Overview
As a provider of comprehensive and integrated behavioral health solutions, Beacon
recognizes the increasingly prominent role of psychotropic drugs in the efficacious
management of mental illness and substance abuse. Beacon further recognizes that
effective prescription drug management also serves to prevent adverse healthcare
events. Because of the high unit costs of newer psychotropic medications, the prevalence
of non-specialist prescribers and the challenges of using traditional formulary
management, the inappropriate prescription and/or usage of psychotropic drugs can
negatively impact their cost/benefit ratio. Since prescription drug costs represent
nearly 45% of total behavioral health care expenditures and with 30% annual cost
increases for certain psychotropic medications, effective health plan management
of psychotropic drugs is imperative.
Click the image to view the PDIP Slideshow
What are the Goals of the Program?
Beacon has developed its Psychotropic Drug Intervention Program with the following
clinical and quality goals in mind:
- Improve members healthcare outcomes
- Provide clinicians with timely and relevant
information
- Ensure efficient use of limited resources
PDIP in Action
Beacon's comprehensive Psychotropic Drug Intervention Program utilizes Beacon's
FlexCare Behavioral Health Management System to perform rigorous analysis of regularly
supplied health plan pharmacy data. Through this analysis, cases of sub optimal
dosing, non-evidence based polypharmacy, multiple prescriber involvement and other
outlier practices are identified and acted upon. Based on the unique characteristics
of a particular case, Beacon's PDIP Team will employ strategies to identify opportunities
to improve members' health outcomes, facilitate information exchange amongst clinicians
and better control psychotropic drug expenditures.
Interventions that Beacon will employ are comprised of a combination of mailings,
phone calls, emails, automated voice messages, faxes and physician profiles to clinicians
and members. The exact combination of communications will be flexible and informed
by the achievement of sustainable results. Interventions will be administered in
English, Spanish or additional languages as necessary.
Commitment to Results
Beacon is committed to delivering measurable results and will align its incentives
to demonstrate confidence in the efficacy of the Psychotropic Drug Intervention
Program. Examples of quantifiable improvements in healthcare quality and cost include:
- Increase in the number of members continuing antidepressant and SGA medications
at 84 and 180 days • Decrease in behavioral health related emergency room utilization
-
Decrease in the number of behavioral health inpatient admissions and readmissions
• Increase therapeutic share shift from more costly "branded" drugs to generic or
preferred branded drugs
Ease of Implementation
Beacon will work closely with you in order to ensure a seamless implementation.
To get started, Beacon will receive and analyze historic pharmacy, medical and behavioral
health claims data. Once this review has taken place, Beacon will share its findings
with you and outline the range of interventions that we believe will be most effective
to meet the program's objectives.