It’s AIDS Awareness Month, and we want to recognize and remember those lost to AIDS, support those living with HIV, help to spread awareness about prevention and treatment, and provide information around our patient-centric AIDS Drug Assistance Program (ADAP) services that have helped so many patients.

By the numbers

Did you know that more than 1.1 million people in the U.S. are living with HIV today, and one in seven don’t even know they’re infected?¹ Thanks to significant improvements in treatment over the last few decades, HIV/AIDS patients are living longer, more prosperous lives than ever before. In 1996, the total life expectancy for a 20-year-old person with HIV was 39 years. In 2011, the total life expectancy increased to about 70 years.²

Even though many advancements have been made in treatment, the fight’s not over yet. You may have noticed that HIV/AIDS is no longer getting the attention that it used to, but these patients are still very much in need of quality care and treatment.

Our ADAP services: It’s all about the patient

At Magellan Rx Management, we offer differentiated programs for our HIV/AIDS patients. We’re not just another PBM, enrolling members and processing claims. To us, the most important thing is that these patients receive the care they need to thrive and manage their condition.

Our approach puts the patient at the center; they are the sole focus. While our comprehensive AIDS Drug Assistance Program (ADAP) solution offers claims processing, prior authorization, coordination of benefits, and many more core functions, we don’t just stop there.

Our #1 goal is to make sure that every patient who qualifies for treatment, gets treatment.

Going the extra mile

When we say we strive to get these patients the care they need, we mean it. One of our patient’s insurance had lapsed right before becoming a Magellan member, and as a result, was refused costly treatment in the hospital.  Our team truly went the extra mile – calls were made to both the insurance company and the hospital to make sure the patient received the necessary treatment.

We also go the extra mile at the client level.  Recently, we implemented our ADAP program and here is what the client had to say:

“Again the Magellan team is exceeding our expectations!  You guys continue to be a joy to work with!”

We wholeheartedly believe in leading humanity to healthy, vibrant lives and that means doing everything it takes to make sure our HIV/AIDS patients are getting the care they need.

Click here to learn more about our ADAP services.

¹ Content Source: HIV.gov.Date last updated: July 11, 2018. (2018, September 25). U.S. Statistics. Retrieved December 7, 2018, from https://www.hiv.gov/hiv-basics/overview/data-and-trends/statistics
² Scaccia, A., & Madell, R. (n.d.). Facts About HIV: Life Expectancy and Long-Term Outlook. Retrieved December 6, 2018, from https://www.healthline.com/health/hiv-aids/life-expectancy

Sadly, nearly every day Americans are faced with traumatic events. Whether it be weather-related incidents, mass shootings or other emergencies, these experiences are frightening. In response, Magellan has developed a Crisis Communications Resources page that includes downloadable tip sheets in English and Spanish about:

• Helping children cope after a traumatic event
• How to cope after a traumatic event
• Living with threats of violence
• Supporting employees during traumatic events

You can also find links to resources on the Ready.gov website, such as guides and videos for nearly 30 different types of disasters.

Caring for a family member or friend who has a disability or a chronic illness can be rewarding. But it’s also demanding. One of the keys to being a successful caregiver is to manage stress by seeking support and taking care of yourself. Managing stress is especially important for a caregiver, because stress can weaken his or her immune system. A weak immune system makes the caregiver more likely to get sick.

Think about the kinds of caregiving tasks or situations that trigger stress for you. Then you can focus on one or two things you can do that will help the most to reduce stress. Here are some ideas:

Get support
Ask family members for help. Include them in caregiving decisions.

• Ask family members for help. Include them in caregiving decisions.
• Share the tasks. Make a list of weekly tasks, and share that list with your family. Ask for help with shopping, housecleaning, and errands. You don’t have to do all the work on your own.
• Stay involved. Make time for social activities and friends, even if it’s only a phone call or coffee during the week.
• Join a caregiver support group. Meeting other caregivers helps you know you’re not alone. And it gives you a chance to talk about your worries and concerns with others who understand.
• Find respite care. Respite services provide someone who can stay with your family member while you get away for a few hours or days. Time away can help you manage your stress and be a better caretaker.
• Look up caregiver resources in your community. Hospitals, churches, and other groups may provide transportation or other services that support caregiving tasks. You can reduce stress by planning ahead so you know who to call when you need extra help.

Take care of yourself

• Put your own health first. Be sure to schedule and go to your medical checkups.
• Eat a healthy diet, and get enough sleep. Taking care of yourself will help you deal with stressful situations.
• Get regular exercise. Even a 10-minute walk can relieve stress.
• Take a breath. Try stress reduction techniques like deep breathing and meditation.
• Take a break. It’s important to take time off from caregiving once in a while. Spend some time doing things you enjoy or on things in your own life that need attention.

What to think about
Depression is common among caregivers. It’s emotionally draining to care for a loved one whose health is getting worse. Don’t dismiss your feelings as “just stress.” If you’re having trouble coping with your feelings, it may help to talk with a counselor. If you have symptoms of depression, such as a lack of interest in things you enjoy, a lack of energy, or trouble sleeping, talk with your doctor.

Help is available. For additional mental health information and resources, visit MagellanHealthcare.com.

Source: Healthwise

1. Share the responsibility of care with our partner, relatives, or other support persons.
2. Remember to rest when your child is resting. If you feel uncomfortable about leaving your sleeping child alone, sleep close by your child.
3. Talk with your doctor if you feel exhausted and unable to continue to care for your child adequately. This can happen to any parent.

Being a parent of a child with physical, emotional, or behavioral problems can be exhausting. Try to take good care of your physical and emotional health. Doing so will help provide you with needed energy to care for your child with special needs.

Schedule time for yourself. Use a calendar or planner to set aside specific times for buying and cooking healthy foods, resting, visiting with friends, and doing other things you enjoy. Don’t be afraid to ask family members or friends for help. Take a break while your child uses community services (such as school programs, social skills training, job training, and counseling). Ask your doctor about other resources that can provide you with needed personal time.

Learn ways to handle the normal range of emotions, fears, and concerns that go along with raising a child with special needs. Seek information about your child’s condition so that you will know what to expect. Use exercise, positive self-talk, relaxation, deep breathing, and other techniques to help you handle stress. Learn how to recognize when you need to use them.

Find out whether there is a support group in your area for parents of children with the same condition. Local and national groups can help connect families and provide much-needed sources of information. It may help you to share your feelings with others or simply to find out how others have addressed common issues. It can be comforting to talk with other parents who also face the challenges and joys of raising a child with special needs.

Seek and accept support from others. Don’t wait for information and assistance to come to you. Consider using respite care, which is a family support service that provides a break for parents and siblings. Trained staff can relieve family members from caregiving duties as needed. These breaks can help families communicate in a less stressful context and allow parents to focus complete attention on their other children for a while.

Allow yourself time to grieve if needed. You may feel a sense of loss about the dreams you had for your child. As you work through your grief, you will be better able to care for yourself and your family. Talk with your doctor or another health professional if you think you or another family member may be depressed or having other emotional difficulties.

Be realistic. In raising any child, there are no guarantees for success. It is important to remember to do the best you can and to know that you can’t control everything.

Believe in yourself. When self-doubts creep into your thoughts, remember to focus on the many good things you do for yourself and your child. If you are having problems dealing with your feelings about your child’s condition, talk with your doctor about whether counseling may be helpful.

Work with family and friends. Your family and friends may have concerns about your child. To address those concerns, you can:

• Talk about how your child’s condition affects you. Be open and honest about your hopes and concerns. Encourage others to talk about their feelings.
• Encourage them to learn about your child’s condition.
• Ask your other children to help with the care of the affected child as much as they are able. Allow them to refuse to help if they do not want to.

For additional information, visit MagellanHealth.com/MYMH

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.

Recently, employees from Magellan Rx Management were featured on Rx Radio, a podcasting media company serving the pharmacy profession with a goal of inspiring healthcare professionals to take an innovative approach with healthcare. Host Richard Waithe, President of VUCA Health, sat down with eight of our pharmacists to talk about the future of pharmacy, and what it is like to be a pharmacist in managed care.

Listen while you are at work, out for a jog or doing homework (looking at you, pharmacy students), and go inside Magellan Rx to get the full scoop on the work that we do.

Listen here and start with whatever episode makes you happy – we recommend starting with our General Manager of Specialty, Steve Cutts.

Follow our campaign on Twitter and LinkedIn using #ThisIsMagellanRx to learn more about our team!

Parity Progress

Ten years ago today, the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA) was passed into law. This ground-breaking legislation required health plans to treat mental health and substance use conditions like physical medical conditions without treatment or financial limitations. For more than 40 years, Magellan has wholeheartedly supported and actively advocated for parity. Every day, we work together with our customers — health plans, employers, state Medicaid and military and government clients — to innovate new solutions on behalf of those we serve, which continues to advance the law and helps to reduce the stigma around mental health and substance use issues. At Magellan, mental health is fundamentally as important as physical wellness, but it’s just a start.

Beyond equal to individualized and integrated

While our country has made positive strides in parity, we know achieving a healthy, vibrant life is tied to many factors beyond parity – namely social determinants, such as housing, poverty, education and access to transportation and healthy food. One way we are addressing and accounting for these social determinants is by focusing on providing individualized, integrated care.

Complete Care-Person-centered. Community-focused. Evidence-based.

A great example is Magellan Complete Care, which operates person-centered health plans that provide complete care coordination for recipients in Medicare and Medicaid. In the state of Florida, we developed the first-in-the-nation Medicaid specialty health plan to integrate physical and behavioral healthcare and address the social determinants of health for individuals living with serious mental illness and substance use disorders. In Arizona, Massachusetts, New York and Virginia, our Medicaid health plans integrate the full continuum of healthcare services – including mental health and substance use disorder services and treatments individualized to help each member live their healthiest, most vibrant life.

Integrated Health Neighborhoods

Magellan Complete Care plan participants include many individuals who contend with complex conditions that impact their physical health and mental well-being every single day. These individuals need to stay connected to their families, friends, neighbors and others in their communities to maintain independence and achieve optimal health and well-being. Doing so makes the difference between surviving and thriving. To these ends, we have pioneered a care coordination model called the Integrated Health Neighborhood (SM).

This model challenges the definition of what you might think a traditional health plan does for its members. Instead of just focusing on physical and behavioral health treatment, Integrated Health Neighborhoods work within existing community support agencies and local public health systems to strengthen and extend their reach. Our local teams help each member navigate these systems and supports based on their needs as well as their preferences for connecting in their own communities. This helps minimize member disruption through the use of familiar local provider networks and support from trusted community organizations.

Our Integrated Health Network teams are comprised of Magellan associates who live in the same communities as the members they serve. Our assigned teams personally know people at agencies, organizations and local resources across their neighborhood, whom they can call on, person to person, to find the right resources for each member. They work collaboratively to help each individual member find his/her path to independence and well-being.

Recovery Support Navigators

A unique part of the team are the Recovery Support Navigators. These are certified peer support specialists who have lived experiences with some of the same challenges our members face – they have experienced substance use disorders or psychiatric disabilities and may have personally been homeless, had their utilities turned off or experienced food insecurity. They can relate to the members they support, empathize, and then draw on real-world solutions to help them.

For the past 20 years, Magellan has been a leader in increasing access to peer support through partnerships with the recovery community and providers.  We have assisted state customers in developing robust certified peer specialist capabilities, driven in large part by our depth and breadth of experience.   We create shared learning opportunities for the peer workforce and others to improve and enhance the knowledge, skills, and competencies of the peer workforce across the continuum.  Our Recovery Support Navigators represent our best practice approach to tapping the power and potential of peer support.

We know people are more than just a diagnosis – or multiple diagnoses. Truly living healthy, vibrant lives means seeing more than parity for the pieces. It’s seeing and caring for the whole person and bringing together the right resources across the community to help. Integration and individualization are the next steps, and I am proud to say Magellan is out front and on the ground in neighborhoods around the country, taking these steps with our partners and members – together!

If you have, or believe you may have, a mental health problem, it can be helpful to talk about it with others. It can be scary to reach out for help, but it’s often the first step to helping you heal, grow, and recover.

Build your support system
Find someone—such as a parent, family member, teacher, faith leader, coworker or healthcare provider who:

• Gives good advice when you want and ask for it
• Assists you in taking action that will help and doesn’t escalate bad feelings
• Likes, respects and trusts you, and who you like, respect and trust, too
• Allows you the space to change, grow, make decisions, and even make mistakes
• Listens to you and shares with you, both the good and bad times
• Respects your need for confidentiality so you can tell him or her anything
• Lets you freely express your feelings and emotions without judging, teasing, or criticizing
• Works with you to figure out what to do the next time a difficult situation comes up
• Has your best interest in mind

Find a peer group
Find a group of people with mental health problems similar to yours who are taking care of the problems in a positive way. Peer support relationships can positively affect individual recovery because:

• People who have common life experiences have a unique ability to help each other based on a shared history and a deep understanding that may go beyond what exists in other relationships
• People offer their experiences, strengths, and hopes to peers, which allows for natural evolution of personal growth, wellness promotion, and recovery
• Peers can be very supportive since they have “been there” and serve as living examples that individuals can and do recover from mental health problems
• Peers also serve as advocates and support others who may experience discrimination and prejudice

You may want to start or join a self-help or peer support group. National organizations across the country have peer support networks and peer advocates. Find an organization that can help you connect with peer groups and other peer support.

Participate in your treatment decisions
It’s also important for you to be educated, informed, and engaged about your own mental health. Get involved in your treatment through shared decision making. Participate fully with your mental health provider and make informed treatment decisions together includes:

• Recognizing a decision needs to be made
• Identifying partners in the process as equals
• Stating options as equal
• Exploring understanding and expectations
• Identifying preferences
• Negotiating options/concordance
• Sharing decisions
• Arranging follow-up to evaluate decision-making outcomes

Develop a recovery plan
Recovery is a process of change where individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential. Studies show that most people with mental health problems get better, and many recover completely.

You may want to develop a written recovery plan. Recovery plans:

• Enable you to identify goals for achieving wellness
• Specify what you can do to reach those goals
• Can be daily activities as well as longer term goals
• Track your mental health problem
• Identify triggers or other stressful events that can make you feel worse, and help you learn how to manage them

Help is available. For additional information, visit MagellanHealth.com/MYMH

Source: MentalHealth.gov

This blog post 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. Should you require specific help or feel that you are in crisis, you should seek the assistance of an appropriately trained professional.