Behavioral Health Pharmacy Management Program improves patient care while
saving Medicaid dollars
INDIANAPOLIS, April 16 /PRNewswire-FirstCall/ -- URAC announced the winners of its inaugural Best Practices in Consumer Empowerment and Protection Awards competition, naming the Missouri Department of Mental Health, Missouri HealthNet, Comprehensive NeuroScience, Inc. and Eli Lilly and Company as Silver Award winners in the Health Information Technology category for the Behavioral Health Pharmacy Management (BPM) program. The program also received an Honorable Mention Award in the Integrated Care Coordination category.
The awards were presented at a black tie gala during URAC's Best Practices in Consumer Empowerment and Protection Conference in Orlando, Fla. During the conference, award finalists presented their model programs to attendees so these best practices can be duplicated in communities across the country. Details on the BPM program are available online at http://www.lillyforbetterhealth.com.
"A Best Practices Award is a strong signal to the market that an organization places a premium on consumer protection and empowerment," said Alan P. Spielman, URAC's president and CEO. "We are excited about this opportunity to recognize these trailblazers and draw attention to programs that are models for the industry."
How the Program Works
The BPM program evaluates pharmacy claims for all mental health medications to identify prescribing patterns that are inconsistent with evidence-based best practices in standards of care, including research published in medical journals. The program then alerts and educates doctors whose data is inconsistent with these best practices
The program may be tailored to identify several types of care
improvement opportunities such as:
-- Duplicative prescribing of medication by different doctors for the same
-- Premature, rapid switching from one medication to another
-- Prescribing above or below recommended dosing levels
-- Patients' failure to refill their medications in a timely manner
Missouri's BPM program has produced positive results. Program studies have shown a 43 percent decrease in hospital admissions for program participants and an overall savings of $7.7 million in Medicaid costs that the state would have incurred in fiscal year 2004.
The program has run in half of states nationwide, resulting in more than 2 million Medicaid patient care improvement interventions.
"Not only do the patients do better, but the doctors are able to provide care more effectively and efficiently," said Joe Parks, M.D., medical director for the Missouri Department of Mental Health. "The partnership is a model for reducing hospitalizations, containing pharmacy costs, improving prescribing practices and maintaining open access to psychiatric medications."
States and CNS work together to identify prescription patterns. Lilly provides financial support for the initiative, and the operation and implementation of the program is done solely by the states and CNS. If a state decides to share data with Lilly, the data is blinded aggregate data that does not contain information about individual patients. In addition, Lilly has received approval and support from the Centers for Medicare & Medicaid Services for these initiatives.
"Just like cancer or diabetes, mental illness is a devastating disease that impacts millions. We believe that funding programs which leverage information, technology and education to improve patient care and efficiencies in the health care system will have a huge beneficial impact on our society," said Jack Bailey, vice president, Lilly.
"At CNS, we work to provide treating physicians with comprehensive information about their patients' treatment histories and the most applicable evidence-based best practice insights from the literature. Armed with the right information, physicians can make better treatment decisions," said John Docherty, M.D., founder and chairman at Comprehensive NeuroScience, Inc. "The Behavioral Health Pharmacy Management program demonstrates how state Medicaid programs can improve patient care while freeing scarce Medicaid dollars for other pressing healthcare needs."
In all, URAC honored 22 winners for excellence among entries from health care management, health information technology, health plan and pharmacy benefit management organizations. Entries were judged by a distinguished panel of industry experts in three categories: consumer decision support, consumer/patient safety and integrated care coordination. Programs were selected as winners for their ability to measurably demonstrate an impact on consumer empowerment and/or protection, as well as their potential for widespread implementation of the program by other organizations.
A complete list of winners of the Best Practices in Consumer Empowerment and Protection Awards may be found at http://www.urac.org.
About Comprehensive NeuroScience, Inc.
Comprehensive NeuroScience, Inc. (CNS) is a national privately-held clinical research company based in White Plains NY. CNS specializes in products and services that enhance the efficiencies of clinical development and use of therapeutic pharmaceuticals for persons with serious mental illnesses. The Care Management Technologies division of CNS, leverages the expertise and scientific breakthroughs for which CNS is known in order to deliver innovative and effective integrated care management solutions focusing on improving quality of care while reducing pharmacy and health care costs for people, payors and the larger community.
About Eli Lilly and Company
Lilly, a leading innovation-driven corporation, is developing a growing portfolio of first-in-class and best-in-class pharmaceutical products by applying the latest research from its own worldwide laboratories and from collaborations with eminent scientific organizations. Headquartered in Indianapolis, Ind., Lilly provides answers -- through medicines and information -- for some of the world's most urgent medical needs. Additional information about Lilly is available at http://www.lilly.com.
URAC, an independent, nonprofit organization, is well-known as a leader in promoting health care quality through its accreditation and education programs. URAC offers a wide range of quality benchmarking programs and services that keep pace with the rapid changes in the health care system and provide a symbol of excellence for organizations to validate their commitment to quality and accountability. Through its broad-based governance structure and an inclusive standards development process, URAC ensures that all stakeholders are represented in establishing meaningful quality measures for the entire health care industry. For more information, visit http://www.urac.org.
|SOURCE Eli Lilly and Company|
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