Successful Disease Management Programs Can Play Role in Health C...(Dr. Joseph Parks chief clinical officer ...),Health

How the Program Works

The BPM reviews Medicaid prescription patterns for more than 400 mental health medications. Then, it compares them to national best practice guidelines, which are compiled by each state Medicaid department and CNS. These guidelines are based on the latest medical research, including studies published in peer-reviewed medical journals.

When there is an inconsistency with what is considered best prescribing practice, the BPM sends an educational mailing to the physician, so they can consider the information for the next visit with the patient.

Some of the inconsistent patterns the program has identified include: duplicative prescribing of a medication by different doctors for the same patient; prescribing above or below recommended dosing levels; and prescribing multiple medications from the same therapeutic class.

"Physicians will change their prescribing practice patterns to be in keeping with best practice, when they know what the best practice is. They use the educational information from the program's mailing, and, when they do, the overall care of the patient is improved, and we see overall reduction in health care costs," said Carol D. Clayton, Ph.D., vice president, account management services, CNS.

The BPM also informs physicians when their patient has not refilled their prescription. This is a health care concern because poor compliance or non-compliance with medication treatment is strongly is linked to relapse, rehospitalization, poor outcomes, and high economic costs.(3)

In addition, physicians receive regular information bulletins about special topics related to mental health medications, such as tips for addressing and discussing treatment adherence with patients.