Fear and anxiety about a disease can be overwhelming and cause strong emotions in adults and children. The Social Distancing concept, which is intended to reduce disease transmission and currently being practiced by communities at large, can be very isolating and lead to increase in stress levels. How you respond to the outbreak can depend on your background, the things that make you different from other people, and the community you live in.

People who might have more difficulty responding effectively to the stress of a crisis include:

• Those who have mental health conditions including problems with substance use
• Children and teens

If you, or someone you care about, are feeling overwhelmed with emotions like sadness, depression, or anxiety, and feel like you want to harm yourself or others please call 911.

In general, health impacts from stress during an infectious disease outbreak can include:

• Fear and worry about your own health and the health of your loved ones
• Changes in sleep or eating patterns
• Difficulty sleeping or concentrating
• Worsening of chronic health problems
• Increased use of alcohol, tobacco, or other drugs

People with physical and mental health conditions should continue with their treatment and be aware of new or worsening symptoms. Make sure you continue to take your medications as prescribed and contact your healthcare provider if you find you are starting to feel worse.

Taking care of yourself, your friends, and your family can help you cope with stress. You can do this remotely through phone or video.

Things you can do to support yourself

• Take breaks from watching, reading, or listening to news stories, including social media.
• Take care of your body. Take deep breaths, stretch, or meditate. Try to eat healthy, well-balanced meals, exercise regularly, get plenty of sleep, and avoid alcohol and drugs.
• Make time to unwind. Try to do some other activities you enjoy.
• Connect with others over phone or video. Talk with people you trust about your concerns and how you are feeling.

Look out for these common signs of distress:

• Feelings of numbness, disbelief, anxiety or fear.
• Changes in appetite, energy, and activity levels.
• Difficulty concentrating.
• Difficulty sleeping or nightmares and upsetting thoughts and images.
• Physical reactions, such as headaches, body pains, stomach problems, and skin rashes.
• Worsening of chronic health problems.
• Anger or short-temper.
• Increased use of alcohol, tobacco, or other drugs.

Reduce stress in yourself and others

1. Take breaks from watching, reading, or listening to news stories, including social media.
2. Take care of your body. Take deep breaths, stretch, or meditate. Try to eat healthy, well-balanced meals, exercise regularly, get plenty of sleep, and avoid alcohol and drugs.
3. Make time to unwind. Try to do some other activities you enjoy.
4. Connect with others over phone or video. Talk with people you trust about your concerns and how you are feeling.
5. Use trusted sources for information such as the U.S. Centers for Disease Control & Prevention (CDC), The World Health Organization and state health department websites and encourage others to do the same.

For Parents

Not all children and teens respond to stress in the same way. Some common changes to watch for include

• Excessive crying or irritation in younger children
• Returning to behaviors they have outgrown (for example, toileting accidents or bedwetting)
• Excessive worry or sadness
• Unhealthy eating or sleeping habits
• Irritability and “acting out” behaviors in teens
• Difficulty with attention and concentration
• Avoidance of activities enjoyed in the past
• Unexplained headaches or body pain
• Use of alcohol, tobacco, or other drugs

There are many things you can do to support your child, including:

• Take time to talk with your child or teen about the COVID-19 outbreak. Answer questions and share factual information about COVID-19 from the aforementioned trusted sources in a way that your child or teen can understand.
• Reassure your child or teen it is ok if they feel upset. Share with them how you deal with your own stress so that they can learn how to cope from you.
• Limit your family’s exposure to news coverage of the event, including social media. Children may misinterpret what they hear and can be frightened about something they do not understand.
• Try to keep up with regular routines. If schools are closed, create a schedule for learning activities and relaxing or fun activities.
• Be a role model.  Take breaks, get plenty of sleep, exercise, and eat well. Connect with your friends and family members over the phone or through video.

Call your healthcare provider if stress gets in the way of your daily activities for several days in a row.

To learn more about what Magellan Healthcare is doing to support clients during the COVID-19 pandemic, visit MagellanHealthcare.com/COVID-19.

To learn more about Magellan Health’s corporate response to the COVID-19 pandemic and to view Magellan’s available resources click here: https://www.magellanhealth.com/news/covid-19/

Teen dating violence is just as serious as adult domestic violence. And it’s common. About 2 in 10 teen girls say they have been physically or sexually abused by a dating partner. About 1 in 10 teen boys reports abuse in dating relationships.

Teen dating abuse is a pattern of abusive behavior used to control another person. It can be:
•Any kind of physical violence or threat of physical violence to get control.
•Emotional or mental abuse, such as playing mind games, making you feel crazy, constantly texting you, or constantly putting you down or criticizing you.
•Sexual abuse, including making you do anything you don’t want to do, refusing to have safer sex, or making you feel bad about yourself sexually.

Who’s at risk?

Like adult domestic violence, teen relationship abuse affects all types of teens, regardless of how much money your parents make, what your grades are, how you look or dress, your religion, or your race. Teen relationship abuse occurs in straight, gay, and lesbian relationships.
Relationship abuse is not just dangerous for you physically and emotionally. It can also put you at risk for other health problems, such as:
•Eating disorders.
•Depression.
•Low self-esteem.

Teens in abusive relationships are also more likely to take sexual risks, do poorly in school, and use drugs, alcohol, and tobacco. Girls are at higher risk for pregnancy and sexually transmitted infections (STIs).

Is it abuse?
Abusive relationships can have good times and bad times. Part of what makes dating violence so confusing is that there is loved mixed with the abuse. This can make it hard to tell if you are really being abused. But you deserve to be treated in a loving, respectful way by your boyfriend or girlfriend.

Does your boyfriend or girlfriend:
•Act bossy and make all the decisions?
•Put you down in front of friends?
•Try to control who you see and talk to?
•Threaten to hurt or kill himself or herself?
•Blame you for “making” him or her treat you badly?
•Pressure you to have or force you to have unprotected sex?
•Stalk you? This can include constantly texting or calling you to find out where you are and who you’re with. You might think that’s about caring, but it’s really about controlling the relationship.

Do you:
•Feel less confident about yourself when you’re with him or her?
•Feel scared or worried about doing or saying “the wrong thing”?
•Find yourself changing your behavior out of fear or to avoid a fight?

If you answered “yes” to any of these questions, you might be in an abusive relationship. There are people who can help you. You’re not alone. Talk to your parents or another adult family member, a school counselor, a teacher, or someone else you trust. Call a help center or hotline to get help.

How parents can help

Teens may not have the experience or maturity to know if their relationships are abusive. A teen may think of dating violence as only physical violence—pinching, slapping, hitting, or shoving. Teens may not realize that any relationship involving physical violence, sexual violence, emotional abuse, or the threat of violence is an unhealthy relationship.

For example, a teen may think his or her partner cares when he or she calls, texts, emails, or checks in all the time. But that kind of behavior is about controlling the relationship.

Talk with your teen about what makes a healthy relationship. Explain that a caring partner wouldn’t do something that causes fear, lowers self-esteem, or causes injury. Let teens know that they deserve respect in all of their relationships. Think about values and messages that you want to pass on.

You might start by asking your teen:
•Is your boyfriend or girlfriend easy to talk to when there are problems?
•Does he or she give you space to spend time with other people?
•Is he or she kind and supportive?

Hotlines for help
These national hotlines can help you find resources in your area.
•National Domestic Violence Hotline toll-free: 1-800-799-SAFE (1-800-799-7233), or see the website at www.ndvh.org.
•National Teen Dating Abuse Hotline toll-free: 1-866-331-9474 or (1-866-331-8453 TTY) or see the website at www.loveisrespect.org.

©1997–2019, Healthwise, Incorporated
Read the full article here: https://www.healthwise.net/magellanhealth/Content/StdDocument.aspx?DOCHWID=tm7098

It’s officially the holiday season—bring on the parties, travel, end-of-year work activities, and squeezing in quality time with loved ones! This year, remember to make time to take care of yourself and start 2020 off with your healthiest, most vibrant YOU. Here are our top three holiday health hacks:

Be mindful of your alcohol intake.

Avoiding triggers can be challenging this time of year. Dr. Caroline Carney, chief medical officer of Magellan Rx, was quoted in a helpful Huffington Post article that offers 14 useful tips for navigating the holidays when you’re not drinking.

Be mindful of your plate.

The celebration over food and eating during the holidays can be tough…but it doesn’t have to be! With a little planning and preparation, you can make healthy choices. Check out these 10 easy tips to for managing your diet this holiday season.

Be mindful.

Close your eyes, take a deep breath through your nose, and exhale slowly through your mouth. It will do wonders when you’re sitting in all that holiday traffic.

Wishing you and yours a happy and healthy holiday!

The following is an excerpt from the 2018 Magellan Community Impact Report.

Standing tall is a tall order. How do  you know what the right thing is? Answers aren’t often cut and dried. Instead, we know by having lived through similar, difficult experiences ourselves and standing beside those we support—standing together as peers on the path to recovery.

Living through the same kinds  of challenges

Magellan’s recovery support navigators represent our best practice approach to tapping the power and potential of peer support. Peer support is an evidence-based practice, and numerous studies continue to validate the effectiveness of these supports. Recovery support navigators are professionals who have lived experiences with some of the same challenges our members face. They have experienced substance use disorders or psychiatric disabilities and may have personally been homeless, had their utilities turned off or experienced food insecurity. They can relate to the members they support, empathize, and then draw on real-world solutions to help them.

Sharing our stories

Every day recovery support navigators show up and not only listen to and support our members, but also share pieces of their own stories to inspire hope and change. Dana Foglesong, director of recovery and resiliency services for Magellan Complete Care of Florida, knows first-hand the transformative power a peer specialist can have. She knows not just because she has been certified as a peer recovery specialist since 2010, but because Dana had the support of a peer support specialist herself.

Dana describes her journey: “In my late teens and early twenties, I bounced from state hospitals to crisis stabilization units. I was desperate to end my life. I had no hope that my former goals could ever be realized. When I started working with a peer specialist, I began to view myself and my future more positively. My peer specialist expected me to recover and connected me to the resources that empowered my recovery process.”

Dana not only recovered—she has thrived! She recently completed a master’s degree in social work and leads Magellan’s diverse team of recovery support navigators. She has been awarded for her commitment to providing help and hope to others, including for her work founding the Peer Support Coalition in Florida, which expands leadership, advocacy and employment opportunities for people, like her, with lived experience. Dana describes her life now, saying: “At Magellan, I have the opportunity to do such meaningful, passion-filled work. It keeps me inspired and grateful to be a part of helping our members lead healthy, vibrant lives.”

Leading the way

Magellan was the first managed care company in the United States to recognize and incorporate peer support services into the continuum of care. Since 1999, we have been a leader in increasing access to peer support through partnerships with the recovery community and providers. We have assisted state customers in developing robust certified peer specialist capabilities, driven in large part by our depth and breadth of experience. Magellan continues to create shared learning opportunities for the peer workforce and others to improve and enhance the knowledge, skills, and competencies of the peer workforce.

The following is an excerpt from the 2018 Magellan Community Impact Report.

Coming together for the win

Nowhere is our value of Win Together more apparent than when you see the smiling faces of our employees working together to help improve the communities we serve. Every year, Magellan employees, located throughout the country, voluntarily organize and participate in Magellan Cares community service activities. Magellan Health and the Magellan Cares Foundation also support our employees’ giving in two ways: paying for time off to volunteer and matching their financial gifts. And when times get tough, we help lift up one another through our eMbrace employee assistance fund. Fully funded by employees through payroll contributions, the eMbrace fund helps employees who are facing a personal financial hardship.

Volunteer Time Off (VTO)

• 2018 volunteer time spent: 17,000
• 2018 volunteer states served: 36
• 2018 volunteer impacted organizations: 560+

Matching Gifts

•  2018 matching funds total dollars: $69,398.77
•  2018 matching funds impacted organizations: 152
•  2018 employee donated matched: $25,416.54

eMbrace

•  2018 total gifts received: : $136,419
•  2018 Total distributions to employees: $144,770
• Total gifts received since 2012: $726,499

The Magellan Cares Foundation also provides grants to nonprofits or nonprofit organizations for initiatives that are aligned with our focus areas. Donations support national or large-scale health access and quality improvement initiatives; efforts that help improve the social supports around a quality healthcare system, such as access to housing, food, clothing or self improvement opportunities, and efforts to support America’s military service members, veterans and wounded warriors.

•  2018 total dollars granted: $560,000
• 2018 total impacted organizations: 130

Precision medicine is the concept of tailoring disease treatment and prevention to account for differences in genetic, environmental, or even lifestyle factors specific to groups of people.¹ Precision medicine takes genetic and biochemical information unique to a group of patients and uses that information to develop more specific and streamlined medications or treatments. The goal is to ensure that each medication or treatment is best suited to treat the individual, resulting in decreased side effects and increased effectiveness.²

Precision vs Personalized Medicine

Although the terms precision medicine and personalized medicine are used interchangeably, there can be nuanced differences. The National Research Council (NRC) issued a statement saying that the term “personalized medicine” can refer to a treatment that may be completely individualized to a specific patient, which is not the true definition of precision medicine.³ The difference here is that precision medicine seeks to create treatments that are applicable to groups of individuals who meet certain characteristics. This is different from “personalized medicine,” which implies individualized treatments available for every unique patient.

Current Landscape

In 2015, the Precision Medicine Initiative (PMI) was launched, with $215 million dollars invested into precision medicine research.⁴ A new program was created—All of Us Research Program—which had the goal of recruiting 1 million Americans and creating a nationwide database for research.⁵ Other examples of precision medicine initiatives include the Geisinger Health System’s National Precision Health Initiative, the Partnership for Accelerating Cancer Therapies (PACT), and Cancer Moonshot.¹ There has been particular success in the field of cancer, with new medications developed for a specific cancer types with certain genetic characteristics. With increased funding, decreased costs to sequence DNA and analyze genetic information, and improved data analytics, many believe precision medicine to be the future of healthcare delivery.

1. Bresnick, Jennifer. 2018. “What Are Precision Medicine and Personalized Medicine?” HealthITAnalytics. HealthITAnalytics. January 11, 2018. https://healthitanalytics.com/features/what-are-precision-medicine-and-personalized-medicine.
2. Genetics Home Reference. n.d. “What Is the Difference between Precision Medicine and Personalized Medicine? What about Pharmacogenomics?” Genetics Home Reference. Accessed October 11, 2019. https://ghr.nlm.nih.gov/primer/precisionmedicine/precisionvspersonalized
3. Council, National Research, Committee on a. Framework For Development a. New Taxonomy of Disease, and Others. 2010. Toward Precision Medicine: Building a Knowledge Network for Biomedical Research and a New Taxonomy of Disease. National Academies Press.
4. “FACT SHEET: President Obama’s Precision Medicine Initiative.” 2015. Whitehouse.gov. January 30, 2015. https://obamawhitehouse.archives.gov/the-press-office/2015/01/30/fact-sheet-president-obama-s-precision-medicine-initiative.
5. “Program Overview – All of Us | National Institutes of Health.” n.d. Accessed October 11, 2019. https://allofus.nih.gov/about/all-us-research-program-overview.

“For a turtle to walk forward, it has to stick its neck out. Because Wraparound challenges systems to support families in unique and strength-based ways, staff must take chances when doing things differently than has been done in the past. Hence, they stick their necks out for change and work toward a better future for children, youth and their families.” – National Wraparound Implementation Center

Our challenge as wraparound providers is to stick our necks out for change! We are all working for a better future for the children, youth and families in Wyoming. Though our roles may differ, the objective is the same. Keep more youth at home, in school and out of trouble.

I have had High Fidelity Wraparound graduates tell me, “You saved our family.” The comments are heartfelt and genuine. But in wraparound, we don’t save their family. We do our duties with respect and fidelity. We show up for families, have hard conversations, reframe thoughts and ideas into action items and create tangible goals. We help them start to build a solid team of “go to” people and supports. We give a lot of suggestions and do a lot of work. But we alone, do not save their families.

They save their family. They do the hard stuff. They listen when they don’t yet understand how things could be different. They show up to their wraparound meetings and start to learn the process. They work to strengthen relationships needed for more natural supports. They are brave enough to question systems and processes that don’t work for them. They try new things, even though they are unsure of the outcome. They trust a stranger, like me, who shows up to help. They believe in me, and I believe in them. They keep on building trust in each other and confidence in their own abilities. They keep doing this work until one day they don’t need me anymore. It’s not as if everything is changed, fixed and all challenges solved. They did grab onto a life preserver when it was thrown. They did all the hard stuff to save themselves. That’s the true work. As wraparound providers, we share in the work load, but it is not all ours to do. Not even close.

Some families that I hear from I have worked with over 10 years ago. I believe this is because we built solid connections which are genuine. I stuck my neck out and let people know how to reach out if they ever need me, even after they transitioned from wraparound. What stands the test of fidelity to the model of wraparound is not how many youths are “saved”, but how many families and individuals we influence to create lasting and positive change in their lives. The relationships we build is what sets the stage for how well the process of wraparound gets incorporated into everyday life. We must be brave and risk our necks at times to build authentic relationships with people. We are all vulnerable. Sticking our necks out for the right reasons, at the right time and in right way, keeps Wyoming’s families moving forward.

Who’s with me? Turtles unite!

Prior authorization (PA) goes by many names—preauthorization, preapproval, advance notification, precertification and preadmission, to name a few. All these terms refer to the utilization management (UM) process used by many U.S. health insurance companies to ensure patients receive the right services, equipment and prescriptions at the right time and place. PA requires healthcare providers to request and obtain approval before rendering certain services, equipment or prescriptions in order to receive insurance reimbursement for those services. Not everything requires PA. Typically, authorization is needed for more complex services such as hospital admissions, diagnostic tests, medical equipment and complex prescription medications.

The PA process is intended to act as a safety and cost-saving measure. It can lower costs to the patient, prevent unnecessary or invasive procedures, and reduce the use of unnecessary tests that may expose patients to potentially harmful radiation and/or undue stress. For example, up to half of advanced imaging procedures ordered fail to provide information that improves patients’ welfare.[i] In addition, despite studies demonstrating overuse, rates of advanced imaging procedures continue to rise—increasing costs and exposing consumers to excessive radiation.  Despite its benefits, the prior authorization process needs an upgrade.

According to the 2018 CAQH Index , manual prior authorizations (via fax or telephone) are the second most-costly medical administrative transaction, costing providers $6.61 per submission. Providers estimate their staff members spend up to 30 minutes completing one manual prior authorization. While manual prior authorization is a much-debated topic due to the time and cost it requires, many parties support standardizing and simplifying the process.

Technology can significantly  decrease the need for expensive manual processes.  According to the 2018 CAQH Index, the medical industry could save $417 million annually by transitioning to electronic prior authorizations, which includes $278 million in annual savings for providers and $139 million for health plans.

While many health plans offer web portals to process prior authorizations, this approach requires providers to use different online systems for each health plan. Instead, digital solutions should include automation within the electronic health record (EHR) and the physician’s workflow. Automation is essential to reducing inefficiencies for providers and health plans and enabling authorizations at the point of care while maintaining clinical integrity.

The goal is to make the right decision for each patient—quickly and easily so patients get the care they truly need. Automating prior authorizations will benefit everyone involved.

[i]Beachy, D. (2014, September 8). Defensive medicine driving up wasteful imaging. Retrieved from https://www.healthimaging.com/topics/healthcare-economics-policy/defensive-medicine-driving-wasteful-imaging.