Since joining Magellan Behavioral Health of Pennsylvania (Magellan) two years ago, Stephanie Cassanese, stays busy in Cambria County supporting many different aspects of Magellan’s business in the Pennsylvania counties served by Magellan. In her role as supervisor of Recovery and Resiliency Services, Cassanese first and foremost leads the recovery and resiliency team and leads MY LIFE for Pennsylvania, where she oversees all aspects of the youth and young adult program for all Magellan counties.

“I do many things and every day here is different which is one of the reasons I love the job. It’s never the same day twice,” said Cassanese. Continue reading to learn more about the many innovative initiatives Cassanese and her team are working on at Magellan:

What project have you recently worked on that is impactful?

My team completed a project at the end of 2022 called the Peer Professional Employment Guide. It’s a workbook that we provide to new certified peer support (CPS) professionals with the goal of providing a source of advice and inspiration. This was a part of our Workforce Development Project that we’re continuing into 2023 post-COVID. There have been staffing shortages in every industry, but particularly in mental health. We’ve struggled to find and retain workers, so this is a part of our hope to retain newly trained peer professionals. There are a lot of individuals that get into peer support and don’t know what they’re getting into. The workbook shares information on everything from getting hired, interviewing, ethics, boundaries, and self-care. We also include testimonials from working peer professionals, so that individuals coming into peer support know what to expect.

Why is Magellan Behavioral Health of Pennsylvania the best place to work on creative projects?

Magellan is more than just a managed care organization; we really want to collaborate with the counties that we serve. I think Magellan encourages relationship building and that’s really the core tenet of my job, just building relationships with our county and provider partners and reassuring them that if they have questions or need any peer support related information, they can come to me. That’s something that Magellan really promotes collaboration and the idea of going above and beyond.

What are your thoughts on the culture at Magellan Behavioral Health of Pennsylvania? How has that culture impacted your team?

The culture here is really to be collaborators with our counties and providers. I think what differentiates us from other managed care organizations is that we’re not just the people that pay the claims. More than that, we try to be present at different events together with other stakeholders. Leadership is supportive; they want us to be out there in Pennsylvania communities, and leadership is always looking to help make that happen. We always strive to do better than we did the day before, that’s the culture here.

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

The biggest one that comes to mind is the focus that the state and federal government is putting on suicide prevention and education. Since COVID, suicide rates have skyrocketed, and people are feeling more isolated and lonelier than they ever have before. This can also be related to another research push I’ve seen recently, which is on the impact of social media on youth and young adults on FOMO (the fear of missing out), self-esteem, and body image issues. I think that focusing on both, post-COVID, is going to be important.  Self-care has become common, and I think it is important that we encourage people to focus on caring for themselves, both physically and mentally. Magellan has also implemented a suicide risk assessment plan to identify members who may need additional support or treatment.

The healthcare industry also continues to conduct research focusing on things that are significantly impacting mental health, post-COVID. This is also more of a focus because our physical health and our mental health are one. When you’re struggling with your mental health, then your physical health will suffer and vice versa. I hope we continue with that direction because they are not two separate things. We’re one body, soul, spirit, and mind and it’s all connected.

As a Medical Director for Magellan Behavioral Health of Pennsylvania, Chris Squillaro, DO, manages many different responsibilities. As a supervisor of the Pennsylvania medical staff, he performs reviews, attends complaint and grievance hearings, and leads various rounds with our care managers. Dr. Squillaro also provides the executive leadership with input on strategy and focusing on prioritizing what’s important to our county customers. Whenever a medical opinion or perspective is needed, Dr. Squillaro, who has been with Magellan since 2021, always provides that medical input into the initiatives and intervention being done in Pennsylvania. Continue reading to learn more about what innovative behavioral health projects and initiatives Dr. Squillaro is currently working on in Pennsylvania:

What sort of innovative projects are you currently working on?

There’s an enterprise-wide movement to develop a common suicide pathway to decrease suicidality. Pennsylvania is heavily involved with that project although it involves more than just Pennsylvania. I’ve been working on this with the corporate and Pennsylvania leadership.

We are also doing a project in Pennsylvania called Project Red, which aims to decrease readmission rates and standardize the discharge process. This is a project that’s being led by two researchers out of Massachusetts who had developed Project Red originally for the medical side, and they want to convert it to the behavioral side.

I’m also involved in a trauma informed care summit because of a Pennsylvania Commonwealth initiative. The goal is to transition all the Commonwealth residential treatment facilities to tiered trauma designations that demonstrate competency in trauma care for children and adolescents in that level of care. Included in this would be consistent trauma screening and treatment, decreasing physical and chemical restraints, having a trauma informed lens as patients move through care and awareness of experiences in the milieu that may be triggering.

We also have a medication adherence project where I clinically supervise the pharmacist who is working on improving medication adherence for some of our more severe patients through direct member education and training.

Why is Magellan Behavioral Health of Pennsylvania the best place to do these projects?

I think we have a holistic view of the healthcare delivery system, not just within individual units across the country but enterprise wide. We have our eyes on national issues through touchpoints with the corporate team. We understand what Pennsylvania’s priorities are, what their initiatives are, and what issues are important to them. We can get even more granular at a county level. Each county is in tune with what are its’ constituents wants and needs. Pennsylvania is very diverse, there are swings in socioeconomic status between regions and resources. We get this population health view at a national level, that then is informed all the way down to the county level so we can see it not only for what’s important from a national perspective, but then in each Pennsylvania community. With that information, we can come up with the best way to approach problems.

I think there’s also a lot of willingness and eagerness to use technology at Magellan. It helps us to sort and track outcomes. Magellan is really getting involved with technology, this is something that’ll be hugely helpful for what we can do in the future.

What are your thoughts on the culture at Magellan Health? How has that culture impacted the projects you’re working on?

Before I worked at Magellan, I was a provider. Magellan has always been willing to try new things. If providers had a good way of solving common problems, in my experience, Magellan was certainly willing to entertain it and develop programming around it. I think that willingness to adapt, change, and try new things is what makes projects successful. The culture of being able to move around problems and to adapt is one of the things I saw since before working at Magellan and has only been reaffirmed since I’ve joined this team.

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

I feel we are learning from the way that care is delivered on the medical side. Using outcomes and data to make decisions is one of the things that’s exciting in behavioral health. Some screening tools that have been developed have become more reliable and it’s starting to create a common language that we can have with our medical counterparts. This then creates opportunities to coordinate at key levels of care. There’s also a lot more collaboration between medical and behavioral health. It’s not new information that behavioral health has a significant impact on medical costs overall and medical quality. I see medicine becoming more integrative. On the behavioral health side, we’re catching up on the importance of data-driven decision-making outcomes and managing from a population health perspective.

Another trend is in customer care. We are learning from industries where customer satisfaction is critical to ease of access, utilization, adherence, and adoption of a plan. We’re doing a lot of customer surveys and making sure people are happy with the service that they’re getting.

Lastly, we’re adopting the standardization and checklist mentality that I most associate with the airline industry. This is a public safety concern that has been effectively managed by airlines to assure safety and limit mistakes. We are utilizing and promoting standardized tools and checklists to consistently diagnosis issues. We are then using algorithms to standardize treatment pathways. This assures consistencies across providers and assures that the most appropriate evidence-based interventions are being utilized to treat people.

You’re buying a car. Before you hit the lot, you do your planning and research, establish a budget, figure out what features you want and what style you’re looking for. You probably search online for car and dealer reviews, prices and sales. Based on all of that work, you make a decision, negotiate and pay for your new car.

Your car research was relatively easy. But finding a healthcare provider? Not so much.

While you may know what you want in a provider, very little information is available about the services they provide, appointment costs, reviews and other important details to help you make an informed choice about your care. And if you ARE lucky enough to find someone who seems to fit your needs, you’re often still left wondering what kind of quality you can expect from your treatment experience.

The bottom line is that it’s easier to buy a car than it is to find a healthcare provider. Silly, right? We think so, too – which is why Magellan is bridging these information and quality gaps by employing value-based purchasing models.

Rewarding quality care yields informed choices

Value-based purchasing takes various forms. But it generally operates on the premise that aligning providers’ incentives and reimbursement with organizational and individual goals incents behavior and drives positive outcomes, ultimately benefiting all involved in the healthcare continuum. This includes consumers, customers and payers, in addition to the providers themselves, who also enjoy improved reputations through public reporting.

In fact, one of the key tenets of Magellan’s value-based collaboration and purchasing models is to ensure stakeholders become more informed as a result of these initiatives:

• Customers benefit by knowing whom to partner with for network management;
• Payers benefit by knowing whom to pay for value; and
• Consumers, of course, benefit by having those online provider reviews become a lot less elusive, enabling them to make an informed decision about whom to choose for their care.

Magellan’s models also center on:

• Engaging and empowering providers in compensation model evolution. We partner with provider leaders around compensation design, employ transparency to ease the compensation shift and create meaningful incentives for providers to encourage active engagement. (1)

• Building provider compensation for an evolving healthcare market. Our priorities center on population management, team-based care and member access. We integrate new quality and efficiency standards into compensation, and remove compensation barriers to population goals. (1)

Why do we give value-based purchasing strategies the green light?

Take our Assertive Community Treatment (ACT) program as just one example. Through program data analysis and close collaboration with our ACT provider teams, we developed a three-tiered rate structure based on overall program goals to support recovery, wellness, and to improve community tenure. As a result, we saw a 21 percent decrease in inpatient admissions and a 24 percent decrease in the inpatient readmission rate.

Our drive for engagement continues

Providers nationwide are in different phases of readiness, so we keep our wheels in motion by providing a graduated maturity model to move them from the most basic stage—learning the behavior through activity incentives—to the most complex arrangements, which transform care delivery through outcomes-based incentives or other payment structures (2). We look forward to working with stakeholders, providers and consumers as we continue to expand this innovative and exciting model.

(1) Medical Strategy Group Council: “Next-Generation Physician Composition,” The Advisory Board Company

(2) Physician Quality Reporting Initiative: The Advisory Board Company