Since joining Magellan Health over a year ago, Karen Riccardi has been a part of developing various behavioral healthcare products aimed at helping people to live healthy, vibrant lives.  As senior product development manager, Riccardi’s main responsibility involves the development of behavioral health products and solutions that positively impact the lives of others and drive growth for the company.   Some of the products she has worked on include Magellan Healthcare’s Digital Emotional Wellbeing tool, Senior Assistance solution, and Collaborative Care product.  Riccardi, who is a Licensed Professional Counselor based in Virginia, discusses the products she is working on below.

What sort of cool, innovative projects are you currently working on?

Most recently, I have been working on the implementation of our Collaborative Care Management solution that increases access to behavioral health screening and care for low to moderate-risk behavioral health conditions within the primary care setting.  By using NeuroFlow’s technology and Magellan’s clinical management, we can improve medical and behavioral health integration.

I’ve also been working on the launch of our new Senior Assistance solution powered by DUOS. Senior Assistance helps address older adults’ social determinants of health (SDOH) needs and assists them in aging independently in their own homes by building long-term, high trust, one-on-one relationships with a personal assistant called a Duo.  Our pilot last year successfully addressed 93% of members’ SDOH needs.

There have been several other innovative products and projects I have had the chance to work on, including the development of the Wellbeing Navigator, which provides one-on-one support and guidance for employees and their household members with complex life concerns, the launch of eMbrace, Magellan’s evidence-based solution that supports members’ wellbeing, and development of a suicide prevention solution that includes education, awareness, tools, resources, and addresses other health issues such as substance use and teen mental health.

Why is Magellan Health the best place to develop these projects?

Magellan has a long history of behavioral health innovation and is well known in the behavioral health space.  The history and knowledge, along with leaders who encourage us to be creative and explore new, innovative solutions, make Magellan the best place to develop products that benefit the lives of our members.

What are your thoughts Magellan’s culture and how has it impacted your projects?

Everyone at Magellan is here because they want to make a difference and are dedicated to the work they do. It is energizing to work with coworkers who are passionate about what they do.  This makes working together easier and allows us to come together as a team.

What exciting trends have you noticed in the healthcare industry? In what direction do you see healthcare going? What lessons are there to learn from other industries that can be applied to healthcare?

There has been increased recognition of the importance of mental health and how it is a vital part of one’s wellbeing.  Telehealth and digital tools have proven to be effective means of treatment and are helping to address accessibility to providers.  Individuals have more choices today on how they want to receive behavioral health care, allowing them to be more in control of their healthcare.  It is vital we continue to focus on products and solutions that are high quality, demonstrate positive outcomes, and provide an exceptional patient experience. Individuals need to feel comfortable in seeking behavioral health care when they do not feel well mentally.

While up to 80% of all primary care visits include a behavioral health component, primary care providers (PCPs) may feel overwhelmed and ill-equipped to meet their patients’ behavioral health needs. Collaborative care can help.

What is collaborative care?

Collaborative care is a specific type of integrated care that uses a team-based, patient-centered approach to address behavioral health in the primary care setting. Collaborative care links a patient’s PCP with a behavioral health care manager and psychiatric consultant to help meet their mental health goals. This approach has been studied in over 90 different randomized control trials and has shown to be highly effective in delivering a better patient experience, as well as improving patient outcomes and providing cost reduction.

Collaborative care gives PCPs the tools and support they need to manage ongoing mental healthcare and helps improve the quality of care provided.

• A patient registry allows PCPs to track patients and ensure that no one falls through the cracks. Patients who do not show improvement are outreached, and behavioral health specialists offer caseload-focused consultation.
• Screening tools, such as the Patient Health Questionnaire (PHQ)-9 for depression and the Generalized Anxiety Disorder (GAD)-7 for anxiety, help identify and direct patients to the appropriate levels of care for mental health conditions.
• A behavioral health care manager supports the PCP in myriad ways, including:
  • Ensuring effective communication among the team
  • Coordinating the team and mental health treatment
  • Providing progress updates and treatment recommendations to the provider
  • Alerting the PCP when the patient is not improving
  • Supporting medication management
  • Facilitating communication with the psychiatric consultant regarding treatment changes
  • Conducting brief interventions, such as motivational interviews with patients to guide their progress
• A psychiatric consultant reviews cases alongside behavioral health care managers and assists the care team with treatment planning, and diagnostic and treatment recommendations.

Collaborative care allows patients to get mental healthcare where they regularly seek physical healthcare, rather than having to go elsewhere.

 Throughout the U.S., individuals lack access to mental healthcare. In fact, over 26 million individuals experiencing a mental health condition are going untreated. Providing mental healthcare in the primary care setting allows patients to:

• Address mental health concerns with a provider they trust and see regularly for physical health concerns
• Receive mental health treatment at an earlier stage to help prevent more serious problems
• Have regular contact with a behavioral health care manager who can deliver brief interventions and individualized care planning
• Receive coordinated care for co-occurring mental and physical conditions
• Reduce the burden they carry in communicating treatment updates to multiple providers when they have comorbid physical and mental health concerns
• Feel comfortable that all of their health needs are being addressed
• Receive mental health treatment that is often less expensive

Magellan Healthcare’s collaborative care solution, powered by NeuroFlow

 Collaborative care has been proven to double the effectiveness of depression care, as well as improve physical function and reduce healthcare costs. Magellan Healthcare’s evidence-based Collaborative Care Management solution for health plans and healthcare delivery systems provides care management and psychiatric consults for primary care patients and augments physical health providers’ staff with Magellan staff to facilitate integrated physical and behavioral healthcare. Learn more here.

Sources:

• 2020 Adult Data | Mental Health America (mhanational.org)
• Benefits of Behavioral Health Integration for Primary Care Providers | Bipartisan Policy Center
• Collaborative Care | University of Washington AIMS Center (uw.edu)

Behavioral health is an important indicator of a society’s overall wellbeing, as it interacts closely with physical health. Unfortunately, most individuals do not receive the behavioral health treatment they need. Fear of treatment, shame, and embarrassment keep many from seeking care. More than one-third of Americans live in areas lacking mental health professionals.[1] Fifty percent of individuals who receive a behavioral health referral do not follow through or have only one visit.[2] Collaborative care addresses these problems by providing physical and behavioral health care in the primary care setting.

What is collaborative care?

Collaborative care is a specific type of integrated care developed at the University of Washington’s AIM Center that treats common mental health conditions, such as depression and anxiety, that require systematic follow-up due to their persistence. Based on principles of effective treatment of chronic illness, collaborative care focuses on defined patient populations tracked in a registry, measurement-based practices, and treatment to target. Trained primary care providers and embedded behavioral health professionals provide evidence-based medication or psychosocial treatments, supported by regular psychiatric case consultation and treatment adjustment for patients who do not improve as expected.[3]

Principles of collaborative care

Developed in consultation with a group of national experts in integrated behavioral health care in 2011 with the support of the John A. Hartford Foundation, The Robert Wood Johnson Foundation, Agency for Healthcare Research and Quality, and California Healthcare Foundation, five core principles define collaborative care and should inform every aspect of implementation to ensure effective collaborative care is practiced.[4]

• Patient-centered team care—Primary care and behavioral health providers effectively work together using shared care plans that include patient goals. Being able to receive both physical and mental health care in a familiar location provides patients with comfort and reduces duplication of assessments. Increased patient engagement often leads to a better health care experience and improved patient outcomes.
• Population-based care—Care teams share a specific group of patients that are included in a registry. The registry is used to track patients and ensure that no one falls through the cracks. Patients who do not show improvement are outreached, and behavioral health specialists offer caseload-focused consultation.
• Measurement-based treatment to target—Each patient’s treatment plan includes personal goals and clinical outcomes that are measured using evidence-based tools, such as the Generalized Anxiety Disorder scale on a routine basis. If patients do not improve as expected, treatments are adjusted until clinical goals are met.
• Evidence-based care—Patients receive treatments with sound research evidence to support their efficacy in the treatment of the target condition, including various evidence-based psychotherapies that have proven effective in primary care, such as problem-solving treatment, behavioral activation, and cognitive behavioral therapy, and medicines.
• Accountable care—Providers are responsible for and receive reimbursement for the quality of care and clinical outcomes, not just the volume of care provided.

Collaborative care has been proven to double the effectiveness of depression care, improve physical function, and reduce health care costs. Magellan Healthcare’s evidence-based Collaborative Care Management product, enabled by NeuroFlow, provides care management and psychiatric consults for primary care patients and augments physical health providers’ staff with Magellan staff to facilitate integrated physical and behavioral healthcare. Learn more here.

[1] https://usafacts.org/articles/over-one-third-of-americans-live-in-areas-lacking-mental-health-professionals/

[2] https://aims.uw.edu/collaborative-care

[3] https://aims.uw.edu/collaborative-care

[4] https://aims.uw.edu/collaborative-care