Wyoming’s High Fidelity Wraparound program continues to show successful outcomes for enrolled youth with complex behavioral health challenges.  Operated by Magellan Healthcare, Inc. through a collaboration with the Wyoming Department of Health, Division of Healthcare Financing (Medicaid), Wyoming’s High Fidelity Wraparound demonstrates that young people are getting more needs met in their own homes and communities.

High Fidelity Wraparound, an evidenced-based non-clinical intensive care coordination program, is a national model designed to bridge gaps for youth where challenges in behavior and mental health exist. The program uses peers and lived experience in a strengths-based way, focusing on what people do well and provides alternative options in addition to therapy and other traditional methods that fit individual preferences and cultures. This team approach provides a network of support for families, allowing them to be the experts of their lives and learn to drive the process.

“When youth behavior is extreme, there is higher probability of needing to leave home or school to address their needs in a clinical, therapeutic or detention setting. We meet people where they are, use assessments like the Child and Adolescent Needs and Strengths (CANS) to identify needs and strengths, which inform the team of behaviors that should be addressed,” said Tammy Cooley, senior director of operations, Magellan Healthcare. “Youth are supported in meeting challenges like staying in school, having more positive relationships, and doing more of the things children should be doing at their age, which ultimately builds confidence and lasting positive change.”

In Wyoming’s High Fidelity Wraparound programs, CANS are administered at the beginning of a youth’s enrollment into the program and every three months until the youth successfully completes the voluntary program and transitions out.

Barbara Dunn, Director of Program Innovation and Outcomes for Magellan of Healthcare in Wyoming, said, “From July 2018 to June 2019, over 75 percent of youth enrolled in Wyoming’s High Fidelity Wraparound program experienced reduced severity of needs. The typical youth enrolls with nine treatment needs and resolves almost four while increasing strengths to maintain their gains.”

 Decreased Needs and Increased Strengths

July 2018-June 2019

Cooley said, “The evidence is powerful and shows reductions in high prevalence needs between a youth’s enrollment and discharge. Our program works when youth and families are engaged. Wyoming’s Department of Health, Division of Healthcare Financing (Medicaid) has given us a chance to deliver a quality home and community-based program through a care management entity model that gives high risk youth more access to care right where they need it most. From the results of this year’s CANS report, we show Wyoming’s High Fidelity Program is making a positive impact in the lives of our youth participants. We want all youth who qualify for this Medicaid program to see the benefits.”

 Wyoming CANS Initial Scores vs. CANS Discharge Scores in Key Intervention Areas

June 2019-July 2019

For more information about Wyoming’s High Fidelity Wraparound program, please visit www.MagellanOfWyoming.com.

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.

The costs associated with cancer care continue to rise, and many new therapy developments are on the horizon. When looking specifically at medical benefit drug spend, which has historically gone unmanaged, oncology medications make up one-third of total per-member-per-month spend, with an average cost per claim of over $2,300 for commercial plans.¹  With estimates that overall oncology spending will reach $220-$250 billion dollars over the next five years², there is a critical need to provide better management for this spend category.

We asked Rebecca Borgert, Pharm.D., Senior Director of Clinical Oncology Product Development at Magellan Rx Management, for her thoughts on what strategies payers should consider for patient-focused, holistic oncology management.

When it comes to tried-and-true cost containment strategies, like utilization management guidelines, what innovations do you see in the oncology space that are making an impact for payers and their members?

The need to ensure patients are receiving evidence-based cancer treatment continues to be of paramount importance. In the era of precision medicine , treatments are often personalized and based on the patient’s specific genomic profile; payers want to ensure their members are receiving the best treatment for their particular cancer. Due to the extremely high cost of most cancer medications, interventions aimed at unit cost savings can improve value and decrease waste. For example, waste often occurs as part of the drug compounding process due to limited vial size availability. Compendia guidelines endorse rounding doses to within 10% of the calculated dose in order to optimize vial utilization and decrease waste. Additionally, other classes of drugs may be candidates for dose optimization strategies. These increased efficiencies can account for thousands of dollars of savings per dose while decreasing overall waste in healthcare.

While a focus on the patient is critical, there’s also the need to engage providers and provide solutions that allow for cohesive workflow. Enhanced claim edits and appropriate network/fee schedules can also be effective management strategies. At Magellan Rx, we stay up to date on the latest trends and have more than 15 years of experience in providing our customers with flexible interventions, like the ones just discussed, to manage both medical and pharmacy oncology spend. It’s important to understand that a one-size-fits-all approach will not work in today’s dynamic healthcare environment.

In 2018, the U.S. Food and Drug Administration set an all-time record with the highest number of drug approvals in the last 23 years (59 total). Several new medical pharmacy drugs were approved for oncology, including 6 biosimilars. How can payers and providers be better prepared for this evolution and ever-expanding pipeline?  

Unlike the pharmacy benefit where formulary management is an industry standard practice, formulary management under the medical benefit is a relatively underused strategy. The introduction of multiple oncology biosimilars presents a perfect opportunity to execute a medical pharmacy formulary strategy in this space.

Currently there are a number of oncology supportive care biosimilars already in the market and, most recently, we have seen the launch of two oncology therapeutic biosimilars. In late 2019 and early 2020, we anticipate the launch of several more of these FDA-approved oncology biosimilars which will create true competition in the marketplace. While discounts for biosimilars compared to their reference products are in generally only in the range of 10%-15%, due to the high cost of these therapies and their prevalent utilization, it is possible for payers to achieve large cost savings with these agents by adopting a thoughtful biosimilar formulary strategy.

At the center, we have patients and their caregivers who are trying to navigate the complex journey from diagnosis to treatment through survivorship. Is this an area of focus that can have a positive effect on outcomes and mitigate rising oncology spend?

Receiving a diagnosis of cancer often results in a total upheaval of the patient’s life as well as the lives of their family members. Providing patients with consistent support and personalized assistance can help to ensure they are able to be compliant with their prescribed treatment. This also helps patients understand the anticipated side effects of treatment and how to proactively manage those side effects, avoiding the need for unplanned acute care.

1. IQVIA. 30 May 2019. Global Oncology Trend Report 2019. https://www.iqvia.com/insights/the-iqvia-institute/reports/global-oncology-trends-2019. Accessed October 15, 2019.

Precision medicine is the concept of tailoring disease treatment and prevention to account for differences in genetic, environmental, or even lifestyle factors specific to groups of people.¹ Precision medicine takes genetic and biochemical information unique to a group of patients and uses that information to develop more specific and streamlined medications or treatments. The goal is to ensure that each medication or treatment is best suited to treat the individual, resulting in decreased side effects and increased effectiveness.²

Precision vs Personalized Medicine

Although the terms precision medicine and personalized medicine are used interchangeably, there can be nuanced differences. The National Research Council (NRC) issued a statement saying that the term “personalized medicine” can refer to a treatment that may be completely individualized to a specific patient, which is not the true definition of precision medicine.³ The difference here is that precision medicine seeks to create treatments that are applicable to groups of individuals who meet certain characteristics. This is different from “personalized medicine,” which implies individualized treatments available for every unique patient.

Current Landscape

In 2015, the Precision Medicine Initiative (PMI) was launched, with $215 million dollars invested into precision medicine research.⁴ A new program was created—All of Us Research Program—which had the goal of recruiting 1 million Americans and creating a nationwide database for research.⁵ Other examples of precision medicine initiatives include the Geisinger Health System’s National Precision Health Initiative, the Partnership for Accelerating Cancer Therapies (PACT), and Cancer Moonshot.¹ There has been particular success in the field of cancer, with new medications developed for a specific cancer types with certain genetic characteristics. With increased funding, decreased costs to sequence DNA and analyze genetic information, and improved data analytics, many believe precision medicine to be the future of healthcare delivery.

1. Bresnick, Jennifer. 2018. “What Are Precision Medicine and Personalized Medicine?” HealthITAnalytics. HealthITAnalytics. January 11, 2018. https://healthitanalytics.com/features/what-are-precision-medicine-and-personalized-medicine.
2. Genetics Home Reference. n.d. “What Is the Difference between Precision Medicine and Personalized Medicine? What about Pharmacogenomics?” Genetics Home Reference. Accessed October 11, 2019. https://ghr.nlm.nih.gov/primer/precisionmedicine/precisionvspersonalized
3. Council, National Research, Committee on a. Framework For Development a. New Taxonomy of Disease, and Others. 2010. Toward Precision Medicine: Building a Knowledge Network for Biomedical Research and a New Taxonomy of Disease. National Academies Press.
4. “FACT SHEET: President Obama’s Precision Medicine Initiative.” 2015. Whitehouse.gov. January 30, 2015. https://obamawhitehouse.archives.gov/the-press-office/2015/01/30/fact-sheet-president-obama-s-precision-medicine-initiative.
5. “Program Overview – All of Us | National Institutes of Health.” n.d. Accessed October 11, 2019. https://allofus.nih.gov/about/all-us-research-program-overview.

In 1989, one survey of the general public found that more than half of respondents believed lack of discipline was a possible cause of mental illness. The survey found that, at that time, Americans were more likely to receive information about mental illness from mass media than from medical providers or psychologists. Thirty years later, with the availability of information on the internet, the public should theoretically have a more accurate and balanced perspective of mental illness. But is the public obtaining their information from science-based sources? While there is still much to learn about mental illness, scientists have identified several factors that can play a role in mental health, including genetics, environmental exposure, altered brain chemistry, significant stress, and comorbid medical conditions. With the availability of misinformation on the internet and on social media websites in particular, are we really any better educated on mental health than we were 30 years ago?

The National Institute of Mental Health (NIMH) reports that approximately 1 in 5 adults experiences mental illness annually, with approximately 1 in 25 experiencing mental illness that substantially interferes with or limits 1 or more major life activities. Based on data from the 2018 National Survey on Drug Use and Health, approximately 19% have an anxiety disorder, 2.8% live with bipolar disorder, and fewer than 1% have schizophrenia in the United States (US) adult population. In addition, 7.2% of adults have experienced at least 1 major depressive episode in the last year. Unfortunately, only about 43.3% of adults with a mental health condition received mental health services within the past year, and of those with a serious mental illness, only 64.1% received mental health services within the past year. Even the indirect costs of mental health have a significant impact. Serious mental illnesses have been estimated to cost over $193.2 billion in lost earnings per year in the US, and mental illness has been predicted to cost the global economy $16 trillion by 2030.

Much has changed in the treatment of mental illnesses in the past 30 years. Key treatments for depression, such as selective serotonin reuptake inhibitors (SSRIs) and newer serotonin-norepinephrine reuptake inhibitors (SNRIs), have mitigated some of the limitations of earlier antidepressants (e.g., drug-food interactions or select adverse effects). Even in the past year, novel approvals for treatment-resistant depression (TRD) and postpartum depression (PPD) have emerged. For those with schizophrenia, the availability of newer generation antipsychotics has significantly altered care as well. Although testing for genetic alterations to better identify the best medication choice for a patient is in its relative infancy, the role of pharmacogenomics is rapidly expanding, too. These advances offer promise for individuals with mental illness, but no medication is without risks, and a discussion with a licensed medical provider is essential to establish an appropriate treatment regimen. In addition to medications, the role of nonpharmacologic treatment has expanded in the past 30 years as well, with additional treatment modalities beyond the advancements in psychotherapy alone (e.g., modern cognitive behavioral therapy, interpersonal therapy). A more holistic approach, incorporating lifestyle changes (e.g., diet, exercise) and non-traditional medicine (e.g., meditation, acupuncture), is also gaining in popularity; however, it is critical to understand that herbal or “natural” treatments can have adverse or toxic effects and drug interactions. These should only be used in consultation with a healthcare provider.

Mental illness can contribute to the risks for suicide. Unfortunately, the Centers for Disease Control and Prevention (CDC) reports that suicide rates have increased by approximately 30% from 1999 to 2016. Notably, suicide is rarely caused by a single factor, and the National Alliance on Mental Illness (NAMI) reports that approximately 54% of those who die by suicide do not have a diagnosed mental health condition. Regardless, this leaves a significant portion of patients with known mental health conditions where intervention may have been helpful. Moreover, NAMI also reports that approximately 90% of those who die by suicide show symptoms of a mental health condition. The CDC includes several warning signs on their website and offers advice to several groups ranging from laypersons to the government to healthcare providers. One component the CDC emphasizes to healthcare systems is the need for affordable and effective mental and physical healthcare where people live. In addition, the Zero Suicide Institute provides a framework for continuous quality improvement in health and behavioral healthcare systems aiming to prevent suicide.

Of late, the public seems particularly concerned with the risk of violence in those with a mental illness. A 2006 survey found that 32% and 60% of Americans thought people with depression and schizophrenia, respectively, were likely to act violently toward someone else; however, research has demonstrated that there are several factors that contribute to violence, and that when accounting for these additional factors, the presence of a mental illness is only a modest contributor (at best) to violence. According to the 2018 National Survey on Drug Use and Health, approximately 19.4% of those over 12 years of age have used an illicit drug in the past year and 3% had at least 1 illicit drug use disorder. Additionally, 3.7% of adults reported dual diagnosis (both any mental illness and substance use disorder). Studies of patients with substance abuse or dual diagnosis have found higher correlations with violence compared to mental illness alone. Most importantly, adequate treatment has demonstrated improved outcomes.

With the discussion of mental health in the press and the plethora of inaccurate information on mental health online, it is difficult for the public to develop a truthful foundation on mental illness. While public access to information and scientific discovery have advanced in the past 30 years, the most critical component for the proper diagnosis, effective treatment, and safety of those with mental illness remains consultation with a healthcare provider and/or team.

If you or someone you know may be at risk for suicide, contact the free and confidential Suicide Prevention Lifeline at 1-800-273-TALK (8255). It is available to anyone 24 hours a day, 7 days a week.

Children with attention deficit hyperactivity disorder (ADHD) may have difficulty in school, because their symptoms—inattention, impulsiveness, and hyperactivity—get in the way of learning.

Success in school is important for the development of healthy self-esteem and confidence.

You can help your child succeed in school by:

• Working with teachers and other school personnel.
• Educating yourself about ADHD.
• Helping your child control his or her symptoms.

How can you help your child be successful in school?

You can help your child have the greatest chance of success in school by educating yourself, building relationships, maintaining open communication, working with your child, and keeping good records. Preschool or kindergarten is the best time to start using these techniques. But it is never too late to help a child improve his or her school performance.

Education                                                          

Learning as much as you can about ADHD and your child’s education rights will help you work with the school system more effectively.

• Learn about ADHD. Use the Internet to locate national organizations, ask your doctor, or visit your local library or bookstore for information about ADHD.
• Know your child’s symptoms and treatment plan. Talk with your doctor about your child’s behaviors that may interfere with learning and about ways to control those behaviors. Develop a record of your child’s treatment plan.
• Learn about your child’s education rights. Laws exist ensuring education rights for children who have conditions that interfere with learning. These laws also stipulate that parents have a right to be informed about and participate in educational decisions concerning their child. Contact your state and local education departments for information about ADHD in the schools and your rights to educational accommodations.
• Talk with other parents of children with ADHD. Join a support group for ADHD families. Find out how others have effectively worked with school systems.

 Build relationships

A positive relationship with teachers and other school personnel will improve your child’s chances of being successful in school.

• Start early. Before a school year begins, get to know the principal and other appropriate school personnel. Find out as much as you can about the school policies and rules, especially how behavior problems are handled. Find out if there are other children with ADHD in the school and how their behavior is being handled in the classroom.
• Share what you have learned. Find out if the teachers and other personnel need information about ADHD. Look for ways to help them get that information, such as suggesting books, pamphlets, or any local educational programs.
• Get to know your child’s teacher. Before the school year begins, talk with your child’s teacher about his or her style of teaching and discipline in the classroom. Find out whether the teacher has experience teaching children who have ADHD. Share with the teacher information about your child’s symptoms and what behaviors may interfere with his or her ability to learn. You may want to share your child’s treatment plan with the teacher.
• Make a school plan. Work with the teacher to design a plan to help your child perform to his or her potential. Address how to minimize misbehavior and how to react to it. Your plan will change as your child grows and develops. You may need to work with the school to develop an individual education plan (IEP) for your child. An IEP is a tool for classroom and homework adaptations for a child with a disability. For children with milder symptoms, the school may suggest a plan that is used for medical conditions that do not meet the IEP standards (called a 504 plan).
• Ask school personnel for help when needed. Tutoring or services that help with study or organizational skills are sometimes provided through the school. If not, school personnel often have a list of local resources that can help your child.

Keep communication open

Open communication with your child’s teacher can help resolve problems that may occur throughout the school year. The following are suggestions for working and communicating with your child’s teacher:

• Understand the demands upon your child’s teacher. Most children with ADHD can be taught in a regular classroom, although adjustments are sometimes needed. Not all teachers are trained to do this. Also, teachers are stretched to their limits by large numbers of children in the classroom, making it difficult to give each child personal attention. Ask the teacher what he or she needs from you to help assimilate your child.
• Keep the teacher informed. Share with the teacher any relevant changes in your child’s treatment plan. Help facilitate the sharing of information among you, your child’s teacher, and your child’s doctor.
• Visit the classroom. If possible, volunteer for school activities and parties. This will let the teacher know that you are interested in your child’s education and willing to help.
• Request progress reports. Children with ADHD often lose or forget their assignments. Ask the teacher to complete regular progress reports of your child’s performance and behavior.
• Have a final conference. Meet with the teacher at the end of the school year to discuss your child’s overall progress and the teacher’s suggestions for the next year. Ask him or her about possible teachers for the next year and how to help your child get the best chance for success in school.

Work with your child

• Use treatment methods as recommended by your child’s doctor. This may include medicine and/or behavior management techniques. This will help your child control symptoms of ADHD at home and school.
• Keep your child involved. Let your child know that you support his or her teacher. Clearly outline your expectations and the consequences of misbehavior. Talk with your child about how the teacher will let him or her know that a behavior is becoming inappropriate.
• Link school and home. Use the same signals (such as hand signals) that the teacher uses at school to indicate when a behavior is becoming inappropriate. Also, you can reward your child with privileges for remembering to bring home school progress reports. You can further reward him or her if the report is positive. If your child fails to bring a progress report home, you may treat it as if he or she had an unsatisfactory report and withhold a privilege.
• Help your child organize. Even young children can learn to use lists, daily planners, or calendars to keep up with homework assignments, tests, and activities. A young child may need a teacher’s help in writing down assignments.
• Use learning aids, such as tape recorders or computers. Teach your child how to take notes and to underline important information. If your child seems to learn best visually, ask about books that have helpful pictures and diagrams or workbooks.
• Have short sessions. Keep homework sessions to no more than 20 minutes without a break.

Keep good records

Health and school records can help monitor your child’s academic and behavioral progress as well as help identify when treatment adjustments are needed. You should keep and update the following records:

• ADHD evaluations. Collect copies of any records that are used to evaluate your child for ADHD. These records often identify the type of ADHD that your child has, which helps with treatment.
• Evaluations for any other conditions with similar symptoms.
• History of medicines. Record all medicines that your child has taken or is taking to treat ADHD.
• School progress records. Keep copies of any school plans, daily school progress reports, and formal progress reports throughout the year. Also, keep your child’s final grades and any achievement test results. You may find them helpful as you develop school plans for the following year.
• Individual education plan. If your school developed an individual education plan (IEP) for your child, ask for a copy. You may need to share that information with the health professionals working with your child.

©1997–2019, Healthwise, Incorporated

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This document is for your information only. It is not meant to give medical advice. It should not be used to replace a visit with a provider. Magellan Health does not endorse other resources that may be mentioned here.

Children who are socially withdrawn, shy, and appear to lack self-esteem are more likely than other children to be targets for bullying. Children who appear confident and strong are better able to discourage children from harassing them.

Parents and other important adults in a child’s life can use these suggestions to help boost a child’s self-esteem:

• Encourage your child to participate in extracurricular activities such as sports or drama, which can raise a child’s confidence and sense of mastery. Sports, in particular, also help build strength, which can level the imbalance of physical power between children. Some children may prefer individual sports (such as karate, gymnastics, and swimming) over group sports (such as soccer or baseball). Drama classes can help children project strength and confidence, even if they don’t feel it at first.
• Help children become involved socially with other children through school, church, or community activities. This way, children will build social skills and learn to be at ease with others. Children who have friends and “hang out” with them at school are less likely to be targets for bullying than lonely children who have no social support.
• Role-play with children to show them how to appear confident and how to handle encounters with children who harass them. Help children learn to look people in the eye and to speak with a strong voice—but not shout—when talking to would-be bullies.

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Childhood isn’t all fun and games. Even young children can feel worried and stressed.

Stress can come from outside sources, such as family, friends, and school. It can also come from children themselves. Just like adults, children may expect too much of themselves and then feel stressed when they feel that they have failed.

How can you help your child with stress?

Adults can help children and teens with stress in many ways. Three important things you can do are to:

• Try to reduce the amount of stress in your lives.
• Help them build positive coping skills.
• Teach them to let stress out.

Reduce the amount of stress in your lives

• Acknowledge your child’s feelings. When children seem sad or scared, for example, tell them you notice they are sad or scared. If appropriate, reassure them that you can understand why they would feel sad or scared.
• Develop trust, and let your child know that mistakes are learning experiences.
• Be supportive, and listen to your child’s concerns. Allow your child to try to solve his or her own problems, if appropriate. But offer to help and be available to your child when he or she needs you.
• Show love, warmth, and care. Hug your child often.
• Have clear expectations without being too strict. Let your child know that cooperation is more important than competition.
• Don’t over-schedule your child with too many activities.
• Be aware of what your child wants (not just what you want).

Build positive coping skills

It is important to help children learn positive coping skills. These skills are often carried into adult life.

• Provide a good example. Keep calm, and express your anger in appropriate ways. Think through plans to reduce stress, and share them with your family.
• Teach them about consequences. Children need to learn about the consequences—good and bad—of their actions. For example, if they do all of their chores on time, they will get their allowance. If they break another child’s toy, they must find a way to replace it.
• Encourage rational thinking. Help your children understand what is fantasy and what is reality. For example, help them see that their behavior did not cause a divorce, or that they are not failures because they were not picked first for something.
• Provide them with some control. Allow your children to make choices within your family framework. For example, allow them to arrange their rooms, choose family activities, and help make family decisions.
• Encourage them to eat healthy foods, and emphasize the importance of a healthy lifestyle.

Get the stress out

Finding ways to get stress out of their systems will help children feel better. The best ways to relieve stress are different for each person. Try some of these ideas to see which ones work for your child:

• Exercise. Regular exercise is one of the best ways to manage stress. For children, this means activities like walking, bike-riding, outdoor play, and individual and group sports.
• Write or draw. Older children often find it helpful to write about the things that are bothering them. Younger children may be helped by drawing about those things.
• Let feelings out. Invite your child to talk, laugh, cry, and express anger when he or she needs to.
• Do something fun. A hobby can help your child relax. Volunteer work or work that helps others can be a great stress reliever for older children.
• Learn ways to relax. This can include breathing exercises, muscle relaxation exercises, massage, aromatherapy, meditating, praying, yoga, or relaxing exercises like tai chi and qi gong.
  • Stress Management: Relaxing Your Mind and Body
• Laugh. Laughter really can be the best medicine. You can be a good role model in this area by looking for the humor in life. Your child can learn this valuable skill by watching you.

©1997–2019, Healthwise, Incorporated

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This document is for your information only. It is not meant to give medical advice. It should not be used to replace a visit with a provider. Magellan Health does not endorse other resources that may be mentioned here.

More than 400 nationally-recognized payers, physicians, and industry insiders came together to share thoughts and insights on the ever-evolving specialty drug landscape at the 16^th annual 2019 Magellan Rx Management Specialty Summit hosted August 26-28 in New York City.

As the specialty drug trend continues to rise (especially on the medical benefit) and the pipeline continues to expand, focusing on management strategies and solutions is key. With biosimilars flooding the market and capturing the headlines, and looming policy updates creating uncertainty, this year’s event was a platform to tackle these critical topics and the future of our industry.

“We’re honored to be the forum that brings people together to share insights, engage in thoughtful debate, so that we can all walk away with actionable solutions to effectively manage this growing specialty drug trend.” –Steve Cutts, senior vice president & general manager, specialty, Magellan Rx Management

Highlights from this year’s program include:

• Dr. Peter Bach of the Memorial Sloan Kettering Cancer Center reviewed the latest developments for better oncology management and Dr. Rafael Fonseca, a Mayo Clinic Distinguished Investigator, examined applications for a more personalized approach to treatment for complex specialty conditions.
• Magellan Rx chief medical officer Dr. Caroline Carney was joined by Sarah K. Emond, executive vice president and chief operating officer of the Institute for Clinical and Economic Review (ICER), in a fireside chat about ICER’s approach to health policy and excellence in the U.S.
• Mostafa Kamal, CEO of Magellan Rx, led a panel of forward-thinking innovators who are disrupting the status quo by providing tech-based solutions to improve healthcare delivery and outcomes: Raj Agarwal, chief executive officer at Medocity; Adam Hanina, chief executive officer at AiCure; and Richard Waithe, president of VUCA Health.
• Several panel discussions highlighted next-level management strategies around medical pharmacy solutions as well as emerging therapies like CAR-T and other gene therapies to treat rare and orphan diseases, and featured a diverse group of speakers including executives from national and regional payers, pharmaceutical manufacturers, and physicians:
  • Martin Burruano, RPh, Vice President, Pharmacy Services, Independent Health
  • Mona Chitre, PharmD, CGP, Chief Pharmacy Officer & Vice President Clinical Analytics, Strategy & Innovation, Excellus BlueCross BlueShield
  • Kim Dornbrook-Lavender, PharmD, BCPS, Director, Clinical Pharmacy, Medica
  • Pat Gill, RPh, Director of Pharmacy Programs, Horizon BCBCS of NJ
  • Doug Long, Vice President, Industry Relations, IQVIA
  • Joseph Nolan, General Manager – US, AveXis, Inc.
  • Helio Pedro, MD, Clinical Geneticist, Hackensack Meridian Health
  • Carly Rodriguez, PharmD, Pharmacy Director, Clinical Innovation, Moda Health
  • Natalie Tate, PharmD, MBA, BCPS, Vice President, Pharmacy Management, BlueCross BlueShield Tennessee
• Industry experts Claire Wulf Winiarek, Beth Hebert-Silvia (VP & Practice Lead, Health Plans at Pharmaceutical Strategies Group) and Michael McCaughan (founding member of Prevision Policy LLC) shared their insights on the current policy landscape.
• TV personality and author Janice Dean graced the audience with her very own patient story—after receiving a Multiple Sclerosis diagnosis in 2005, she underwent treatment and found hope and a passion for sharing her story to encourage others who are living with MS to live their best lives as well.
• Keynote speaker Keller Rinaudo shared his incredible story of perseverance that led to the launch of a revolutionary healthcare startup, Zipline, that is rapidly changing the face of medicine in remote parts of the world—and future expansion for U.S. disruption.

As pioneers in specialty pharmacy management since 2005, Magellan Rx has been leading the conversation around better management strategies that not only provide cost savings for payers but positively impact patient health outcomes. Each year, we develop the Specialty Summit agenda with those values in mind. Mark your calendars and join us next year in NYC on August 24-26, 2020 as we host another event that will ignite inspiration and innovation across the industry.