Exponential Organizations (ExOs) deliver outcomes (or impact) that are disproportionally (10x) greater than their traditional competitors through the use of innovative business models, organizational techniques and digital technologies. Over the past two years, we at Magellan have developed, implemented and are continuously improving a new approach for managing IT in ExOs. Magellan Exponential IT (ExO IT) is a digital and cloud-first healthcare strategy that is enabled by agile operational processes and implemented by a highly engaged learning organization. These three basic components of ExO IT – Digital Strategy, Agile Operations and Learning Organization, work together in a cadence to deliver iterative technology enabled capabilities that build on each another to deliver business agility, 10x results and be adaptive to meet the evolving needs of today’s healthcare industry.

Earlier this year, we started to automate Magellan’s ExO IT model through a highly scalable, secure and always-on system called DREAMS (Digital Real-time Management System). DREAMS has six modules that are built on ServiceNow (Kingston) platform using a customer focused low-code, no-code approach. With DREAMS, we aim to deliver minimum efficient scale through the use of today’s cloud-based technologies, ubiquitous access, real time insights and lean processes. It is highly influenced by Design Thinking, Lean Thinking (The Toyota Production System), Agile Methods, and the Amazon Way (Customer first, develop press releases, two-pizza team etc.). The broad scope of DREAMS includes:

1. Lead IT – This module operationalizes and automates our ExO IT strategy through focused and highly visible initiatives and expected outcomes. It does this through several Lean Thinking work products such as the X-Matrix, Leader Standard Work, Visual Management Systems, Initiative Press Releases, Project A3s and OKRs. At the center of Lead IT is a Digital 5S System. 5S (Sort, Standardize, Set-in-order, Shine and Sustain) is a Lean Thinking technique that makes the most frequently used and current and properly configured tools available to the right people, at the right time and at the right place. The Digital 5S is used to enable a highly engaged, productive and collaborative IT leadership team.
2. Manage IT – This module aims to maximize the throughput of IT by continuously aligning demand with the supply of IT at the most optimal cost. Manage IT standardizes and automates IT Service Delivery capabilities such as demand, resource, capacity, portfolio and financial management. This module is built around the Magellan Asset Portfolio (MAP) and it provides an easy to use and easy to search repository of infrastructure and application assets used within Magellan. MAP is enabled and operationalized through Service Owners and Solution Owners within our ExO IT organizational model.
3. Ask IT – This module aims to improve employee productivity by helping them request and receive IT solutions and services through simple, secure, easy-to-use, reliable and context-aware experiences. Ask IT implements a Services Portal and Services Catalog that can be used by employees to order, track and receive solutions and services in a way that is similar to leading online services such as Amazon.
4. View IT – This module focuses on driving continuous improvement within ExO IT by providing access to real-time dashboards, interfaces, benchmarks, metrics and outcomes used to measure the effectiveness of IT and its operations.
5. Secure IT – This module automates Security Operations, GRC, adherence to standards, audit controls and other mission critical functions related to protecting the security and privacy of healthcare information and
6. Operate IT – This module focuses on delivering predictable, secure, always-on operations using standardized and automated IT Service Management capabilities in the areas of Incident, Problem, Change, Event, Release and Capacity Management.

We are currently in flight with rolling DREAMS V1.0 out to the leadership ranks within Magellan IT. This release provides limited scope across all six modules and represents a significant step forward. We have 4 more releases planned for 2018. These releases will add more functionality and roll these capabilities out to a broader audience within Magellan.

Our own Seth Feuerstein spoke recently at the APA annual meeting about how Digital Mental Health Care is increasing access and delivering positive outcomes.

“Here’s what’s interesting…subjectively, patients described [the digital program] as by far the most positive experience they have when they go to that center,” said Feuerstein. “Their engagement with it was kind of off the charts.”

You can read about Seth’s comments and more at the American Journal of Manage Care by clicking here

April is Autism Awareness Month and another opportunity to promote inclusion and self-determination for those on the autism spectrum. Like many impacted by this challenging disorder, my family has our own story and my hope is that by sharing it, we can help others.

Our now nine year old son, Vaughn, was diagnosed with autism at 18 months. A mere 13 months younger than his typically-developing sister, my husband and I could tell that something was not quite right with our son. Vaughn wasn’t walking or talking and was overly-obsessed with anything that spun. He wouldn’t make eye contact with people and wasn’t motivated to engage with our family. It was both scary and heartbreaking and we knew we needed to do something. Little did we know how much our next steps would change, and continue to shape, our lives.

Artwork by Vaughn

The day we were given the diagnosis was one of the hardest days of my life. I worried about my son’s future and whether he would ever learn to communicate his needs, make friends or even live independently. As a mother, you want those things for your children and you worry when the future path isn’t clear. Thankfully my husband and I parked our tears and bonded together to do everything we could to change the trajectory of Vaughn’s life. We quickly immersed ourselves in learning all we could about this complex and wide spectrum disorder, discovering just how important it was to intervene early and often for the biggest impact. And we did just that; fully determined, we dove in and never looked back.

While most children were enjoying the freedoms of exploration and play, Vaughn was working as many as 35 hours a week for years on things that would seem so simple to some—things like learning how to speak and shape sounds, how to play appropriately with toys and even how to properly engage other children and people. My husband and I often marveled at how hard Vaughn worked and how little he complained. However, as parents, we often struggled to strike the balance between being therapists consistently executing interventions and being just a regular mom and a dad to both of our children.

Fortunately, and with the help of many wonderful people and organizations, we were able to effectively navigate the system and provide Vaughn with comprehensive services and support, some of which he still receives today. Vaughn is in a typical classroom, participating in typical activities and has many friends. He is a talented artist with a creativity and sense of design well beyond his years. And, most importantly, he has a loving and supportive big sister that celebrates his success, despite the years of being in her brother’s autism shadow. We are fortunate.

In an effort to honor those that have helped us and to give back to our community, I have joined the board of directors at Arizona Autism United as they have played, and continue to play, a key role in Vaughn’s treatment and success. It is my goal to do whatever I can to support this organization that has done so much for my family and share what we have learned to help other families struggling with autism in our community.

I’ve said it a million times, and will say it again. If I could go back in time to the day Vaughn was diagnosed and change things, I wouldn’t. He is such a special and creative person that has positively shaped how our family sees the world. Our journey has made us who we are and we are grateful for the lessons we’ve learned and the people we’ve met along the way. This Autism Awareness Month, take the time to learn more about autism and what you might be able to do to help those in your own community.

In honor of World Hemophilia Day, Magellan Rx Management has released results from the first six months of its hemophilia management program launched in collaboration with Health New England, a non-profit health plan serving the commercial, Medicaid and Medicare markets.

Hemophilia is a rare genetic bleeding disorder, for which treatment is expensive and difficult to manage. The average annual cost per member with severe hemophilia can exceed $250,000, and may be upward of $1 million for members who have developed inhibitors. Personalized care programs for patients with hemophilia aim to reduce unnecessary costs while improving the overall quality of care.

“As April 17 is World Hemophilia Day, we’re excited to bring hemophilia care into the spotlight and highlight the early results achieved with Health New England through our hemophilia management program,” said Haita Makanji, vice president, clinical specialty solutions at Magellan Rx Management. “Through personalized interventions, we’re able to better determine the individual member needs and coordinate across key stakeholders to deliver a truly personalized care program that ensures members with hemophilia receive best-in-class care and achieve optimal outcomes.”

Since launching the hemophilia management program in August 2017, Magellan Rx Management and Health New England have standardized care across various stakeholders without compromising patient outcomes, resulting in:

• Optimized doses through assay management or pharmacokinetic (PK) testing in 50 percent of members
• Reduced average assay dispensed in prophylaxis patients from 5 percent to 1 percent, reducing the potential for waste
• No breakthrough bleeding reported from members who had a dose reduction

“In the past eight months of collaboration with Magellan, we’ve achieved our goals of ensuring high quality of care for members with hemophilia while minimizing potential waste created through excess dispensing and inappropriate dosing,” said Andrew J. Colby, R.Ph, MBA, Health New England’s pharmacy director. “By announcing our hemophilia management program results on World Hemophilia Day, we hope to raise the profile of this condition and look to continue to make strides in standardizing best treatment practices to benefit members across the country.”

The hemophilia management program aims to enhance overall quality and personalization of hemophilia care by coordinating with prescribers, members and pharmacies while reducing unnecessary costs. Key elements include:

• Helping payers analyze information related to member bleed history and hemophilia treatment patterns.
• Standardizing dispensing and optimal dose protocols to promote best practices and improve transparency in hemophilia care.
• Updating policies to encourage individualized treatment regimens based on member-specific metabolic factors.

Magellan Health today announced the launch of a new thought leadership website, www.MagellanHealthResources.com.

With a curated assortment of materials, focused around individual topics, Magellan Health Resources was designed as a repository of research, information and materials for healthcare professionals, members of the media and researchers.

To launch, Magellan Health Resources is showcasing information and materials around the opioid crisis.

The site includes videos  webinars, downloadable white papers, research, a news archive and more.

You can take a look here

By Carol Sickler, Screen Liaison Supervisor, TMG by Magellan Health

April is National Donate Life Month, and in honor of this, we would like to share a story from Carol Sickler, a TMG by Magellan Health Screen Liaison Supervisor. Fourteen years ago, Carol gave a life-saving gift to her brother, and she’s proud to be a living organ donor. Here is Carol’s story.

On March 18, 2004, I donated my kidney to my brother Lee. He had been in kidney failure for a year due to Berger’s disease (also known as IgA nephropathy) and was on dialysis. Berger’s disease causes the kidneys to become inflamed, which can affect how the kidneys filter waste from the blood. Since only 50 percent of people on dialysis live beyond 5 years, Lee’s best bet for long-term survival was to find a new kidney. I wanted to give Lee a fighting chance.

Our dad had also been on dialysis due to what we believed was Berger’s disease (it was never confirmed because he had other health issues, too). Unfortunately, our father was not a candidate for a transplant, and passed away in 2002 at the age of 72. My brother Steve also has Berger’s disease, but fortunately he has not experienced kidney failure (not everyone with Berger’s does).

Lee and Carol Sickler

Since this disease is hereditary, you might be wondering why I decided to donate one of my kidneys – wasn’t I at risk of Berger’s disease, too? Thankfully for me, Berger’s is primarily a disease found in males. It also tends to show up by the time a person is 40, and I was 40 at the time. So, for me, the risk of developing Berger’s disease was relatively low.

When I first considered donating my kidney, there were so many questions that were going through my mind about both of our futures, and if this was the right choice for us. However, my decision was solidified when the doctors at UW Hospital in Madison told us I was a match for Lee. And not just a match, but an identical match, with all six antigens matching as if we were identical twins, even though Lee is seven years younger than me. The doctors were baffled by this and had never experienced anything like this before. For me, though, I knew then that it was part of my life’s path to move forward and give my kidney to my brother. So, fourteen years ago we hugged and went into surgery together, becoming connected in a way we had never before imagined.

Today, we are both fully recovered and doing well. I personally have no regrets, and no health issues or ill effects from the donation. What I do have is an amazing bond with my baby brother Lee – the depth of this bond is unexplainable, and it’s something I would gladly give my kidney for again if I had to. Because organ donations are treatments and not cures, the kidney donation didn’t cure Lee of Berger’s disease, but it has allowed him to live a fulfilling, healthier life off of dialysis. Also, this gift of life allowed him to have a daughter, Jazmyn Carol, for which our entire family is grateful.

For anyone who is interested in becoming a living donor, there are a lot of great resources at both the www.organdonor.gov and at the University of Wisconsin Living Kidney Donor page. One of the most important things to know is that as long as the donor is evaluated thoroughly and cleared for donation, they will most likely lead a normal life after the surgery. And should a health condition arise because of the donation, there is a priority system in place on the National Transplant Waiting List so that living donors move to the top of that list.

I’m grateful that I had the chance to give my kidney to my brother, and love sharing my story in hopes it will inspire others to give the gift of life.

Traumatic events, such as a sudden death, natural disaster, motor vehicle accident, or terrorist attack can leave children and teens feeling stressed, frightened, and helpless. Whether they personally witness the event or are exposed to it on the news or social media, children may experience intense emotions and a heightened sense of insecurity. Children’s reactions to a traumatic event depend on their age and personality, the severity of the event, the availability of support, and previous experience of trauma

Tips for all ages

Traumatic events can disrupt children’s sense of safety and result in fears and worries, nightmares, and physical reactions such as headaches, stomachaches, problems sleeping, and loss of appetite. Here are suggestions to help children through the emotional and physical challenges they may face after trauma:

• Be aware of your own reactions to the event and manage your own stress. Stay calm and offer hugs and reassurance to help restore your child’s sense of safety and security.
• Share information about the event and answer your child’s questions honestly. Listen to your child’s fears and let him/her know it is okay to share his/her feelings at any time.
• Limit or prevent exposure to disturbing news and social media coverage of the event. Children who see graphic images or hear distressing news stories may become re-traumatized.
• Maintain stable routines as much as possible, including regular mealtimes, bedtimes, and exercise.
• Engage in fun activities to help children relax and feel that life is returning to normal.
• Watch for signs of trauma, even after weeks have passed. Children cope with trauma in different ways, and some may show signs of sadness, anxiety, and troubling behavior weeks or months after the event.

Tips by age group

Preschool age

After a traumatic event, children who are age five and under may display behavior from an earlier stage of their lives, such as bedwetting, thumb-sucking, clinginess to parents, and fearfulness of strangers. They may have tantrums or cry more than usual, or become withdrawn from others. Parents and other adults can help children by providing comfort and reassurance, maintaining routines as much as possible, encouraging them to express their feelings, and giving simple explanations to children’s questions about the event. Children look to their parents for cues as to how to feel and react, and will pick up on a parent’s distress or anxiety. It is best not to expose young children to the news on TV or the radio about the traumatic event. Involving toddlers and preschoolers in fun activities and playtime with others will provide a healthy distraction.

Early childhood

Children ages 6 to 11 may show some of the same reactions that younger children have, such as reverting to more childish behaviors. They may have nightmares or trouble sleeping, find it difficult to concentrate in school, become irritable, anxious or disruptive, or lose interest in family, friends, and fun activities. Parents should reassure children that they are safe and will be taken care of no matter what. Encourage family discussion about the event and answer questions, but be careful about exposing children to news and TV footage. Keep bedtime and meal routines as normal as possible, and involve children in activities that keep them busy. Identify the positives such as community recovery activities and the ways people help each other get through difficult times.

Adolescence

Older children ages 12 – 17 may have stress reactions such as nightmares and flashbacks of the event, lose interest in school, hobbies, and friends, feel angry, guilty, or depressed, withdraw from others, have physical symptoms such as headaches, or abuse alcohol or other drugs. As with younger children, parents can help teens rebuild a sense of trust and safety by listening to their concerns without judgment and providing them with peer support opportunities. Age-appropriate volunteer activities can help teens feel useful and productive.

When to get help

Be aware of signs that a child may need extra help coping with the trauma. If six weeks or more have passed since the traumatic event and your child is not feeling better, has trouble functioning at school or at home, is withdrawn from friends and family, or continues to have physical complaints such as headaches, stomach pains, and problems sleeping or eating, contact a mental health professional.

The Centers for Medicare and Medicaid Services (CMS) Star Rating program is designed to measure and improve the overall performance and quality of care health plans provide to

Medicare beneficiaries.  Due to changes in individual measure specifications, benchmarks, and inclusion into the overall calculation, this quality rating system continues to evolve – which can make it challenging to achieve and maintain 5-Star performance.

Listen to our latest webinar to learn about clinical strategies that can help you stay ahead of the curve for various Part C and D clinical measures such as rheumatoid arthritis management, osteoporosis management, statins in diabetes, and medication adherence for diabetes, hypertension (renin-angiotensin system antagonists), and cholesterol (statins).