Today, Magellan Pharmacy Solutions, a division of Magellan Health Services (NASDAQ: MGLN), announced a new, comprehensive clinical quality management program, Whole Health Rx SM, which works to address the quality of drug management across the fragmented delivery systems that deal with behavioral health and pharmacy benefits. Whole Health Rx uses medical diagnosis, behavioral and pharmacy claims, and lab data to identify patients taking behavioral health medications who also have common co-morbid conditions such as heart disease, diabetes, asthma, and other chronic diseases. Magellan then works with behavioral health providers, primary care physicians and nurse practitioners to identify and resolve inappropriate prescribing, gaps in care and potential drug interactions to improve member safety and reduce cost. Through our advanced proprietary clinical algorithms, best practice guidelines, and active partnership with providers, Whole Health Rx improves clinical outcomes and reduces non-compliant prescriber behavior.
Whole Health Rx gives providers feedback and evidence-based information to allow them to better manage patients with behavioral health conditions who often have common co-morbid physical health conditions that affect cardiovascular, endocrine and respiratory systems. It targets vulnerable pediatric and geriatric populations as well as patients with potential substance abuse issues.
Approximately 86 percent of adults with a behavioral health condition also have at least one co-morbid medical condition. Coordinated treatment between all prescribers and system integration will improve evidence-based practice. Under the current delivery system, these patients often experience poor health outcomes and increased costs.
“Whole Health Rx is the next-generation pharmacy management tool that combines behavioral, pharmacy and medical claims to identify prescribing patterns that are outside of evidence-based guidelines,” said Teresa DeLuca, M.D., MBA, chief medical officer, Magellan Pharmacy Solutions. “By utilizing the behavioral expertise of Magellan Behavioral Health and the pharmacy experience of Magellan Pharmacy Solutions, we are uniquely positioned to create innovative protocols that look at the whole patient and help determine where medications may be over- or under- prescribed, and identify gaps in care.”