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.

A study by a team of Magellan researchers, demonstrating the pervasiveness of opioid addiction, was presented at the American Psychiatric Association (APA) Annual Meeting, and was also the subject of an article by Clinical Psychiatry News.

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.

Dr. Shareh Ghani, vice president medical director at Magellan Healthcare, and lead author of the study spoke of the importance of fully understanding the scope of the addiction crisis: “Having worked in commercial and Medicaid markets, I have reviewed numerous cases of accidental overdose and suicides related to pain prescriptions. The opioid crisis in this country demands that we understand the issue and identify predictors of risk.”

Study co-author Gowri Shetty, vice president of analytics, underscored the importance of the work: “This study helped us understand the clinical characteristics associated with long-term and persistent opioid use and provided a better understanding of how to tailor interventions targeting those at increased risk of inappropriate opioid use.”

The opioid crisis remains a key area of research and development across Magellan Health. You can read the article by clicking here to visit the Clinical Psychiatry News website.

I shared this message with all 10,000 associates at Magellan yesterday. As I said in my message, times like these require all of us not to be silent, but instead to stand tall and make it very clear that we are committed to an environment where all people can progress personally and professionally, and work in a positive, uplifting workplace. Given the current state of events in our country, and particularly the divisive events of this week, I felt it important to reaffirm the values we hold dear within Magellan.

“Leading humanity to healthy, vibrant lives” is what guides our decision making and inspires us to accomplish meaningful, positive change in the lives of those we serve. This can only be done if we respect and value each other, and every person we serve, without condition or qualification.

For the many years I have been associated with Magellan, I have been impressed by the integrity and commitment of Magellan team members to create a culture of caring. I have seen great respect for people of all races, religions, gender and sexual orientation, to name only a few of the things that make us different. There is no doubt that the diversity of our people allows us to better understand and execute our vision of making a powerful impact on the world around us.

I want to reaffirm in a direct and simple way that we will never diverge from valuing differences, and creating a culture in which we can learn from each other and grow as individuals, teams, and a company.

Times like these require all of us not to be silent, but instead to stand tall and make it very clear that we are committed to an environment where all people can progress personally and professionally, and work in a positive, uplifting workplace. Our differences are to be celebrated; they are absolutely key in helping us in “leading humanity to healthy, vibrant lives.”

Thank you for the great work you do. I am proud to be associated with you.

The past decade has seen some remarkable changes in technology, which has ushered in an era where we are always “on,” always connected and where most everything that was analog now is digital. Many of us walk around with powerful computers in our pockets –also known as smartphones–that are more powerful than the computers that help put a man on the moon only a few decades ago. Today, we can order car rides from our phones, pay for our groceries, watch movies or do just about anything from a smartphone or network-connected device from anywhere across the globe. Yet for many of us, we go through a time warp when we move from our personal lives to our work environments.

Magellan: a Digital Healthcare Company

At Magellan, we have an inspired leadership team that is building a workforce of the future. We recruit the best talent wherever we can find it across the globe and provide them with great work-life integration by providing flexible working arrangements. Over 40 percent of our workforce does not work in one of our offices, and many of our employees are mobile and on the road helping our member and providers. This kind of a workforce requires the collaboration platform of the future.

During the summer of 2016, we assembled and rolled out Magellan’s next generation collaboration platform. This platform was built with a mobile-first, cloud-first, always digital mindset designed to provide secure, seamless and context-aware experiences within the enterprise. This new platform is all about providing choices: it works across Macs and PCs, across browsers, across Apple and Android mobile devices and can work across a 4G connection and high-speed wifi alike.

The platform uses five technologies that we use in our personal lives on a daily basis:

• Workplace and Workchat for desktop and mobile devices. These are the enterprise- grade versions of Facebook and Facebook Messenger, complete with networking, group collaboration and social sharing capabilities.
• A cloud-based document and content management solution from Box.
• Enterprise-quality HD video conferencing and desktop sharing through Zoom.
• Productivity applications from Microsoft through Office 365.
• An integrated access portal tied together by a robust security and identity management solution from Okta.

Okta acts as a gateway to every other application, website or solution provided by Magellan. It simplifies password management and provides secure multi-factor authentication – in short it makes our applications accessible to everyone, anywhere, at any time over any network or device. It allows an employee to take a video call from her home office and collaborate with her colleagues in a Workplace group and continue that conversation on a mobile device as she takes the train into see a customer for an afternoon meeting – secure, seamless and context-aware collaboration.

 Technology leading culture; culture leading technology

One of the interesting developments in our culture is the use of desktop and mobile video conferencing which allows us to personalize each call, read body language and emotions and share the true benefits of face-to-face communications, instead of being on nameless, faceless, monotonous conference calls.  This is changing the cultural fabric of Magellan by making the enterprise more personal and more social.  It is challenging our management orthodoxies and help reinvent management.

With this new platform, we are building communities that span geographies, business units, departments and even companies. In the past year, we have seen over 700 groups evolve organically on this platform.  Some of these groups focus on specific projects, initiatives or events, and others focus on communities of users and social groups. We even have a community of musicians at Magellan. In short, the platform helps people stay connected in a personal way without having to be located in the same spot.

Ultimately, our technology is a means by which we can help improve the experience – and quality of care – for our customers and members. Our objective for this new platform is to make the technology invisible to the user and allow them to seamlessly play their part to help individuals live healthy, vibrant lives.