Magellan Rx Management’s Live Vibrantly: Whole Health Program Leverages Behavioral Health and Opioid Management

Program improves patient outcomes and reduces cost of care

Magellan Rx Management, a division of Magellan Health, Inc. (NASDAQ: MGLN), offers an innovative, integrated approach to improving healthcare and cost of care outcomes with Live Vibrantly: Whole Health.

This solution focuses on behavioral health and opioid management, utilizing specially trained clinical pharmacists with certifications in pain management and psychiatry. Through Live Vibrantly: Whole Health, pharmacists work face-to-face with providers to equip them with the tools and resources necessary to make informed decisions regarding treatment plans for their patients. The program also focuses on quality measures that are important to providers and clients including HEDIS® measures around adherence, appropriate laboratory monitoring, and overuse of medications like opioids and antipsychotics.

“Our program is centered on the quality of care in prescribing medications for members with complex conditions that require behavioral health medications and opioids,” said Caroline Carney, MD, MSc, FAPM, CPHQ, chief medical officer, Magellan Rx Management. “In focusing on avoiding polypharmacy, overly high doses, and dangerous combinations of drugs, we improve outcomes and save lives.”

Improved Behavioral Health Outcomes

According to SAMHSA, over 47 million Americans live with a mental health condition and serious mental illness costs Americans $193.2 billion in lost earnings per year1. As a result of implementing the Live Vibrantly: Whole Health program, one health plan customer reduced overall utilization of behavioral health medications and significantly improved the recommended metabolic screenings for members taking antipsychotics which is also a HEDIS measure. Over a three month evaluation period:

• 67 percent reduction in the number of members taking multiple (six or more) behavioral health medications resulting in an average reduction of one behavioral medication per impacted member;
• 46 percent of impacted members were no longer taking two or more atypical antipsychotic medications; and
• 110 percent increase in the number of members on antipsychotics receiving recommended metabolic screenings.

“The personal attention and individualized patient focus from a clinical pharmacist really sets the Whole Health program apart from the rest,” said Ilan Melnick, MD, chief medical officer, Passageway Residencies of Dade County. “The program recognized the specific needs of my patients and we were able to collaborate in order to optimize medication management, as gaps or delays in treatment may create a downward spiral in a fragile population.”

Addressing Inappropriate Opioid Prescribing

In addition to behavioral health results, the program was implemented with another health plan customer to address inappropriate opioid prescribing. Opioid abuse is another crisis in the United States, resulting in more than 130 deaths from overdose every day2. Following a six month evaluation period, significant gaps were addressed and closed through the use of the program:

• 97 percent of individuals engaged in doctor/pharmacy shopping (at least three doctors and three pharmacies) no longer engaged in that practice with an average reduction of two prescribers and one pharmacy per member;
• 73 percent of impacted members no longer received opioids at high doses reducing the average morphine milligram equivalents (MME) per person per claim from 97.9 to 63.2; and
• 85 percent of members were no longer on the combination of a high dose opioid medication and a benzodiazepine.

“Through the Live Vibrantly: Whole Health program, our pharmacists work collaboratively with providers in the communities they serve to close gaps in care and consult on complex patient cases,” said Crystal Henderson, PharmD, BCPP, senior director, behavioral health pharmacy solutions, Magellan Rx Management. “This program helps providers better understand prescribing patterns that put members at risk for adverse outcomes and drive high costs of care. By working with providers, we help their members’ lead healthier, vibrant lives.”

1. https://www.nami.org/learn-more/mental-health-by-the-numbers
2. https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis

About Magellan Rx Management: Magellan Rx Management, a division of Magellan Health, Inc., is a full-service, next-generation pharmacy benefit manager (PBM) that helps our customers and members solve complex pharmacy challenges by connecting them to the people, technology, and information they need to make smarter healthcare decisions. As experts in managing specialty spend both on the prescription and medical benefit, we are energized by discovering new and better ways to deliver solutions in today’s complex and rapidly-evolving healthcare environment, leading people to live healthier, more vibrant lives.

About Magellan Health: Magellan Health, Inc., a Fortune 500 company, is a leader in managing the fastest growing, most complex areas of health, including special populations, complete pharmacy benefits and other specialty areas of healthcare. Magellan supports innovative ways of accessing better health through technology, while remaining focused on the critical personal relationships that are necessary to achieve a healthy, vibrant life. Magellan's customers include health plans and other managed care organizations, employers, labor unions, various military and governmental agencies and third-party administrators. For more information, visit MagellanHealth.com.

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