Meredith Delk, general manager of the government markets division within Magellan Rx Management

What is the government markets division within Magellan Rx?

We are the largest pharmacy benefit administrator across 27 states and Washington D.C. working with Medicaid and public health agencies. We partner with states across the country to ensure that their Medicaid or AIDS Drug Assistance Program (ADAP) enrollees, depending on the state, have access to the drugs they need at the right time and at the right place. Additionally, we process approximately $18 Billion in rebate dollars on behalf of 20 states annually.

How does your work in the government markets division align with Magellan’s mission of leading humanity to healthy vibrant lives?

Our work is focused on people living in poverty across the United States. So, irrespective of the state and specific program, everyone we serve within the government markets division is affected by poverty and our commitment is to provide our customers (government agencies) and the consumers they serve with best-in-class service to access medications, therefore positively impacting their quality of life. We have about 1,000 employees on any given day who are dedicated across 27 states to ensure that the individuals we serve have a role in accessing their drugs and that they understand that their voices matter.

Further, we are deeply committed to our work across the country administering ADAP, thru our ADAP Center of Excellence. This is a federally funded program benefiting those who are affected by HIV and AIDS. As a result, these members are able to receive their life changing and lifesaving medications. In addition, there are wraparound services and other support services for people living with HIV and AIDS who do not have commercial healthcare and are not on Medicaid. The Ryan White program created a solution to ensure that, regardless of your socioeconomic status, if you are affected by HIV or AIDS, you will have access to medications. It is a fantastic program and one we are honored to be a part of here at Magellan.

Given everything that’s happening in healthcare right now with the pandemic, how does Magellan’s mission and improving customer service relate to the work you’re doing?

In many respects, the work we are doing in the government markets division supports the fabric of the safety net for millions of Americans. We know that through this pandemic unemployment has been on the rise, which means Medicaid enrollment has been on the rise, throughout the country. We also know that mental health issues have increased, creating additional challenges related to overall physical health and access to behavioral health services and medications. Within Magellan Rx and the government markets division, we’re on the front lines with our customers.

We partner with public health agencies to provide them real time solutions beyond our core POS work, for example. Right after the COVID vaccine was made available a Governor in a state where we have business announced during a press conference, that Magellan’s call center would be the vaccine hotline for every person in that state, regardless of their type of insurance. Almost overnight, we stood up a call center to support that state in improving their vaccination rates. We’re listening to and keeping a close eye on new and innovative challenges that Governors and Medicaid regulators have experienced during this pandemic.

How does your background in social work influence the work you’re doing and your leadership style?

I’m a trained clinical social worker and I also have a PhD in counseling. I have spent quite a bit of time while working on the PhD focused on people living in poverty who were also affected by a mental health issue and more specifically families who had a family member affected by severe mental illness. Additionally, I worked on the streets of Washington DC with people who were homeless and seriously affected by poverty, who also suffered from serious mental health issues. That’s really where I grew up in my 20’s, focused on people living in poverty and their access to mental health care. I worked at a lockdown stabilization unit for people who were suicidal and homicidal. It was a 7 p.m. to 7 a.m. shift on Friday and Saturday nights at the lockdown unit. That’s how I put myself through graduate school. I have seen firsthand the effects that mental illness and poverty combined have on people, families, and communities. In many respects, that is what created the foundation of my career. It helped establish the first pillar of my leadership style which is focus on your people first.

What is your strategy for keeping your team on mission and integrating them into the broader Magellan culture?

Every business leader and CEO rightfully would answer that question by talking about being best-in-class and supporting those we serve. I think the difference between us at Magellan and many other teams is the drive it takes to do that every single day. We are very disciplined about the data and metrics that bring to light how well we are doing on behalf of our associates, customers, and members.

I’m a former Amerigroup executive and Jim Carlson was the CEO when I went to work for them after spending a few years in state government. At AmeriGroup, I was very young and very green. I had the benefit of working under an extraordinary executive team led by Jim. Jim used to say, ‘don’t confuse effort with results.’  This aphorism has defined much of my career. To this end, we focus a great deal on the results we achieve with our customers, associates, and other key stakeholders.

The true measure of how well we are doing includes metrics like winning new business, bringing on new customers and retaining existing customers. In 2020, the government markets division earned a 100% customer satisfaction results. We surveyed all our government customers who are Medicaid regulators, and achieved 100% satisfaction, which is extraordinary and a direct result of the terrific work that our team does day in and day out.

Additionally, we have among the highest associate engagement scores on our internal customer service surveys. There are 28 people on my leadership team who bring 369 years of experience in our fee for service PBA (pharmacy benefit administration) business. On this team, 20 of those individuals have more than 10 years of experience with Magellan and eight of those individuals have more than 20 years. Three people have over 30 years of experience and the longest serving person on the team has 39 years of experience with Magellan. So, when you think about that, you know the turnover among leaders and subject matter experts is very low. This team is fundamentally about the people who come to work every day – they are truly focused on getting good work done, they like one another, they want to be here, they enjoy the work they’re doing and feel respected and valued for it.

What is exciting you about where we’re going, in terms of both Medi-Cal and Magellan Health as a broader company?

It is an exciting time for us in the government markets division. Medi-Cal is an extraordinary project, and it has been a true testament to the commitment and leadership brought by hundreds of people across the company and an exceptional California-based team led by Billy Thomas. They have shown up every day for the last year and a half, even during the pandemic, and are a team that’s so deeply committed to this work, and we will go live with Medi-Cal on January 1, 2022. The Medi-Cal project is transformative for the government markets division.

Additionally, we’re very excited about the work within the ADAP business. We’ve recently piloted our Navigate Whole Health program with our ADAP members. Results so far have shown us that very simple and straightforward clinical interventions with our providers and prescribers can really move the needle on quality and general efficacy of treatment modalities for HIV and AIDS medication. For example, we developed a regimen for one patient who didn’t want to take medications at work. As a result, the patient will be more compliant with the regimen. I believe it’s about adding more value and being a smart and sophisticated partner to these government entities and the people they serve.

Our national footprint allows us to be big thinkers. We can be more thoughtful and add more value because we are in 27 states across the country and every state is a little different. We also have the ability to leverage expertise, technology, infrastructure and innovation across the country.

Are you currently hiring for the Medi-Cal team?

Yes, we are. It’s a truly extraordinary project and an opportunity to be part of a team like no other in the country. There’s no state that has done quite what California has done with their Medi-Cal pharmacy benefit. This is a full drug carve out for all 14 million Medi-Cal enrollees.  It’s an opportunity to join a team led by Billy Thomas and his leadership team who are the best in the business. I also think it’s an opportunity to join a team where growth and development is a big part of the culture. We’re just very proud of the work that we have done with the state of California so far and are excited about serving them in a meaningful way. Anyone who’s interested in being part of that team should find out more. It’s a great team and it’s important work.

Learn more about joining the Medi-Cal team here.

Swarna Ramachandran is bringing a new digital experience to the world of behavioral health. As vice president of digital and contact center solutions for Magellan Healthcare, Ramachandran is leading a team that is redesigning the online digital experience for members, making it more intuitive when finding the necessary resources. Digital transformation, including technology, experience and Contact Center modernization, has been core to where she is today, and navigating the whole realm delivery & PMO come natural to her, says Ramachandran. Keep reading to learn how Ramachandran and her team are creating a new digital experience for Magellan Health members.

Q: What kind of projects are you working on right now?

A: Digital transformation is a key area of focus for Magellan Health. Engaging and enabling members digitally for care and self-service, helping reduce the stigma around mental health, and enabling self-service for providers and clients digitally are some of our key transformation goals.

The COVID-19 global pandemic has increased awareness and need for mental and behavioral health care for all of us. Several products have been released in the market that are either point solutions or solves for a couple areas of mental health, leaving the member with a myriad of apps and tools, leading to a dissatisfied member. One of Magellan Health’s core strengths is mental and behavioral health and with our diverse population of members across our products, we are in a unique position to provide our members with a guided approach to accessing care and address issues at their root by understanding the stressors, specific resources and community support.

Our vision is a holistic approach to member wellbeing and care. Our approach starts with member engagement and navigation to help remove the stigma towards mental health by helping the member to approach mental health and wellbeing as part of their whole health. We do this by promoting annual digital wellbeing checks in a self-service mode.

Q: How did you and your team come up with this idea? Why is Magellan Health the best place to work on this project?

A: Digital is everywhere and in everyone’s hand today in the form of mobile apps, websites and internet.  Ideas are plenty but solving for the real need is key. We conducted various design thinking sessions with members and studied the need thoroughly from the member perspective.

Magellan Health’s core strength is mental and behavioral healthcare, and we have a significant population of behavioral health members. We have members from our other products like Employer solutions, State and Federal, which puts us in a unique position to capitalize on our strengths and serve this large group of members at their doorstep and to get them healthy mentally and physically.

Learn more about the digital experience here.

New data from the Centers for Disease Control and Prevention shows that suicide rates have risen to over 30% in the US since 1999.[1] Since COVID-19 began, suicidal ideation in the US has more than doubled, with younger adults, racial/ethnic minorities, essential workers and unpaid adult caregivers experiencing disproportionately worse effects.[2] As suicide has reached crisis-level proportions in our nation, it’s time to recognize suicide as a public health crisis and learn about the warning signs and the skills needed to save a life.

Know the warning signs of suicide

It is hard to tell whether a person is thinking of suicide. Most people who take their own life show one or more warning signs, either through what they say or do.

• Feelings: Expressing hopelessness, talking about suicide or having no reason to live, showing moods such as depression, anxiety, irritability
• Actions: Showing severe/overwhelming pain or distress, using drugs or alcohol, searching for ways to end their life
• Changes: Withdrawing from activities, isolating from friends and family, sleeping more or less
• Threats: Talking about, writing about or making plans to kill themselves
• Situations: Going through stressful situations including loss, change, personal humiliation or difficulties at home, school or with the law

Take action to prevent suicide

Suicide remains the second leading cause of death among Americans between the ages 10 and 34, according to the CDC.[3] It is a major health crisis—and preventable. When someone says they are thinking about suicide or says things that sound as if they are considering suicide, it is important to pay attention and take action. Suicide is often preventable.

• Ask and listen: “Are you thinking about killing yourself?” is not an easy question, however, a study by the National Institute of Mental Health shows considering suicide may reduce rather than increase suicidal thoughts. Be willing to listen and discuss their feelings.
• Keep them safe: Reducing a person’s access to highly lethal objects or places is an important part of suicide prevention. Asking if the at-risk person has a plan and removing access to lethal means can make a difference.
• Get them help: Connect with a trusted family member, friend or mental health professional. Call the National Suicide Prevention Lifeline’s (1-800- 273-TALK (8255)) and the Crisis Text Line’s number (741741). Save these numbers in your phone so they’re there when you need them.
• Stay connected: Staying in touch after a crisis or discharge from care can make a difference. Let them know they matter and you care. Leave a message, send a text or call them.

For more information and helpful resources, visit MagellanHealthcare.com/Prevent-Suicide.

If you are in crisis or considering suicide, or if someone you know is currently in danger, please dial 911 immediately.

[1] https://www.nimh.nih.gov/health/statistics/suicide

[2] https://www.cdc.gov/mmwr/volumes/69/wr/mm6932a1.htm

[3] https://www.nimh.nih.gov/health/statistics/suicide

Irvin Towson, VP of Talent Acquisition, oversees all the Enterprise, Magellan Healthcare and Magellan Federal recruiting. Based out of Virginia and with seven years spent at Magellan Health, Towson takes pride in his team’s track record of finding the best talent to join Magellan Health. Targeting more than 2,500 hires this year, he is focused on recruiting strategies and execution, as well as the upcoming Centene acquisition.  We caught up with him recently to get his thoughts on how Magellan Talent Acquisition makes a difference in the lives of our teams and our members. Read more to see how Towson uses Talent Acquisition to help make a positive impact.

Q: What sort of cool projects are you working on right now?

A: This year we’re committed to hiring 2,500 people, so that’s exciting and keeps everyone more than busy. I’m always glad when recruiting is in an active state; I think it’s good for everyone within the company. I like that we have an impact on the lives of people and real-world issues and I’m looking forward to expanding upon that, too.

Q: How do you sell Magellan Health to potential new hires during the recruitment process? Why is Magellan Health the best place to work?

A: We always talk about our ability to impact the lives of people that we support, including how the mental health aspects of our work have come into greater focus. Also, Magellan Health is truly a very collegial organization. Companies often talk about fostering collaborative, collegial environments, but it is embedded in our DNA. These selling points attract exceptional talent to the company, since so many people want to be part of a great company and doing work that matters. I’ll also mention our culture of support and encouragement of remote work. That allows us to identify and recruit the most qualified candidates, irrespective of where they are located geographically. It opens a lot of doors for the company and individuals who could be interested in joining us.

Q: What are your thoughts on how the culture is here at Magellan Health, and how does that culture impact the recruitment process?

A: The leaders of this organization connect with employees in respectful ways. It is not an overly autocratic culture, in which the needs and feedback of team members are disregarded. I see a tremendous amount of mutual respect on display daily throughout the company and this makes a huge difference in someone’s experience at work. Most people here at Magellan Health are very engaging and interested in input from others, no matter their level in the organization. The willingness of leaders to be open and connect with people is one of our distinctive features and it defines the work environment we offer.

Q: Anything else you’d like to add?

A: In my view, acquiring talent is one of the most important things any company does, and I never forget how important it is to do that better than our competition. I’m very passionate about what I do and what we do at Magellan Health. Great organizations attract and keep the best people. It is through the best people that we create superb outcomes for our employees and help leading humanity to healthy vibrant lives.

• Read more about working at Magellan Health here.
• Learn more about working for Magellan Health here.

Jennifer Foley is leading a triage team of trained clinicians on the Employee Assistance Program (EAP) to connect members with a variety of services to promote whole health, including new virtual wellness and counseling experience. Foley, the interim senior manager of the employee Center of Excellence triage team, uses her experience as a former lifestyle coach with the EAP where she is responsible for managing clinicians and working with the account executives, sales team members, and executive leadership. Foley is based out of Davenport, Iowa, and has worked for Magellan Health since January 2012. As someone who is self-proclaimed “EAP for life,” Foley lives by the mission of focusing on overall wellness. Between her team, and help from various app partnerships, she can connect members with the help they need when they ask for it.

Q: What kind of projects are you working on now?

A: I manage a group of clinicians who talk to our members on the phone or over chat. We have a lot of amazing things happening with the core changes for the Employee Assistance Program (EAP). We recently had more services set up for our entire book of business, which is an exciting transition for us to be adding onto the services we offer for most of our companies. We focus on connecting with members and making sure they have the best possible experience in asking for help and a true understanding of all the services available to them to determine what their next best steps are. We are constantly growing and evolving to do that efficiently and effectively. Recently, we had someone call in and speak with one of our team members whose father had just passed away and explained that they were conflicted about it because he was their primary abuser and in prison for most of his life for that, so there was no relationship once he was released. They had learned of his passing because they were his primary beneficiary. One of this person’s primary stressors was that their father was a veteran, and they didn’t know what the next steps would be. My team was able to connect that person with the VA office and with the appropriate counseling. One of the best descriptions of my team is that we’re focused on overall wellness. We support you through the emotional impact and work together to get you to a place where you feel supported, connected, and have all the resources you need. We really do think outside the box and collaborate. That’s why EAP is so amazing, you’re able to look at the whole picture and work with companies who want to take care of employees and their family members to get their needs met.

A: Do you have any other examples of people you’ve helped that you could share?

Q: When someone calls in, they’re able to talk to us in that moment about whatever is going on. We use motivational interview techniques to really get to know them and understand what’s happening in their lives. Another recent call we had came from someone just over the age of 18 explaining that he was calling because a lot of people told him to; most important to him was his parents. We asked him why he wanted to call, he said he’s unsure how he feels about a lot of people telling him he needs help, and he was willing to talk about how he was feeling. That’s one of the amazing things about this, we’re not here to tell someone what they need to do, we’re here to tell them what their options are. He did disclose that he feels like he’s been drinking too much alcohol, he felt like he was using it as a coping mechanism. We were able to help connect him with a counselor, our online self-care platform, MyStrength that is intuitive and guides him through specific exercises to reduce his alcohol use, get him with our Life Enrichement Program that helped him find nearby gyms he could join and use exercise as a coping skill with his friends where he could also socialize without drinking. A lot of times when people think about the EAP they only think of counseling, and while there certainly is counseling, we also provide many other services like, lifestyle coaching, financial resources, identify theft resolution, legal consultations, life enrichment services, and the self-care wellness and resiliency platform. These services are often utilized together to provide the best overall support.

Q: Why is Magellan Health the best place for this?

A: I am EAP for life, I can’t think of a better way to spend my day than to work with these companies and help our members find their next best steps. Magellan Health stands out because our people are truly passionate about what they do. To be able to work with team members who care about what we’re doing and how we can help people means the world.

Q: What are your thoughts on the culture here at Magellan Health and how does it impact the work you do?

A: I do think the culture here is truly the best. It is the most supportive environment. We operate where mistakes can be easily made and miscommunication can happen. The team looks at it in an understanding way. We are all working toward the common goal of promoting overall wellness. Magellan Health’s response to COVID-19 was amazing. We made sure we had the best services to offer our members by bringing on a virtual platform that doubled the number of sessions held per month by recognizing this need in society. This makes me proud to be with Magellan. Just making sure we’re meeting every need on a plethora of services, I’m looking forward to that continued help and development. I’m so excited about our future and know the best is yet to come.

Q: Can you tell me more about the EAP’s app partnerships?

A: We partner with a few and then also have others that we recommend on the website. We work with the app BetterHelp; they’ve been a good virtual platform to partner with to provide additional counseling services. Prior to COVID-19, we offered traditional face-to-face services. We partnered with BetterHelp to be able to have online scheduling for therapeutic scheduled chats on Teams, video counseling, telephonic counseling, and texts. We’ve had about 6,000 sessions a month on this one platform. Being able to pivot and do what we need to do to ensure our members have the best care possible has made this a great partnership. MyStrength is another app-based program we’ve partnered with. Members can log into the app and create a profile. It helps them with pinpointing the things they might want to work on physically, mentally, emotionally, and spiritually. It meets what you need and tracks your overall progress. It’s very user friendly and recognizes if things become more serious, it will then refer you to Magellan Health’s clinician triage team.

Learn more about Magellan Health’s EAP here.

Read more about Magellan Health’s EAP here.

Think back to New Year’s Eve, Tuesday, December 31, 2019. Maybe you had big plans that night to ring in the new year, or maybe you were spending a quiet evening at home. In either case, you probably had expectations about 2020 and hopes that it would be happy, healthy and prosperous…

Fast forward a couple months to February, 2020 when we began hearing more about a new coronavirus, COVID-19, originating from Wuhan, China that had made its way into the United States and was beginning to spread.

Changes caused by COVID-19

We started to see our world and our lives drastically change, experiencing loss and grief in several forms. For many of us, there were no more commutes to work, as we began to work from home if we were lucky enough to keep our job. There was no more getting the kids off to the bus stop or waiting in the drop-off line, as schools closed and switched to a virtual learning environment.

Parents lost the luxury of being able to fully concentrate on their jobs, as they were forced to take on the roles of teacher or daycare worker and daytime entertainer for their kids. Kids missed out on receiving the first-class education they depended on to feel prepared for the next school year or even college.

Healthcare workers risked their lives and those of their family to care for the people who were getting sick from COVID-19, worried they had been infected and wanted to get tested, or needed regular healthcare. Essential workers in grocery stores, post offices, public transportation, and other industries also became heroes as they continued to come to work to keep the country running, despite fearing for their own health and lives.

And there wasn’t a roll of toilet paper or paper towels to be found.

Social isolation

Across the board, we didn’t get to spend precious in-person time with our extended family and friends because we were doing our part to bend the curve and stop the spread of COVID-19. We didn’t get to go to the gym and may have fallen behind in our physical fitness. Our kids didn’t get to participate in their beloved sporting or other extracurricular events. Medical procedures were cancelled. Vacations were cancelled. Weddings were cancelled. Graduations were cancelled. Everything was cancelled.

Our dreams and plans were put on hold.

COVID-19 mental health toll

We certainly couldn’t have imagined this would be how the year would start off and end. Spring, summer, fall and winter, and all that comes with each, did not happen the way we have all become accustomed to for our entire lives.

And while we have done our best to adapt, the grief and loss of loved ones, financial security and social normality we have experienced over the past year has taken its toll on our mental health.

Where to go from here

We encourage you to watch a recording of our webinar “Coping with grief and loss during COVID-19” with Paula Hensley, MD, Magellan Healthcare senior medical director; Sagar Makanji, PharmD, Magellan Rx vice president, clinical strategy and programs; and Mark Santilli, PharmD, Magellan Rx senior director, clinical strategy and programs, as they share knowledge and tips for persevering after grief and loss due to COVID-19 and answer audience questions.

For additional COVID-19 resources from Magellan Health, click here.

Many of us can now say we have experienced the trials and tribulations of parenting during a pandemic. We have attempted to juggle full-time work and regular household duties, along with being a full-time teacher or daycare worker and entertainer for our kids. While we’re all doing the best we can in taking on these new and challenging roles, some parents and caregivers may be wondering about their child’s mental health after they have missed out on so much and dealt with new stress and uncertainty – certainly as many of us know that our own mental health has been affected.

If you’re worried about your child’s mental health or noticing any issues, read on for tips and knowledge shared by Magellan’s Linda Y. Evans, MD, FAPA, child psychiatrist and medical director, and Greg Dicharry, CPRP, youth empowerment director.

Children behavior changes

Changes in your child’s behavior may be a sign of mental health difficulties that should be closely monitored. Depending on the age of your child, stress can manifest in different ways. Toddlers and young children aged 2-6, may show signs of regression and lose the ability to do things previously learned, like toilet training. School-aged children and teenagers may show a disinterest in going to school and/or begin to see falling grades. The most common symptom in teenagers is irritable mood. Kids of all ages may experience vague body complaints, like a headache or belly ache, changes in sleep or appetite, difficulty concentrating, loss of pleasure in activities previously enjoyed, and withdrawal from social interactions.

Often, even the child may not recognize these symptoms as the result of mental health issues. It is important for parents and caregivers to be a barometer for behavioral or other changes in their children – as they may be the first to notice – to be able to identify if their mental health may be suffering. When parents keep the lines of communication open, allowing their kids to share their thoughts and feelings, they are better equipped to identify any troubling signs of childhood depression, anxiety or other mental health conditions.

The child’s primary care physician (PCP) also plays a role in screening for mental health concerns and can be a good first point of contact if parents are seeking additional help. With the shortage of child psychiatrists and mental health professionals trained to work with children in our country, PCPs are increasingly adopting a model of collaborative, or whole-person, care to screen and treat children for mental health issues before they get worse because of potentially waiting long periods to see a specialist.

Interrupted school and family routines

While there’s not much we can do about changing work, school and social arrangements due to the pandemic, it’s important to consider the stability of our kids’ environment and instill predictability in their lives to the extent that’s possible.

Additionally, there are many things that parents and caregivers can do to keep their kids content and engaged amid the chaos and unprecedented change we’re all experiencing. To make up for lost in-person social time with friends and family, virtual meetups can be scheduled. That could be a fifteen-minute Facetime call with grandma and grandpa every Wednesday night at 7:00, or a periodic Zoom/interactive video game gathering with friends. Parents can also take time with their kids away from the screens to play a board game or do a project to make home-time more fun. Exploring and supporting your kids’ passions is a way to get them involved in activities that will bridge the gaps of interrupted routines and help prevent negative mental health outcomes.

Family stress affecting children

We have all been affected by the drastic changes, uncertainty, loss and isolation caused by COVID-19. And it’s not hard for our own stress and worry to be noticed or even absorbed to some extent by our kids. While we’re focusing on our family’s well-being, it’s important to practice self-care and recognize that our own mental health is of paramount importance. Having healthy caregivers is an essential component in the normal development of kids.

When parents are navigating divorce and co-parenting arrangements during COVID-19, it can be even more difficult to filter out the negativity for our kids, especially when parents have different points of view about things like in-person vs. virtual learning, the vaccine and mask wearing. Although it can be difficult to share your kids with an ex-spouse, it’s important to remember they need both of their parents. When parents work together for the benefit of their children and keep the focus on them, the impacts of divorce can be mitigated. Implementing a flexible custody arrangement during COVID-19 is also encouraged; for example, if the child wants to see a parent when it’s not their day for visitation, it might be beneficial to the child to honor their request.

To alleviate stress and some of the burden, parents and caregivers can consider connecting with others who understand the struggles and support each other. They can look for parent support groups in their communities.

Back to school and bullying

For kids who experience any level of social anxiety, the transition back to school, or even a new school, from the comfort of home may be more difficult. While some kids may be happy to get right back to the in-person learning environment, a gradual adjustment may work better for others.

Teachers can be especially helpful in ensuring that children are adjusting well and that a child withdrawing from the group is noticed. When the teacher has a trusting relationship with students, they can initiate conversations to try to understand how a child is doing and if their emotional needs are being met. The teacher’s insights are critical for parents and caregivers who cannot be with their kids at school.

Parents and teachers should be especially sensitive to look for bullying and have a zero-tolerance policy for kids being cruel to one another. Children must understand that bullying is unacceptable, as it can lead to serious and disastrous consequences for those who are targeted.

In general, what kids need for healthy development is a stable routine, predictability, a safe environment and healthy parents or caregivers. COVID-19 has disrupted all of these conditions, leading to increased mental health disorders and interrupted development. There are many things that parents and caregivers can do to nurture their child’s mental health and address what they need for healthy development. We encourage you to explore Magellan’s following resources for additional information and support:

• Mental Health Month website for comprehensive tips and resources to support yours and your family’s mental health.
  • Be sure to check out the recording of our webinar, How are your kids doing? under “Previous events”
• Understanding and Meeting the Needs of Children and Adolescents at High Risk: Foundations of a Model clinical monograph highlighting evidence-based research on the prevention and treatment of problematic behaviors and various types of behavioral health challenges in children and adolescents.
• Stay Home for MY LIFE virtual youth fest, featuring inspirational speakers, uplifting entertainment, fun activities and more, taking place on the 4^th Thursday of each month, from 6:00 – 7:30 p.m. ET, for youth and young adults who have experience with mental health, substance use, juvenile justice and foster-care-related issues, as well as professionals and caregivers across the country.

“These [medical pharmacy] trends continue to be a challenge for all stakeholders involved in the care of patients with complex specialty conditions, making it vital for them to stay current and informed for better decision-making,” said Kristen Reimers, RPh, senior vice president, specialty clinical solutions, Magellan Rx Management.

Medical benefit drug spend, or what we call medical pharmacy, continues to be one of the largest cost drivers when it comes to overall specialty drug trends. At Magellan Rx, we have nearly 20 years of experience in managing this high-cost and complex portion of medical pharmacy spend and have published the industry’s only detailed source for trends related to medical pharmacy for the last 11 years.

Here are the trends you need to know from the eleventh edition of the Medical Pharmacy Trend Report:¹

1. Commercial per-member-per-month (PMPM) spend has increased 89% from 2009 to 2019.
2. Medicare remains the highest spend and utilization line of business (LOB) with 10% of members having a medical drug claim.
3. The average annual cost per member for the top 10 drugs is almost $45,000 for Commercial members.
4. For medical specialty drugs 30% of members are driving 96% of the spend.
5. Gene therapy is the top concern for payers in medical pharmacy.
6. Oncology remains #1 highest-spend category across all LOBs.
7. The oncology pipeline is forecasted to increase 105% in PMPM spend from $52 in 2019 to $106 in 2024.
8. There’s a new top five drug list for commercial: Remicade, Neulasta, Ocrevus, Herceptin, Avastin, with Ocrevus entering the top 5 and having an 85% trend.
9. The highest-cost medical benefit drugs exceed $1M per patient per year.
10. Biosimilars Renflexis and Inflectra (in the BDAIDs category) market share increased 4-6 percentage points for commercial and Medicare and a substantial 24 percentage points for Medicaid.

Want to dig into these trends and more, including the latest in management strategies to combat rising pharmacy trend? Download your copy of the report.

1. Unlock the Latest Trends and Emerging Strategies to Manage Rising Medical Benefit Specialty Drug Spend.” Magellan Rx Management Press Release, 20 May 2021. Accessed May 20, 2021.
2. 2020 Magellan Rx Management Medical Pharmacy Trend Report™, © 2021.