Numerous studies show that job stress is far and away the major source of stress for American adults and that it has escalated progressively over the past few decades.* Negative work stress can come from a variety of factors including having little control but lots of demands, fear of being laid off or fired, working additional overtime due to budget cuts or pressure due to constantly rising expectations.

Start your day off right

After scrambling to get the kids fed and off to school, dodging traffic and combating road rage, and gulping down coffee in lieu of a healthy breakfast, many people arrive at work stressed, and become more reactive to stress at work. In fact, you may be surprised by how much more reactive to stress you are when you have a stressful morning. If you start off the day with good nutrition, proper planning, and a positive attitude, you may find the stress of the workplace rolling off your back more easily.

Be clear about your role

One of the factors that contributes to job burnout is unclear requirements. If you don’t know exactly what’s expected of you, or if the requirements keep changing with little notice, you may find yourself much more stressed than necessary. If you find yourself falling into the trap of never knowing if what you’re doing is enough, it may help to have a talk with your supervisor and go over expectations, and strategies for meeting them.

Stay away from conflict

Interpersonal conflict takes a toll on your physical and emotional health. Because conflict among co-workers is so difficult to escape, it’s a good idea to avoid conflict at work as much as possible.

That means staying away from gossip, not sharing too many of your personal opinions about religion and politics, and steering clear of colorful office humor. Try to limit contact with those who don’t work well with others. If you do have to deal with conflict try these conflict resolution strategies.

Stay organized

Even if you’re a naturally disorganized person, taking the time to plan ahead to stay organized can help you decrease stress at work. Being organized with your time results in less rushing in the morning to avoid being late and being able to leave at the end of the day with a clear mind.

Get comfortable

Another surprising stressor at work is physical discomfort. You may not notice the stress you experience when you are in an uncomfortable chair for a few minutes. But if you practically live in that chair when you’re at work, you can have a sore back and be more reactive to stress because of it. Even small things like office noise can be distracting and cause low-grade frustration. Do what you can to ensure that you’re working from a quiet, comfortable and soothing workspace.

Form positive relationships

While the negative effects of stress are very real, much of the stress we experience can be alleviated simply by talking about it. That’s why positive relationships at work are so important. Even if they can’t solve your problems, the simple act of verbalizing your stress with someone you trust can actually reduce the severity–or clear it up altogether.

Start exercising

Many people are feeling ill effects from leading a sedentary lifestyle. One way you can combat that, and manage stress at work at the same time, is to get some exercise during your lunch break and perhaps take short exercise breaks throughout the day. This can help you blow off steam, lift your mood, and get into better shape.

Keep perfectionism in check

Being a high achiever can help you feel good about yourself and excel at work. Being a perfectionist, on the other hand, can drive you and the people around you a little nuts. Especially in busy, fast-paced jobs, you may not be able to do everything perfectly. But striving to just do your best and then congratulating yourself on the effort is a good strategy. Your results will actually be better and you’ll be much less stressed at work.

Don’t lose sight of your purpose

Each of us is more than the work we do. Taking the time to understand what motivates us and makes us happy is time well spent.  When we starve our purpose—by not engaging with our work, suppressing our creativity, or ignoring our relationships (including the one with ourselves)—we trigger our stress response. When our life is full of nothing but work and obligations, we begin to feel bitter, resentful, depressed, and even angry. The antidote to these feelings is to infuse your life with a sense of purpose and gratitude for what you have every day.

Establish boundaries

In today’s digital world, it’s easy to feel pressure to be available 24 hours a day. Develop some work-life boundaries for yourself. That might mean making a rule not to check email from home in the evening, or not answering the phone during dinner. Although people have different preferences when it comes to how much they blend their work and home life, creating clear boundaries between these realms can reduce the potential for work- life conflict and the stress that goes with it.

For additional information, visit MagellanHealth.com/MYMH

* The American Institute of Stress, Workplace Stress, January 12, 2018. Retrieved from https://www.stress.org/workplace-stress/

How good are you at coping with adversity? Somehow, life always finds a way to present you with challenges that you didn’t see coming. Fortunately, you can improve your resilience skills—enabling you to bounce back when confronted with a crisis or an overwhelming change.

1. Differentiate problems from your response to them.

You have the option of reacting with panic, or responding in a calmer, measured way that allows you to proceed logically toward a solution. It’s your choice!

2. View your strengths positively.

Remind yourself that you’ve gotten through tough times before and be confident in your ability to re-apply those successful strategies.

3. Always be ready for change.

Remind yourself that life is always ready to throw you a new curve, and that sometimes the advent of a big, intimidating change can end up being a positive learning experience that helps you grow.

4. Keep your perspective.

No matter how overwhelming your problem might seem, try to view the situation in the longer- term context of your life and the larger world.

5. Lean on close family, friends and peers.

Being able to share concerns— and to brainstorm innovative solutions together—can give you more confidence as you move forward.

6. Stay flexible.

Try not to get locked into a single approach to solving a problem and have a flexible mindset.

7. Don’t forget your own needs.

In times of crisis, staying physically and spiritually fit helps you fight off stressors of all kinds!

8. When in doubt laugh at it.

Try to find those nuggets of humor, shake your head, and laugh at life’s wackiness.

9. Look for light at the end of the tunnel.

No matter how difficult or uncomfortable a situation may be, remember that even the darkest of days won’t last forever.

10. Keep building you resilience skills.

It may take time to learn how to stay balanced when times are tough. Keep learning from others who seem resilient, and build upon your valuable experience and personal strengths.

Stacy Ellingen is a woman from Wisconsin who’s never met an obstacle she couldn’t overcome. After graduating from high school, Stacy left home to attend the University of Wisconsin-Whitewater. After graduating with a degree in journalism and advertising, she moved to Oshkosh. Now in her thirties, Stacy leads a busy professional life as a small business owner and an independent contractor with InControl Wisconsin, an organization that plays a key role in advancing self-directed supports in the state. She’s become more involved in disability advocacy efforts and the community.

Stacy’s story is a successful one—living independently for more than five years, finding a job about which she is passionate and becoming involved in her community. But now consider this success as part of Stacy’s larger story – she grew up with cerebral palsy, resulting in complex physical support needs. However, Stacy grew up believing that she could do everything others do. Working with her self-directed support consultant, Kathi Miller, an employee of TMG by Magellan Health, Stacy proved she could do everything others do.

“Kathi has helped me reach my goals in many, many ways,” Stacy said. Kathi and Stacy joined forces to identify community home care providers to support Stacy in meeting her daily needs at home and at work. They partnered to identify ways that Stacy could make responsible budget decisions in purchasing services to meet her goals. When developing her small business, Kathi supported Stacy in connecting with the local business community to create professional peer connections that enhanced her business development strategies. “Most of all though, Kathi encouraged me to keep moving forward when things got tough! She has been amazing!” said Stacy.

When I was selected to join the National Quality Forum’s Medicaid Innovation Accelerator Project Coordinating Committee, I thought about the background and experiences I would bring with me – both personally and professionally. As a trained pediatrician, my medical training focused largely on the care and treatment of young children. According to the Centers for Medicare & Medicaid Services (CMS), more than 45.2 million children were “ever-enrolled”¹ in Medicaid and the Children’s Health Insurance Program (CHIP) during fiscal year 2015. In addition, in the time since I was in practice, I’ve worked for several national healthcare companies, with a focus on population health, clinical delivery systems delivery and improvement.

Since joining Magellan as the company’s chief medical officer, I’ve worked with my colleagues to help continually looks for ways to reinvent how care is delivered. I am passionate about supporting the volume-to-value payment transformation, and Magellan has a key role to play because of the deep expertise we bring in behavioral health. Oftentimes, we don’t realize how specialized and important that expertise is, and how it impacts the overall quality of care for a patient, particularly with comorbid conditions. Magellan is also considered a trusted partner because we are an independent company and not part of a big health plan. In addition, we also bring a breadth of experience in medical specialty, medical pharmacy and long-term services and supports (LTSS) which is not found in most other organizations.

NQF’s Medicaid Innovation Accelerator Project (IAP) Coordinating Committee is tasked with identifying and recommending measures in four priority areas to help support states’ efforts related to payment and delivery system reforms.

The four priority areas are:

• Reducing Substance Use Disorders (SUD)
• Improving Care for Medicaid Beneficiaries with Complex Care Needs and High Costs (BCN)
• Promoting Community Integration – Community-Based Long-Term Services and Supports (CI-LTSS)
• Supporting Physical and Mental Health Integration (PMH)

The challenges – and opportunities – are many. Medicaid behavioral health does not currently have standard benefit packages from state-to-state, and there are also not standard billing practices. Both of those elements make it much harder to develop metrics which are reliable, and more technical expertise is needed to ensure that the metrics selected can be broadly used. Ultimately, this committee will provide guidance on performance measures for areas which are unique to Medicaid, including patients with complex health needs, LTSS needs and those with behavioral health and substance use/opioid disorders. The states will then have a list of standardized measures for use in Medicaid performance program evaluation.

All of the committee’s meetings are open to the public. The IAP will issue its draft report in July, and its final report at the end of September. I look forward to working with my committee colleagues as we work to draft these important metrics related to state’s efforts regarding payment and delivery system reforms.

¹These enrollment data are unduplicated counts of children who were enrolled in Medicaid and CHIP at any point in FFY 2015. A child who was enrolled in more than one program (e.g., Separate CHIP and Medicaid) at different times during the FFY is only counted in the program in which he or she was last enrolled.

Thirty years ago, President Ronald Reagan deemed March to be Developmental Disabilities Awareness Month. Awareness months are an important advocacy tool, as they provide opportunities to reflect on progress and continue meaningful conversations about the future. For many people with developmental disabilities, ensuring these discussions take place can be the difference between being invisible and living as full citizens in their communities.

Developmental disabilities awareness is something near and dear to me, not only as the president of TMG by Magellan Health—supporting the largest self-directed long-term services and supports program of its kind in the country—but also because of my graduate work. During my practicum, I worked on the South side of Chicago, assisting low-income families who had children with developmental disabilities. Too often, these families, many of them single mothers, struggled to find the necessary services to help their children live as independently and inclusively as possible. The isolation the children experienced was heartbreaking.

Fortunately, in the 20 years since then, I’ve seen wonderful strides in the resources available for people with developmental disabilities, as well as greater expectations for community inclusion. Self-direction has played a crucial role in this progress. With self-direction, individuals choose not only the services they receive and who provides them, but also how they live their lives. This means people have control over things many of us take for granted: living where and with whom we want; making our own schedule; having meaningful, lasting relationships; pursuing our hobbies and passions; and finding meaningful work or volunteer opportunities. There’s been an amazing nationwide movement towards self-direction, which is not only a best practice, but also the cornerstone of TMG’s work in Wisconsin’s innovative IRIS (Include, Respect, I Self-Direct) program.

While there’s been great progress in raising expectations and increasing opportunities and resources for individuals with developmental disabilities, there’s still much to overcome on the path towards greater acceptance and inclusion. Thankfully, as community inclusion and self-direction are becoming more commonplace, society increasingly recognizes the contributions that people with developmental disabilities can make. As a leader in helping individuals create healthy, vibrant lives, Magellan Health is at the forefront of self-direction with its Wisconsin program, and is building a strong self-direction component in its new managed long-term services and supports (MLTSS) program, Magellan Complete Care of Virginia.

So as you make your way through March, take time to think about the people in your life and in your community and how we can all support one another. Learn how to be a better advocate for individuals with disabilities at sites such as ACL.gov and NACDD.org, and read stories of self-direction in TMG’s The Path Ahead. Encourage and support inclusion and independence whenever you can. But mostly, take the time to get to know people for who they are and appreciate their individual gifts and talents.

In late January, Magellan held its second annual Magellan Open Vision Exchange (MOVE) conference in Scottsdale, Ariz. MOVE brings together a large cast of voices from the healthcare industry to discuss the future of healthcare for patients, plans and providers. Over two days, we heard from private industry experts, government leaders, as well as other subject matter experts and thought leaders both from inside and outside the healthcare industry.

The Future of Healthcare Beyond the Affordable Care Act

Obviously, the continuing debate over the future of healthcare and the Affordable Care Act were a central topic of the conversation at this year’s MOVE. A number of speakers talked about the impact of the Trump Administration’s efforts to repeal the Affordable Care Act. Former Utah Governor Michael Leavitt, who also served as the secretary of the Department of Health and Human Services, said that while he expects repeal and replace legislation will pass, significant parts will be deferred for three or four years. Brian Coyne, VP of federal affairs at Magellan Health, said that he feared gridlock over the next couple of years.

Managing Transformation in the Healthcare World

One of the key topics discussed at this year’s event was the immediate future of the healthcare industry. After a long period of explosive innovation, there was consensus that disruptive change will continue. Magellan Healthcare CEO Sam Srivastava posited that we are currently in a tech-bubble that is about to burst. The industry is waiting to see which of the early healthcare technology entrants will survive and how technology and healthcare will continue to interface with each other.
Leavitt spoke extensively of the need to manage transformation, especially in healthcare. Leavitt stressed that systematic healthcare change takes hold over three to four decade cycle, and he believes we are less than mid-way through the current transformation. Using an analogy of a cattle herd, Leavitt made the point that you can’t drive a herd too quickly, or you risk a stampede. You also can’t push the herd too slowly or it will meander. Applied to healthcare, the idea is simple but true: If we push change too quickly there will be chaos, but if we fail to adapt and change, we will stagnate. Allowing ourselves to be “lulled into inaction” is a recipe for disaster.

Value-Based Healthcare

A critical area of discussion was the expansion of value-based care. Speakers agreed that demand for value-based care is accelerating. Leavitt said he believed this was true regardless of the Trump Administration’s plans for healthcare. Billy Millwee, President and CEO of BM&A Public Policy, cited broad bipartisan support for the value-based model and agreed that it was here to stay.

Chet Burrell, president and CEO of CareFirst BlueCross BlueShield, spoke clearly on the approach that his company was taking: “We started and ended with common sense.” He went on to explain that they had built their model with the primary care physician at the center (PCP). The PCP knows the patient best and is therefore in the best position to make decisions regarding who to refer and to whom. By taking this approach, Burrell relayed, CareFirst was able to build a patient centered medical home model that improved care while reducing costs.

Despite the level of change being experienced throughout healthcare, a common theme was one of our industry being grounded in helping people get the high-quality care they need, affordably. This is the essence of why healthcare is our chosen industry and why we are driven to innovate.

An interesting takeaway was that across the conference and speakers, there was a clear common theme: while the ultimate structure of the pay-for-value transformation is uncertain, the movement will continue. Experimentation, promoted by both public and private payer initiatives, will drive innovation and change. Some will be better prepared than others to handle this paradigm shift.

According to the Kim Foundation, one out of four Americans experiences behavioral health issues. Of those, 60 percent are not receiving treatment.

Why are so many people not receiving treatment?

What does this mean for providers?

What more can be done to increase access to behavioral healthcare?

Learn more about this issue by downloading Magellan’s new infographic, “Mind the Gap: Increasing Access to Behavioral Healthcare.”

“Every citizen has gifts. A strong community knows it needs everyone to give their gifts.”

– John McKnight, Asset Based Community Development (ABCD) Institute

In supporting people with disabilities in our communities, it is important to shift from using a lens shaded by needs and wear one focused on seeing people’s strengths, talents and assets. This new lens reflects the potential of each person and helps to move the conversation from one marked by:

• listing the services a person may need, to one identifying the contributions an individual can make,
• seeing a consumer as a user of services, to one recognizing a citizen who can access shared resources and have valued roles in their community, and
• viewing programs with limited resources, to one recognizing relationships and connections to one’s community with endless possibilities.

The 2016 conference for TASH, an international advocacy organization, provides a unique opportunity for people with disabilities, their family members, other advocates, and people who work in the disability field to come together and learn about strategies that meet the objective of this year’s conference to “reignite their passion for an inclusive world.” I led an interactive session that engaged participants in using tools to clear the path to inclusion, employment and community connections. Attendees learned how to use strength-based strategies to expand and translate their interests, gifts and talents into real connections and a better quality of life.

These strategies, when applied to community inclusion for people with disabilities, are based on an exploration of an individual’s gifts of hand, heart, head and human connection. Gifts of the hand are the things we know how to do. These are our skills, habits or rituals that we learn or naturally possess. Gifts of the heart include our passion or things we care enough about to give of our time and effort. Gifts of the head are the things we know or want to learn about, such as an interest in a local sports team or in a hobby. Gifts of human connections are the people we know and who know us – often called our social capital.

For decades, we have kept those who are different from us, including people with disabilities, separated from the community or segregated in spaces society thinks they feel more comfortable and can live in more safely. While approaches to school inclusion and community living strategies have tried to address this, these efforts have often been more focused on meeting the needs of professionals or systems, as opposed to the needs of people. Far too many people living in their communities are segregated from typical experiences and do not have access to opportunities they deserve as citizens. However, when we support people to create connections to others in their communities based on their natural gifts and assets, opportunities for real inclusion develop.