hoping to speak with a professional, there are now more options than ever to access them. Employers often offer a series of free and confidential coaching or counseling sessions as part of an Employee Assistance Program. If you struggle with transportation or have a packed schedule, or would like to experiment with different types of support, there are also a growing number of online options that can be sought out at any time of day – from online cognitive behavioral therapy programs (CBT), to text or video therapy or coaching, and many mobile apps that can help you track and practice positive daily habits (search for “meditation” or “mindfulness” in your app store, for example.)
  1. Think about how you handle change. Change is constant and often feels disruptive to our lives. Whether it’s broader, societal change that we observe, or more personal life events – changing jobs, moving to a new location, or having a new child, change affects us all differently. It may interrupt our ability to fall asleep at night. It may even induce feelings of fear and anxiety. It may force us to evaluate how to think about ourselves and our relationships. Stepping back and taking a look at how we react to change helps us to be more mindful of the constructive steps we can take to alleviate worries and rise above negativity. Practice reframing what you hear and be open to looking at a situation from all perspectives. Think about different options you have in your reactions, and try to be empathetic to those that may have a different reaction to the same situation. Acknowledge others’ feelings as valid – even if they are different from yours. Lastly, it’s important to focus on aspects of a situation that you can control and impact positively, and to lessen time worrying about things you cannot. There are situations where you’ll have to take things as they come and allow things to happen.
  1. Practice failing well. Chances are, you’ll be making some important life choices this year. Maybe you’re helping your child choose which major to take in school. Maybe you’re evaluating your own education and career options. Maybe you’re looking to deepen existing relationships, or find a fulfilling new one. Self-doubt inevitably can creep in and interfere with your ability to achieve these goals and make helpful decisions. Failing well is a skill, and learning to cope with and navigate failures will do wonders for your confidence and knowledge about yourself. Many successful people have shared that they’ve succeeded because of their failures and ability to find their strengths through them.

In the words of all-star NBA player, Michael Jordan:

“If you’re trying to achieve, there will be roadblocks. I’ve had them; everybody has had them. But obstacles don’t have to stop you. If you run into a wall, don’t turn around and give up. Figure out how to climb it, go through it, or work around it. I’ve missed more than 9,000 shots in my career. I’ve lost almost 300 games. Twenty-six times, I’ve been trusted to take the game winning shot and missed. I’ve failed over and over and over again in my life. And that is why I succeed.”

We at Magellan wish you a happy, healthy and more mindful 2017!




The New Innovators in Healthcare – Solutions for Engaging Customers

Consumerization of products continues to drive new innovations across the marketplace. For example, you can use your smartphone as a GPS device, to request a car service directly to your house and to shop for a new car online, seeing the prices other people paid in real time. In banking, we’ve seen the transition from teller to the ATM to online banking, smartphone banking and now, using your smartphone as a smart pay device. Underscoring all of these innovations is the desire to make whatever experience the consumer is engaging in easier, simpler and more personalized.

Healthcare is no different. Across the healthcare continuum, companies like ours are finding new and innovative ways to enhance member engagement and participation in the healthcare journey, particularly through computerized or mobile devices. Think about how healthcare has changed over the past 50 years – house calls from doctors to office visits to telephone triage and now, computerized therapy and text therapy.

At Magellan, we’ve invested in a unique type of computerized therapy – Computerized Cognitive Behavioral Therapy (CCBT) – to help individuals seek the therapy they need, in the comfort, convenience and privacy of their own home. Our CCBT programs were originally developed more than 20 years ago, for stand-alone personal computer use, but have since been developed for use on the internet and mobile devices, in both English and Spanish.

 The following five conditions make up more than 90 percent of behavioral health complaints in adults, and are present in more than 25 percent of adults:

  • Insomnia
  • Depression
  • Anxiety
  • Substance Abuse
  • Obsessive Compulsive Disorder

Within each condition, studies have shown CCBT to be effective at reducing symptoms and severity. Importantly, our CCBT programs have undergone clinical trials involving more than 1,000 patients and have received endorsements and recognition from the American Academy of Sleep Medicine, the United Kingdom’s National Institute of Clinical Excellence, Accreditation Canada and the Substance Abuse and Mental Health Administration’s National Registry. Underscoring all of the studies and reviews, what can members expect? Sixty-nine percent of users show meaningful improvement within 30 days.

But CCBT isn’t just for members. We’ve found that providers can use a tool called Smart Screening to help screen individuals and triage them to the most appropriate levels of care on the CCBT platform, and in person, for the most serious cases. Various levels of screening can help direct individuals to CCBT, directly to an in-person counselor or a mix of both. Through this triage system, 90 percent of engaged participants rate this program as helpful and useful, and 75 percent of individuals actually prefer a non-medication care option when asked.

The most important thing about innovation in any industry – healthcare, banking or electronics – is refusing to rest on your laurels. There are new start-ups launched everyday whose mission it is to disrupt the status quo and provide new ways of doing things. As healthcare evolves, we plan to do the same.




Person-first language: It’s time to bring healthcare into the 21st century

Written by Thomas Lane, NCPS, CRPS

What’s in a word? Much more than many of us realize.

In the context of behavioral health, substance use and even physical health challenges, using terms and phrases that group people by diagnosis, disability, disease and other characteristics perpetuates stigma, discrimination and exclusion. Yet this type of language has been part of the healthcare lexicon for decades. Outdated terms such as “addict,” “crazy” or “diabetic” are just a few common examples.

We live in a time when individuals are at the center of the healthcare field. As healthcare consumers, individuals are empowered to make their own health choices. As healthcare professionals and activists, we need to mirror this empowerment, and seize the opportunity to pivot how we portray what we do. We need to move away from archaic language that contradicts all of the positive changes we help individuals make in their lives on a daily basis.

This is where “person-first language” can make a big difference.

What is person-first language?

Person-first language means seeing people as “people first,” and not as their disease, illness or disability, or as part of a homogeneous group. It portrays individuals living with behavioral health, substance use or physical health challenges beyond a lens of illness, diagnosis and hopelessness. It helps address issues relating to illness-identity and self-stigma, keeping in mind that we are all unique individuals, with unique lived experiences.

At Magellan Health, our use of person-first language stems from our work in behavioral health, but it applies to everything we do with equal emphasis. It shows our commitment to being culturally and linguistically appropriate in all of our communications. It models our principles of recovery and resiliency, and contributes to evolving and improving our organizational culture.

On a personal level, as an individual in recovery myself I can tell you how important person-first language became to me as I discovered the often unintended consequences of using language that robs one of their individuality. We all deserve respect and appreciation for our unique qualities.

How is person-first language used?

Using person-first language is an intentional practice. Here are some examples of old language that is commonly used in comparison to newer, person-centered language that can be applied by anyone:

  • From “chronic disease management” to “improving health outcomes for people living with chronic health conditions.”
  • From “illness self-management” to “improving health education, support and community inclusion to promote individual wellness and self-direction.”
  • From “crazy, nuts, lunatic” to “someone who may benefit from services and supports.”
  • From “individuals suffering with a mental illness” to “individuals with a mental illness.”

For practice, try to recognize when others use the outdated or inappropriate terms and phrases above. And ask yourself how often you use them. Then, make the conscious choice to omit them from your vocabulary and replace them with new terms. While changing an old habit can be a challenge, consciously developing a new one is an easier path to meaningful change.

Remember, we all have choices about the words we speak and write. Those choices can either affirm the distinctive individuals that we are — or diminish us with labels. The words we use can fill us with hope, or burden us with despair. So let’s choose hope.

Changing the way you speak and write is a gradual process. But by putting the person first when you do, you can play a role in bringing our healthcare language into the 21st century.

For more information and resources, please visit Magellan’s e-Learning Center: http://www.magellanhealth.com/training-site/home.aspx