Contemplating life and death is probably common when in the midst of a natural disaster. As the eye of Irma passed over me on September 10, I was thinking about suicide and suicide prevention. September is Suicide Prevention Awareness Month, and Magellan Complete Care, our health plan for individuals living with serious mental illness in Florida, had been busy preparing for summits to draw attention to and dialogue around suicide prevention to local communities. Two days before Irma hit, I was busy canceling vendors for the summits. The day before Irma, I was dealing with a surprise, last-minute mandatory evacuation order while trying to locate a friend who was experiencing homelessness and depression, and who had expressed a desire to let the storm take his life instead of seeking shelter.

As the winds howled, windows rattled, and rain pounded against the home I had evacuated to, I sat on a closet floor thinking about how much I wanted to live and how that desire to live had not always been there. There were years where, like my friend, I was lost in my own storm. Depression had flooded my soul, my thoughts were battered by negativity and I never felt safe. The aftermath, similar to a hurricane, was a life left in shambles, just wishing for normalcy.

Recent hurricanes, earthquakes and wildfires remind us of the value of life. Suicide Prevention Awareness Month provides another reminder. Every 13 minutes that the winds and rain of Irma pelted my home state, someone in this country was ending their life too soon by suicide. With a completed suicide happening in Florida every three hours , the death toll from suicide may end up being higher than that from Irma’s destruction.

Natural disasters and the realities of suicide provide the same call to action to communities. We have a responsibility to watch out for each other and take care of each other. When the power is out, you share the food and batteries you have and a reminder to hold on. When someone’s internal light is out, you share hope and support and a reminder to stay strong.

There is much work ahead to rebuild lives, homes, and communities devastated by recent natural disasters; to support communities in reducing death by suicide; and to help individuals struggling through adversity. I am living proof that a life can be rebuilt. Whatever challenge you are facing, hold on, stay strong and don’t be afraid to ask for and accept help.

A study by a team of Magellan researchers, demonstrating the pervasiveness of opioid addiction, was featured on CBS Philly (KYW).

The study, an analysis of medical and pharmacy data from 2009—2012 for 2.5 million people aged 20-64 who were part of a commercial health plan, showed that 48 percent of patients who had stopped using opioids for at least six months went on to use them again.

You can read more about the study by clicking here.

Written by Thomas Lane, NCPS, CRPS

September is National Recovery Month, and during this time, we celebrate the fact that people living with mental health and substance use disorders can and do recover.  Recovery is real.  But what does it mean to recover?  It’s an important question, and there is no simple answer.  Each individual experiences recovery in unique ways.  As a person in recovery, here is what I believe we have in common.

Hope – We all need hope in our lives.  Hope is like a beacon, a light that shines in our lives and in the lives of others.  It is vital.  But there are times when we lose hope.  It’s in those times we need someone to hold the hope for us.  Hope doesn’t cost anything to give, yet it is priceless.

Self-determination – Self-determination is a fundamental value in our lives. For many of us, our choices have been limited due to the impact of our mental health or substance use disorders.  Some of us live with both.  There are times when conditions are imposed on us that are not consistent with our own goals and aspirations.  Self-determination is so important, because without it, we can feel hopeless and without control in our lives.  Decision support tools and opportunities to strengthen self-efficacy empower us to choose self-determined roles in communities of our choice.

Connectedness – We are interdependent.  Connections to others and meaningful relationships are human needs.  Without connections, we can feel isolated. Developing circles of support and being included strengthens our recovery.  We are part of our communities and cultures, not separate from them.

Health  – Many of us live with chronic health conditions.  In fact, the average life expectancy for a person living with a serious mental health condition is twenty five years shorter than the general population. Finding good health care professionals who support improvements in our health and conditions, beyond just symptom and illness management, helps us realize improved personal health outcomes.   We develop healthy living habits.  Good nutrition, exercise, restful sleep; we are intentional in our approach to live well.

Peer Support – To me, peer support is the bedrock for recovery.  When someone shares experiences we can relate to, experiences we may have in common, we discover we are not alone.  We discover others have made it through similar difficult times and overcome similar challenges.  We are encouraged.  We gain confidence.  We rediscover hope.  And we pay it forward.

As I think about this year’s National Recovery Month, I know from my own experience that recovery is not a straight path.  I know there may be setbacks and hurdles to overcome.  But I am absolutely convinced that recovery is real.  It happens when we have hope in our lives, when we have choices, and when we are connected to each other and our communities.   It happens when our health care needs are met and we work to become healthier.  For so many of us, peer support represents the beginning of our journey.  Let us celebrate each person’s pathway, honor each person’s journey, and welcome those who walk alongside us.

Magellan’s offices in Virginia have been abuzz for the past few months, busily preparing to implement a brand-new contract as Magellan Complete Care of Virginia (MCC of VA), serving individuals who qualify for Medicaid due to a disability or who are age 65 or older.

On Aug. 1, MCC of VA made its debut in the commonwealth as a full-service managed long-term services and supports (MLTSS) health plan selected by the Virginia Department of Medical Assistance Services (DMAS) to serve members enrolled in the Commonwealth Coordinated Care Plus (CCC Plus) program. The plan initially launched in the Tidewater region, then in the Central Region on Sept. 1, and has been approved to roll out in the Charlottesville/Western region on Oct. 1. MCC of VA will go live in phases for additional regions across the commonwealth through early 2018, pending DMAS approval.

 What are managed long-term services and supports?

MLTSS is the delivery of long-term services and supports through capitated Medicaid managed care programs. Many states use MLTSS as a strategy to expand home- and community-based services, promoting community inclusion, ensuring quality and increasing efficiency. In Virginia, care management is the foundation of CCC Plus, which focuses on improving quality, access and efficiency through high-touch, person-centered support.

Magellan’s role in CCC Plus

Enrolling in CCC Plus means that members will now have their medical, behavioral, substance use disorder and long-term services and supports provided all under one program. When individuals select MCC of VA as their health plan, they can expect to benefit from Magellan’s vast experience coordinating care for individuals who have multiple complex conditions, including chronic physical and behavioral health challenges.

Our person-centered culture is woven into everything we do, as is our dedication to offering choices for our members, who serve at the center of their care coordination team.

 Our approach: It’s all in the ‘neighborhood’

We believe individuals should have a choice in where they live and receive services. Therefore, a key component of MCC of VA’s program is what we call our Integrated Health Neighborhood^SM. [Link to IHN infographic] The IHN is a custom model that helps us work with individuals within their own neighborhoods and communities to improve care, quality of life and health outcomes.

Our care teams live and work within the same communities where our members reside. These team members have first-hand knowledge of community strengths, resources, services, and service gaps.

Our integrated, high-touch, team-based IHN approach drives close collaboration with community partners. This allows us to customize care for our members and provide a seamless, one-stop system of services and supports. We can then address each member’s unique needs and circumstances and continually adjust our interventions as the member’s needs change.

Looking toward the future

We invest our resources into making an impact, one person at a time, by taking a highly individualized, high-touch, community-based approach to care coordination – because we know that each person can live a vibrant, healthy life as independently as possible. And we look forward to helping the individuals we serve in Virginia to meet this goal.

Learn more about MCC of VA

As we observe National Suicide Prevention Week 2017, we sat down with Dr. Shareh Ghani, vice president and medical director at Magellan Healthcare who lead Magellan’s Driving Suicide to Zero Initiative.

Magellan Health Insights: Dr. Ghani, thank you for chatting with us today. Tell us about the work you did with the Driving Suicide to Zero Initiative
 Dr. Shareh Ghani: In some parts of the healthcare community, there is a view that suicide is something ‘that just happens’; that it is unavoidable and acceptable. The Driving Suicide to Zero Initiative sought to change that paradigm. Through our efforts in a public health program, we shifted the viewpoint to one that believes that suicide can be stopped and can be driven to zero.

MHI: You have lead a number of initiatives for Magellan, what was your interest in this particular program?

SG: I have been working in mental health since 1993. From 1993 to 1995, during my residency, I had a lot of experience with suicide prevention research, and again working in community psychiatry. There is a lot of good research on the how of suicide, but I want to understand the why.

MHI: You looked at a lot of data as a part of this initiative. Tell us about that.

SG: We were managing the behavioral health contract for Maricopa County between 2007 and 2012. At the time, Phoenix had the seventh highest suicide rate in the country. The suicide rate for those with mental health issues was even higher.

During that time, we reviewed every case of completed suicide to see what could have been done differently.

MHI: What was the Driving Suicide to Zero Initiative hoping to achieve?

SG: Of course, we were looking to significantly impact suicide rates in Maricopa County. But more than that, we were looking to develop a systematized, data-driven, reproducible model.

Part of that meant preparing the clinical workforce to confidently identify at-risk individuals and improve treatment access and engagement. It also meant incorporating family and community participation to better identify early warning signs, navigate the clinical system, and support members at risk.

Finally, there was the integration of a sustainable and replicable clinical and support model and program tools into an EMR [Electronic Medical Record] to ensure that healthcare providers can, from a single source, identify, manage and plan for zero suicides through the safe management of those at risk.

MHI: And what were the results of the initiative? Was it successful?

SG: The results were highly encouraging. Between 2007 and 2012, there was a 67 percent reduction of the suicide rate for the population. Furthermore, there was a 42 percent decrease in the suicide rate of people with serious mental illness.

MHI: You mentioned earlier that the suicide rate was much higher for those with serious mental illness?

SG: Yes, it is a fact that individuals suffering from severe mental illness are six to 12 times more likely to die from suicide than the general population.

MHI: If you could hope that people would take away one thing from the Driving Suicide to Zero Initiative what would it be?

SG: That employing a rigorous, data-driven, scalable and reproducible population health approach to address suicide prevention, and creating a sustainable ecology of support around the individual and the community, is possible.

The Magellan Driving Suicide to Zero Initiative successfully incorporated population surveillance, analytics, research, early detection, intervention and monitoring to shift the paradigm from crisis mitigation to early prevention of suicide.

We’ve all been impacted by the horrific flooding taking place in Texas due to Hurricane Harvey, and witnessed the many instances of heroism and community support in response to this tragedy. In addition to the widespread damage occurring, we have a number of Magellan team members and their families who live in impacted areas and who are witnessing the devastation first-hand. Unfortunately, some are without power, and others have been displaced from their homes.

Leading humanity to healthy, vibrant lives is what we do on a daily basis on behalf of our members, so it’s no surprise that so many of us want to do something to help. I’m proud of what we as a company are doing to support our Texas-based customers, members and affected communities:

• Supporting the Houston Community: The State of Texas, specifically the Houston area, will be living with catastrophic damage for some time and rebuilding from this damage for even longer. The Magellan Cares Foundation is supporting these clean-up efforts with a contribution of $25,000 to the Houston Relief Fund, which is the organization that has been established by the mayor. This contribution will help local efforts to assist those in need.
• Utilizing Our Expertise: When we looked at the forecast for Hurricane Harvey, we opened our 24-hour crisis line early Friday morning for all Texans affected by the storm, whether they are our members or not. Free, confidential counseling services and other resources, such as referrals to local non-profit organizations, shelters and additional community-based support are available to assist Texans as they work to cope with this natural disaster. This line will remain open in the coming weeks and months as the community begins to assess damages and the full impact of the storm.
• Customer/Member Impact: We continue to serve our Texas-based customers, members and others who have been impacted by the storm. Some have likely spent time in shelters, others have lost power, and still others are facing challenges of which we are probably not aware. I’ve asked all of our associates to think about their situation and consider additional ways in which we can best serve them.

No one ever expects to be challenged with a catastrophic event, but I’ve been so proud of the way in which our team has sprung to action to help those in need in Houston.

Privacy is a funny thing, and peoples’ choices about privacy when technology is involved is often hard to explain. We don’t think twice about letting companies track what we like and don’t; what we search for and when we search; the photos we like and the ones we don’t; our shopping patterns and our wish lists; where we go and when; and now, we welcome full-time listening devices into our homes. I often wonder if these listening devices would find their way into our kitchens if they looked more like a reel-to-reel recording device versus a cute little modern orb with fancy LEDs.

Despite how comfortable we are with technology in some parts of our lives, there seems to be a line that many won’t cross. For some reason, discussing our finances while the orb is listening is okay, but using technology to help us manage our healthcare strikes some people as going too far.

This line is moving, albeit slowly.

There are real challenges in advancing technology in healthcare. But most importantly, we need to allow consumers to choose how they want to see their health information.

Texting is common in healthcare today, but it is inefficient, and often, confusing. Most healthcare-related texts contain either redacted information, such as, “You have not filled AtorXXXXXXXX prescription,” or contain links on which you have to click to take you to another message. Amazon doesn’t make a customer guess at the contents of their message or follow a clunky process to share information, so why do we do it in healthcare?

There are a number of regulations that govern Protected Health Information (PHI), and it’s critical that we take them seriously. After all, we’re talking about very sensitive and private material about diagnoses, medication, diagnostics and other information.

But, with careful planning and execution we can balance what is required of us by law while providing consumers with information that will help make their healthcare journey more efficient and tech-enabled. For example, we were able to craft, on behalf of our clients, end-user agreements that allow us to send texts that look like this:

“Your health is important to [Insert Client Name], please take your cholesterol medication as prescribed.”

The results from this texting pilot were nothing short of amazing. 26 percent of the people who received this message, none of whom were previously following their doctor’s orders, promptly filled the prescription. Interestingly, we saw similar results in every category we piloted. Why? It’s simple: nothing had to be decoded, no incremental steps needed to be taken, no password had to reset, etc. The best part of the pilot? 87 percent of the people who started, stayed in the program.

With pilots like this, we moved the line a smidge.

Texting was one of our first pilots and it was critical to challenging our thinking and finding new ways to solve old problems. The line needs to keep moving forward and we welcome the challenge.

Magellan Rx Management will soon be hosting the 14^th Annual Specialty Summit.  We had the opportunity to sit down with Phillip Vecchiolli, senior vice president and general manager of our specialty division at Magellan Rx Management to share his thoughts on this exciting event.

Magellan Health Insights: What can attendees expect at this year’s Specialty Summit?

Phillip Vecchiolli: The Magellan Rx Management Specialty Summit has become the source for staying ahead in today’s specialty drug management industry.  We host nationally recognized payers, physicians and industry insiders for a program packed with timely insights, thoughtful debate, and actionable dialogue on emerging trends in the evolving specialty market and effective solutions for managing specialty drug trend.

MHI: When and where is it going to be held this year?

PV: We are excited to be back in the heart of New York City. The event takes place on August 28-30, 2017 at the Sheraton New York Times Square Hotel.  And when attendees aren’t engaging in Summit activities, we encourage them to take in the sights, as we’ll be within walking distance of a number of famous attractions including Central Park, The Plaza Hotel, Radio City Music Hall, MOMA and more.

MHI: Why do you think this event is especially important?

PV: This is an exciting and disruptive time in specialty pharmacy. Specialty drug costs are skyrocketing and without an understanding of the unique dynamics around specialty drug management, payers run the risk of overlooking or misunderstanding this critical area of pharmacy spend.

At Magellan Rx Management, we specialize in connecting people with the tools, and information they need to make the best decisions for the populations they serve.  This event serves as a forum for nationally recognized payers, oncologists, and industry thought leaders to explore and discuss the key issues and challenges we face in an evolving specialty market.  Along with general topic presentations we also have a few interviews and panels for even more information-sharing discussions designed to provide an environment of teamwork and strategic information sharing.

MHI: Who typically attends the specialty summit?

PV: The Specialty Summit is designed especially for health plans, employer groups, states, third-party administrators, oncologists, practice managers, brokers, consultants and pharmaceutical manufacturers.

MHI: What are you most excited about this year?

PV: This year’s program is packed with timely insights from thought leaders across the specialty landscape and is designed to shine a light on the emerging trends and effective solutions in this evolving specialty market.

From its beginnings 14 years ago, this conference has exploded in terms of attendance and the caliber of our programming. This year, we’re expecting over 600 attendees, with numerous opportunities to network and meet with our peers, as well as compelling programming and dialogue around the most pressing topics in our industry. I’m particularly looking forward to the presentations and discussions about the oncology landscape, the Affordable Care Act, biosimilars, and medical pharmacy.  Our keynote Dr. Matt Iseman is going to be pretty spectacular too!

MHI: Any closing words?

PV: We are thrilled to again be hosting the 14^th Annual Specialty Summit.  At Magellan Rx, we are proud to be pioneers in specialty pharmacy management. By leveraging our industry-leading expertise and value-driven solutions, we help our clients solve their specialty pharmacy challenges. Our passion is to help people live more vibrant lives and to motivate them to take better control of their health.

Learn more about the Specialty Summit