Magellan Complete Care provides industry-leading behavioral health care for all managed care plan members. We’ve tapped into the clinical excellence of Magellan’s 50-year history in behavioral health, with extensive care management, peer support and digital programs.
Managed Behavioral Healthcare
Magellan is NCQA certified as a Managed Behavioral Healthcare Organization that has improved lives and appropriate utilization of services. Integrating our MBHO program with our physical health models of care can lower medical costs by approximately 25%.
Magellan’s MBHO provides standard managed care services such as customer care, 24-hour support, claims adjudication, and more. But it doesn’t stop there. We take a holistic approach to help members recover and thrive in their communities.
- Analytics help identify undertreated individuals early and point to interventions.
- Utilization management, with a range of automated and expert reviews, helps ensure the right treatment is delivered at the right time.
- Behavioral health screenings help identify potential behavioral health issues, including substance use, and direct members to treatment
- Our network of over 118,000 providers are available for various levels of treatment.
- Case management helps ensure care is aligned and integrated within medical delivery systems.
- Peer support connects members with community and social support.
- Innovative clinical programs are used to manage high-cost, complex populations
- Digital tools help identify, engage, educate and increase access to behavioral healthcare.
- Behavioral, medical and pharmacy costs are analyzed continuously to customize care pathways.
Enhanced Case Management
Magellan’s Enhanced Case Management program is a robust approach to member engagement to prevent escalation of symptoms and help members with the most severe behavioral issues that often result in hospitalization.
Our approach starts with telephonic care workers who:
- Make initial outreach to member
- Takes incoming member calls
- Explains care management and encourages the member to participate
- Secures member commitment, then warm transfers to care manager for assessment and enrollment
Enrollment at this point in a member’s care journey makes them 2.5 times less likely to admit to a facility.
Field-based case managers:
- Meet members at the point of service (high-volume facilities)
- Ensure smooth inpatient discharge via welcome home and follow-up calls
- Coordinate community support services
- Stabilize members for ongoing case management
Enrollment at this point can result in a 25% decline in inpatient readmissions.
Certified peer support specialists
- Help members through recovery journey
- Connect members with social supports
- Support members’ integration back into community after discharge
Participation in Magellan peer support can result in a 15% reduction in total medical and behavioral spend.
Digital Behavioral Healthcare
Magellan Complete Care has a variety of digital programs to address members’ access challenges, from provider availability to taking time off of work and privacy. These programs are integrated into our Virtual Care Solution, a suite of digital tools that facilitate screening and treatment, avoiding escalation of symptoms that can result in hospitalization.
- SmartScreener gives members access to industry-standard behavioral health assessments that identify common mental conditions. Rating members’ risk from low to severe, the screener’s output provides an action plan with evidence-based recommendations for the appropriate level of care, from educational videos to our Digital Cognitive Behavioral Therapy (DCBT) programs or intensive care management. High-risk results trigger notifications to our care managers, who immediately intervene to get members the care they need.
- Screen and Engage is a program that uses the SmartScreener in a primary care practice, helping providers address behavioral health issues in the limited time they have with a member. Members complete the Screener while they wait for their appointment. Their provider reviews the results and discusses them with the member during the visit. The member leaves the appointment with a recommendation for next steps; high-risk members are referred to case management.
- Our DCBT programs and apps address the most prevalent behavioral health conditions—insomnia, depression, obsessive-compulsive disorder, anxiety and substance use—as well as physical problems such as chronic pain. These SAMHSA-approved programs deliver therapy through confidential interactive sessions that members can complete at their own pace anywhere, at any time, using a computer, tablet or smart phone, without the long wait
times, missed work or costs associated with traditional appointments.
- Live chat allows members to meet with a master-level clinician in scheduled one-on-one sessions to discuss issues, define goals and monitor progress.
- Telehealth provides members with the flexibility to meet with mental health and substance use providers in a secure, virtual environment—whenever and wherever it’s convenient for them.