In today’s workplace environment, employee mental health has emerged as a critical factor affecting organizational performance and success. Digital mental health platforms are increasingly being adopted as effective tools to support employee wellbeing while simultaneously improving business outcomes. Magellan Healthcare’s Digital Emotional Wellbeing Program, powered by NeuroFlow, is a core component of our Employee Assistance Program and a strategic solution that transforms mental health support from a cost center into a productivity driver.

Understanding the Business Impact of Mental Health Challenges

Recent research has revealed the significant economic implications of mental health issues in the workplace:

• The World Health Organization estimates that depression and anxiety cost the global economy approximately $1 trillion annually in lost productivity (2022)
• Employees working while struggling mentally (presenteeism) experience an average 8% productivity decline (Journal of Occupational and Environmental Medicine, 2023)
• Healthcare costs for employees with untreated mental health conditions are typically 20% higher (Milliman Research Report, 2020)
• Employee turnover related to burnout and mental health issues costs organizations an estimated $3,000 per employee annually (SHRM/Kronos Study, 2021)

How Digital Mental Health Solutions Are Addressing These Challenges Head-On

Modern digital mental health solutions deliver value across multiple dimensions:

1. Healthcare Cost Reduction – Digital tools that help employees track mood, sleep patterns and pain levels while building coping skills can identify mental health concerns before they escalate. The American Journal of Managed Care has found that early digital interventions can reduce overall healthcare costs by 15-23%.
2. Productivity Improvements – Access to evidence-based relaxation techniques, breathing exercises, and stress management tools directly translates to improved performance and reduced absenteeism. A 2023 Deloitte analysis revealed that companies investing in digital mental health resources saw a $4.20 return for every dollar spent through productivity enhancements.
3. Talent Attraction and Retention Benefits – In today’s competitive labor market, organizations that demonstrate commitment to employee wellbeing gain an edge in recruiting and retaining valuable talent. According to Gallup’s 2023 State of the Global Workplace report, 61% of employees consider mental health benefits “very important” when evaluating job opportunities.
4. Privacy and Accessibility Considerations – Effective digital mental health platforms should be HIPAA-compliant and accessible via multiple channels, ensuring all employees can benefit regardless of technology access. Strong confidentiality measures should protect sensitive health information while still providing organizational leaders with anonymized, aggregate insights.

A Strategic Business Decision

Mental health initiatives aren’t simply about compliance or expanding employee benefits—they represent strategic investments that directly impact operational excellence, innovation capacity and organizational resilience.

Investing in digital emotional wellbeing empowers employees to manage stress, build resilience and improve overall mental health—leading to a healthier, more productive workforce. Magellan Healthcare’s Digital Emotional Wellbeing Program, powered by NeuroFlow, offers accessible, evidence-based tools such as digital cognitive behavioral therapy (DCBT), mindfulness techniques and behavior tracking to support employees anytime, anywhere.

With proactive engagement features like gamification, rewards and automated check-ins, employees stay actively involved in their wellbeing journey. Employers also benefit from enterprise-level reporting that highlights workforce wellbeing trends while maintaining confidentiality. Prioritizing emotional wellbeing not only enhances workplace culture but also drives long-term business success.

By implementing comprehensive digital mental health solutions, organizations aren’t just supporting employee wellbeing—they’re making evidence-based investments in their company’s performance and long-term success.

Learn more about Magellan Employer Solutions.

Sources:

• World Health Organization. (2022). Mental Health and Work: Impact, Issues and Good Practices.
• Hemp, P. (2023). “Presenteeism: At Work—But Out of It.” Journal of Occupational and Environmental Medicine, 65(3), 252-263.
• Milliman Research Report. (2020). “How do individuals with behavioral health conditions contribute to physical healthcare costs?”
• Society for Human Resource Management & Kronos. (2021). “Employee Burnout: Causes and Cures.”
• Mordecai, D., et al. (2021). “Digital Mental Health Interventions: Cost-Effectiveness Analysis.” American Journal of Managed Care, 27(5), 196-203.
• Deloitte UK. (2023). “Mental health and employers: The case for investment – pandemic and beyond.”
• Gallup. (2023). “State of the Global Workplace: 2023 Report.”

We are excited to re-introduce our Thought Leaders series with Dr. Karen L. Fortuna, one of the world’s leading researchers and activists focused on digital peer support and the role of technology in recovery. As a result of COVID-19, technology-enabled peer support has become the norm and vitally necessary to ensure continuity of care. We hope you enjoy our exclusive, virtual e-interview with Dr. Fortuna as she shares her unique insights about the transformation of peer support.

Dr. Fortuna holds a doctorate in social welfare and a master’s degree in social work. She is an Assistant Professor of Psychiatry in the Geisel School of Medicine at Dartmouth College. Her primary research interest is service delivery strategies for older adults with serious mental illnesses and chronic health conditions. Dr. Fortuna is using community-engaged research methods to develop and implement peer-supported mobile health (mHealth) intervention. Dr. Fortuna was awarded a NIMH K01 award (K01MH117496), a NARSAD Young Investigator Grant from the Brain and Behavior Foundation, the Alvin R. Tarlov & John E. Ware Jr. Award in Patient Reported Outcomes, and the Gerontological Society of America’s AGESW Faculty Achievement Award. Dr. Fortuna served on the International Standards Advisory Committee to develop the first-ever international accreditation standards for behavioral healthcare for older adults. Dr. Fortuna also serves on the American Psychiatric Association expert advisory panel on smartphone apps.

Dr. Fortuna led the development of the first digital peer support curriculum to equip older adult peer supporters with the skills and knowledge to offer digital peer support. The Digital Peer Support Certification was co-produced with Dartmouth scientists and peer support specialists and has been found to be an effective knowledge translation training that has shown to increase peer support specialists’ capacity to use digital peer support in practice (http://digitalpeersupport.org/).

And now, let’s hear from Dr. Fortuna!

Magellan: Dr. Fortuna, thank you so much for your time. Can you share what brought you to this field?

Dr. Fortuna: Thank you! My background is in social work. I went into this field because my dad had multiple sclerosis and he was very sick as I was growing up. People treated him like he was different just because he was in a wheelchair. I would say he was marginalized—but, to me, he was always just my dad—not different—not helpless—one of the most amazing and capable people I have ever known in my life. So here I am. Working with peer support specialists that may have at one point in their life been viewed as “different” or “helpless” and I work with peer support specialists to accomplish things they maybe never thought possible.

Magellan: You are recognized as one of the world’s leading researchers into the area of digitally delivered peer support. What drove your interest in pursuing this topic?

Dr. Fortuna: My initial exposure to mental health services began in the first year of a Masters in Social Work internship at the University of Pennsylvania. During this internship, I provided group-based self-management training to adults with a lived experience of a mental health condition and chronic health conditions. During this experience, I was impressed by the severity of disabilities that continued to be present for adults with a lived experience of a mental health condition despite participation in evidence-based programs. I subsequently pursued a volunteer opportunity with Dr. Mark Salzer to learn about efforts to improve the effectiveness of interventions for people with a lived experience of a mental health condition; in addition to being introduced to community-based research and peer support specialists.

As a result, I have developed an understanding of the history of the peer recovery movement, peer perspectives and theories of service delivery—and I saw recovery for the first time. I was sold! Recovery is real! This experience laid the foundation for my research career focused on digital peer support as an innovative service delivery strategy. Digital peer support is defined as live or automated peer support services delivered through technology mediums.

Magellan: One of the hallmarks of your work has been using a co-design approach, working collaboratively with persons with lived experience to inform your projects. Would you share with our readers what co-design is and why you choose this approach?

Dr. Fortuna: Co-design is a partnership in research that promotes shared decision making in all aspects of the research process. Our model, the Peer and Academic Partnership, supports collaboration, engagement, shared decision-making, principles of reciprocal relationships, co-learning, partnership, trust, transparency and honesty. We use this co-design approach because peer support specialists bring new insights and energy to our research that our team believes will lead to the next discovery in the social sciences. Plus, it’s fun! I have an amazing group across the globe that I work with!

This is an excerpt from the Magellan Healthcare eMpowered for Wellness June newsletter. To read the full article, go here.

Primary care providers can be responsible for everything from first line dermatology to behavioral health to musculoskeletal injuries. In a world of rapidly changing technologies, and in which new therapies can cure or alter diseases that only a few years ago would have never been thought possible, the basics still matter. As a clinician, I’ve practiced internal medicine and psychiatry, and still have the opportunity to work with a FQHC in building integrated care. Those experiences and my national view of utilization and prescribing patterns highlight the need for provider support to care for persons with mental health conditions, including opioid use and abuse.

It is often challenging to translate new medical knowledge to the clinic setting. How does a provider care for the individual on a potentially lethal combination of opioids, benzodiazepines, and muscle relaxants? Or, how does one address the young child who has been placed on a combination of psychotropic medications.

In our current health system, primary care providers are in the best place to begin patient care journey or change the course of an already established treatment plan. An effective solution for supporting providers in delivering high quality care is in the form of provider support, especially through programs that involve data analytics, followed by one on one academic detailing. PBMs are in a unique position, having the ability to assist providers in working with patients on complex behavioral health or opioid regimens. PBMs have access to data that allows for identifying outlier member and provider behavior and finding patients who are at risk for adverse outcomes. While PBMs don’t have access to prescription drug monitoring programs, they can see what prescriptions are filled, where there is overlap, and where there are multiple providers interacting with a patient.

Magellan Rx developed the Live Vibrantly: Whole Health program to address those outlier providers and members, with the goal of achieving higher quality care. This program uses evidence-based algorithms to find members who may be at risk for adverse outcomes, and targets prescribers who may be over-prescribing. We become the provider’s go-to source for translating the evidence to the bedside through assistance with difficult issues, such as withdrawing an individual from high dose opioids. Through taking an approach to support providers in delivering high quality care, we’ve been able to truly partner in leading our members to leading more healthy vibrant lives.

For healthcare providers, prior authorization (PA) via fax or telephone is the second most costly medical administrative function. On average, medical staff spend two business days per week on PA. Automating PA while maintaining clinical excellence is essential for better care delivery. With a focus on leveraging digital solutions and fostering data-enabled decisions, Magellan Healthcare is building more provider-friendly approaches to improve care.

Recently Magellan announced a collaboration with Stanson Health, Premier, Inc.’s clinical decision support (CDS) technology division, to deploy DecisionPoint, an industry-leading automated PA solution. Powered by Premier’s CDS technology, DecisionPoint is available at the point of care and supports true automation within the electronic health record (EHR) and the physician workflow, making the PA process easier and more efficient for providers, patients and health plans.

DecisionPoint is built with Magellan Healthcare’s Advanced Imaging Management program clinical guidelines and Premier’s award-winning technology platform. Magellan maintains one of the industry’s most comprehensive evidence-based sets of clinical guidelines. Our clinicians develop our criteria through an extensive process of innovation and refinement. We base these guidelines on the analysis of public, peer-reviewed articles; health plan medical policies; the Centers for Medicare & Medicaid Services (CMS) policies; specialty physician reviews, professional society guideline statements; and other rigorous reviews of scientific documents. We continually monitor peer-reviewed literature, professional society guideline statements, and CMS-covered criteria to update our guidelines regularly, no less than annually. Initially, DecisionPoint will include our suite of the 20 highest-volume advanced imaging studies that make up 85% of all requests.

Working directly in the EHR, DecisionPoint guides provider decisions in real time in response to key workflow events, such as ordering an advanced imaging study. Integrating within the EHR improves efficiency while ensuring safety and quality and reducing undesirable variation in care.

Rules-based programming leverages EHR data, locating all relevant patient clinical information and citing appropriate Magellan clinical guidelines. Requests that satisfy the clinical guidelines are automatically approved and posted in the EHR, and approval IDs are automatically loaded to the record. With a confirmed authorization determination, the member leaves the appointment with a clear plan of action.

Hawai‘i Pacific Health (HPH), one of the largest healthcare providers in Hawai‘i, is leading the way in automating prior authorization by piloting DecisionPoint to help ensure their patients receive real-time, evidence-based decisions at the point of care whenever possible. Administered through HPH’s Accountable Care Organization (ACO) with over 800 physician members, the pilot leverages Magellan’s clinical guidelines and our full panel of clinical experts. We expect DecisionPoint to be available to additional providers in the fourth quarter of 2019 and include additional specialties and tests in the future.

The healthcare industry is in the midst of a significant paradigm shift as it transitions from a fee-for service model to value-based care. As a technology-augmented service backed by the support of providers, DecisionPoint is designed to minimize the industry’s challenges by fully integrating with EHRs at the point of care to enable faster PA and help deliver on the triple aim—improved quality, reduced cost and improved patient/provider experience.

To learn more about DecisionPoint, click here to go to our website, or email ProviderSolutions@MagellanHealth.com.

Prior authorization (PA) goes by many names—preauthorization, preapproval, advance notification, precertification and preadmission, to name a few. All these terms refer to the utilization management (UM) process used by many U.S. health insurance companies to ensure patients receive the right services, equipment and prescriptions at the right time and place. PA requires healthcare providers to request and obtain approval before rendering certain services, equipment or prescriptions in order to receive insurance reimbursement for those services. Not everything requires PA. Typically, authorization is needed for more complex services such as hospital admissions, diagnostic tests, medical equipment and complex prescription medications.

The PA process is intended to act as a safety and cost-saving measure. It can lower costs to the patient, prevent unnecessary or invasive procedures, and reduce the use of unnecessary tests that may expose patients to potentially harmful radiation and/or undue stress. For example, up to half of advanced imaging procedures ordered fail to provide information that improves patients’ welfare.[i] In addition, despite studies demonstrating overuse, rates of advanced imaging procedures continue to rise—increasing costs and exposing consumers to excessive radiation.  Despite its benefits, the prior authorization process needs an upgrade.

According to the 2018 CAQH Index , manual prior authorizations (via fax or telephone) are the second most-costly medical administrative transaction, costing providers $6.61 per submission. Providers estimate their staff members spend up to 30 minutes completing one manual prior authorization. While manual prior authorization is a much-debated topic due to the time and cost it requires, many parties support standardizing and simplifying the process.

Technology can significantly  decrease the need for expensive manual processes.  According to the 2018 CAQH Index, the medical industry could save $417 million annually by transitioning to electronic prior authorizations, which includes $278 million in annual savings for providers and $139 million for health plans.

While many health plans offer web portals to process prior authorizations, this approach requires providers to use different online systems for each health plan. Instead, digital solutions should include automation within the electronic health record (EHR) and the physician’s workflow. Automation is essential to reducing inefficiencies for providers and health plans and enabling authorizations at the point of care while maintaining clinical integrity.

The goal is to make the right decision for each patient—quickly and easily so patients get the care they truly need. Automating prior authorizations will benefit everyone involved.

[i]Beachy, D. (2014, September 8). Defensive medicine driving up wasteful imaging. Retrieved from https://www.healthimaging.com/topics/healthcare-economics-policy/defensive-medicine-driving-wasteful-imaging.

Senior Whole Health, a wholly-owned subsidiary of Magellan Health, has a core mission of addressing the social and medical needs of individuals eligible for Medicare and Medicaid, with a special focus on putting services in place to allow elderly individuals to remain safely in their homes for as long as possible.

The average Senior Whole Health member is 76, female, has several chronic illnesses, and takes five or more medications. In spite of the fact that many members have home-based community services and regular nursing visits, a majority of the admissions for hospital and emergency department care are unexpected. While it is not feasible for all high-risk members to have a daily evaluation by a clinician, Senior Whole Health is implementing a program of passive home monitoring for select high-risk members allowing for early detection of changes in behavior that identify when an individual is at risk for hospitalization. With prompt interventions by clinical staff, trips to the Emergency Department and/or Hospital can be averted.

The program being used by Senior Whole Health is called Lively® Home, a GreatCall product offering. With advance permission of the member and their family, a suite of 10 passive sensors is installed in the home. Activities of daily living such as getting into and out of bed, using the toilet and opening the refrigerator are monitored, allowing for a normal pattern of activity for an individual to be modeled. In the event that the individual’s behavior pattern changes (such as staying in bed much longer than usual or using the refrigerator much less than usual), an alert is sent to clinical staff, allowing for a wellness call to the member to check on their status. Often a medical condition can be identified and treated in the outpatient setting, avoiding more serious outcomes including hospitalizations and/or premature nursing home admissions.

Seniors have listed losing independence as among their greatest fears of aging. The use of passive monitoring technology such as Lively® Home along with direct in-person support services is expected to further extend the ability of high-risk Magellan Health members to live safely and independently as long as possible at home.

Is it necessary to explicitly focus and call attention to the obvious fact that I am a woman in technology? You might not think so these days. Women have accomplished so much since the first bra was burned, that it would be understandable if you believed that we have established and gained enough ground to just be people in technology.

The reality is, unfortunately, there remains a staggering degree of inequality. Last month, the New York Times published an article titled “The Top Jobs Where Women are outnumbered by Men Named John.” The article reveals that there are fewer women among Chief Executives of Fortune 500 companies (5%) than there are men named James (5%); fewer female Venture capital investors in the largest tech deals of the last five years (9%) than there are men named David, James and Peter 11%.

You may giggle at first when reading the article, but its conclusion is stunning: it is more likely that the names of the men in charge will change sooner — fewer Johns and Roberts and more Liam’s and Noahs — than the number of women.

This is a reality that we cannot ignore, and one that exists all over our industry. While some of us women may not “feel it” as much as others, we are all still subject to “it.”

The World of Economic Forum’s 2016 Industry Gender Gap report recognizes that in “nearly all industries and geographies there has been a marked shift away from deliberate exclusion of women from the workplace, there continue to be cultural beliefs that lead to unconscious biases. This includes perceptions that successful, competent women are less “nice”; that strong performance by women is due to hard work rather than skills; and assumptions that women are less committed to their careers.”

We women have all felt this. The one woman that can be “tough enough” always gets through, but not all of us. We internally debate with ourselves whether to be more like our male counterpart in order to simply be heard in a meeting. Sometimes it is a question of style, but more often than not, we don’t have a seat at the table. And when we “power through it all” we still struggle to find a lot of role models to look up to.

I personally attribute my success to relentless stubbornness, shameless self-confidence (which often gets mislabeled since I am a woman) and sometimes blunt confrontation. Still, many times throughout my career I was asked to sit on the sidelines. I was encouraged to “focus on my wedding planning activities, rather than worrying about a promotion” which by the way I well deserved and earned.

At Magellan, we have decided that the only way to overcome these inequalities is to take them on proactively. That is why, in 2018, we have formed an internal ‘Women in Technology’ (WIT) change leadership group.

Being at a company that is not only willing to discuss and support a Women In Technology group, but is actually ready to “put their money where their mouth is” is refreshing.

The WIT group we established has taken off and I am so happy to see the responses, the community and the peer (gender agnostic) support we are offering to women across Magellan IT and beyond.

Our group is not exclusive to women, in fact we need everyone involved to truly make a difference, because our goals are critically important:

• We are focused on fostering female employee development and growth across the IT organization.
• We want to see more of us out there – we want our talent pipeline and the recruiting tactics to bring women to the table.
• We aim to encourage young women in the middle and high schools our communities to consider, try and stick with STEAM (Science, technology, engineering, arts and mathematics).
• We want to support each other through peer-mentoring.
• We want to bring role models forward to provide insights into the possibilities.

Ultimately, we want a future where being a woman in technology is not a heroic accomplishment, and super powers are not needed to claim our earned and well-deserved seat at the table.

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