March is Developmental Disabilities Awareness Month. Today, people with developmental disabilities are more visible across our communities than ever before, and the world is more accessible than it’s been in the past. It’s good to see things are becoming more inclusive, and it’s important for us to continue in this direction. Including people with disabilities into our communities enriches society as a whole – people of all abilities have gifts to offer, and when we find ways to let people share their gifts with others, we all benefit.

One way people can share their talents and become more included in their communities is through employment. Having paid employment gives people a sense of pride, and indicates that the work being done is valued by the employer. It also is a vital component of how people remain independent – when you’re making money, you have purchasing power over the clothes you buy, the food you eat and the home you choose to live in. You don’t have to rely on others to buy all of your necessities for you. It allows you to live a self-determined life where you call your own shots. Unfortunately for many people with disabilities, it can be a challenge to find paid employment. According to a survey of 17,682 adults with intellectual/developmental disabilities conducted by National Core Indicators, only 19 percent of those surveyed had a paid community job, but an additional 47 percent wanted one. These numbers are disheartening, and it’s up to us to start bridging the gap.

One of the roadblocks some people with disabilities run into is figuring out ways to earn money using their gifts and talents. Many will embrace their entrepreneurial spirit and create micro-enterprises: small scale business where they sell things they create, such as jewelry, art, crafts, greeting cards, homemade jams or provide services to those in their community. The possibilities are only limited to their imaginations! Others look to be a part of the traditional workforce, and thanks to programs like Project SEARCH – a national organization that partners with local business and teaches young adults with disabilities the skills they need to get the work they desire – more and more people with disabilities are finding jobs across all kinds of industries. According to the Wisconsin Project SEARCH Expansion, Project SEARCH, which is focused mainly on supporting young adults with intellectual and developmental disabilities, has a national employment success rate of 73 percent.

Melissa Rademacher

Melissa Rademacher, a young woman from central Wisconsin, is one of the many Project SEARCH success stories. Melissa is also enrolled in TMG by Magellan Health’s Wisconsin self-directed long term supports and services (LTSS) program called IRIS. After the restaurant Melissa was working for unexpectedly closed, Melissa turned to Project SEARCH in 2015, where she received her job training at the Kalahari Resort, a large waterpark, conference center and resort in Wisconsin Dells, which has been dubbed the “waterpark capital of the world.” There, she trained in housekeeping and in the bakery, as well as at the spa, which proved to be a fantastic fit. She was offered a job at the spa, and she’s been a spa attendant there ever since. Melissa’s work includes greeting guests and taking them to the relaxation room, stocking shelves, changing out the spa robes and putting guest information into the computer. Since starting at the spa, not only is Melissa in her dream job, but she’s a valued employee and has made wonderful friends at work.

Melissa’s story is a great example of what can happen when we set people up to succeed on the job. In fact, Wisconsin Governor Scott Walker was so impressed with Melissa’s story that he shared it during his State of the State address this past January.

Another key component to helping people with developmental disabilities find meaningful work is embracing the Employment First movement, which believes that everybody can work and that there is a job for everyone. Most states have some type of effort focused on the Employment First philosophy, and an increasing number of states have an official state policy, through legislation or executive order, indicating that employment in the community is the first and preferred option for people with disabilities. Wisconsin is part of this growing trend of state activity. Here, Employment First legislation, which Magellan Health supports, is expected to be signed into law soon. By getting laws like this in place, we’re building a culture that recognizes the value that people with disabilities bring to the workplace, in turn opening up more doors for employment for all.

These changes aren’t going to happen overnight, but if we continue making strides for inclusive work environments, it’s only a matter of time when they become the norm, and not the exception. And when that happens, everybody wins. Because everyone has something to offer, and anyone who wants to work should have the opportunity to do so.

To find out more about employing people with disabilities and what your state is doing to support Employment First, please go to these websites:

Department of Labor: Employment First Policy Resources

APSE: Employment First, Employment for All

As we look back on 2017, it was a year of many milestones on the United States (U.S.) drug approvals front. With 46 novel drugs receiving Food and Drug Administration (FDA) approval, it reached a 21-year high and more than doubled novel drug approvals in 2016. This count does not even include a number of biologics, vaccines, cell-based therapies, and the first ever, direct gene therapy for a hereditary disease.

Among the historic clinical highlights of 2017 was the landmark approval of two CAR-T therapies, tisagenlecleucel (Kymriah™) and axicabtagene ciloleucel (Yescarta™), for select types of leukemia and lymphomas, respectively. CAR-T or chimeric antigen receptor-T (CAR-T cell), is a multiplex process where a patient’s T cells are harvested, genetically modified, and infused back into the same patient to fight cancer cells. 

The role of specialty pharmacies in the invoicing construct for these costly CAR-T therapies is a fascinating component of these new treatment modalities. As illustrated in the CAR-T Invoicing Flowchart, the product is shipped directly from the manufacturing facilities to the certified hospital or treatment facilities. Once the certified hospitals take ownership of the product, they bill the payers who, in turn, pay the certified hospitals. The specialty pharmacies serve as the billing wholesaler between the manufacturers and the certified hospitals to invoice the hospitals and, ultimately, deliver payment to manufacturers. In this unique model, the specialty pharmacy does not handle the drug; rather, it serves as the invoicing clearinghouse between manufacturers and certified hospitals. Hence, there is no interaction between the specialty pharmacy and payers.

Specialty pharmacies are at the epicenter of care for patients with complex conditions. As a high-touch resource, they operate in a clinical environment that leverages specialty pharmacies’ services to dispense, distribute, provide monitoring, case management, adherence programs, reimbursement, and a number of other services particularly for patients with complex and rare diseases. In the CAR-T invoicing construct, the specialty pharmacy takes on the exclusive role of shepherding the invoice.

As we look ahead, future complex therapies will present a new paradigm for all stakeholders including prescribers, pharmacies, payers, patients, hospitals, and regulators. Specialty pharmacies, as an invoicing liaison, may be yet another facet in the evolution towards the next frontier – Specialty Pharmacy 2.0.

Magellan’s offices in Virginia have been abuzz for the past few months, busily preparing to implement a brand-new contract as Magellan Complete Care of Virginia (MCC of VA), serving individuals who qualify for Medicaid due to a disability or who are age 65 or older.

On Aug. 1, MCC of VA made its debut in the commonwealth as a full-service managed long-term services and supports (MLTSS) health plan selected by the Virginia Department of Medical Assistance Services (DMAS) to serve members enrolled in the Commonwealth Coordinated Care Plus (CCC Plus) program. The plan initially launched in the Tidewater region, then in the Central Region on Sept. 1, and has been approved to roll out in the Charlottesville/Western region on Oct. 1. MCC of VA will go live in phases for additional regions across the commonwealth through early 2018, pending DMAS approval.

 What are managed long-term services and supports?

MLTSS is the delivery of long-term services and supports through capitated Medicaid managed care programs. Many states use MLTSS as a strategy to expand home- and community-based services, promoting community inclusion, ensuring quality and increasing efficiency. In Virginia, care management is the foundation of CCC Plus, which focuses on improving quality, access and efficiency through high-touch, person-centered support.

Magellan’s role in CCC Plus

Enrolling in CCC Plus means that members will now have their medical, behavioral, substance use disorder and long-term services and supports provided all under one program. When individuals select MCC of VA as their health plan, they can expect to benefit from Magellan’s vast experience coordinating care for individuals who have multiple complex conditions, including chronic physical and behavioral health challenges.

Our person-centered culture is woven into everything we do, as is our dedication to offering choices for our members, who serve at the center of their care coordination team.

 Our approach: It’s all in the ‘neighborhood’

We believe individuals should have a choice in where they live and receive services. Therefore, a key component of MCC of VA’s program is what we call our Integrated Health Neighborhood^SM. [Link to IHN infographic] The IHN is a custom model that helps us work with individuals within their own neighborhoods and communities to improve care, quality of life and health outcomes.

Our care teams live and work within the same communities where our members reside. These team members have first-hand knowledge of community strengths, resources, services, and service gaps.

Our integrated, high-touch, team-based IHN approach drives close collaboration with community partners. This allows us to customize care for our members and provide a seamless, one-stop system of services and supports. We can then address each member’s unique needs and circumstances and continually adjust our interventions as the member’s needs change.

Looking toward the future

We invest our resources into making an impact, one person at a time, by taking a highly individualized, high-touch, community-based approach to care coordination – because we know that each person can live a vibrant, healthy life as independently as possible. And we look forward to helping the individuals we serve in Virginia to meet this goal.

Learn more about MCC of VA

I shared this message with all 10,000 associates at Magellan yesterday. As I said in my message, times like these require all of us not to be silent, but instead to stand tall and make it very clear that we are committed to an environment where all people can progress personally and professionally, and work in a positive, uplifting workplace. Given the current state of events in our country, and particularly the divisive events of this week, I felt it important to reaffirm the values we hold dear within Magellan.

“Leading humanity to healthy, vibrant lives” is what guides our decision making and inspires us to accomplish meaningful, positive change in the lives of those we serve. This can only be done if we respect and value each other, and every person we serve, without condition or qualification.

For the many years I have been associated with Magellan, I have been impressed by the integrity and commitment of Magellan team members to create a culture of caring. I have seen great respect for people of all races, religions, gender and sexual orientation, to name only a few of the things that make us different. There is no doubt that the diversity of our people allows us to better understand and execute our vision of making a powerful impact on the world around us.

I want to reaffirm in a direct and simple way that we will never diverge from valuing differences, and creating a culture in which we can learn from each other and grow as individuals, teams, and a company.

Times like these require all of us not to be silent, but instead to stand tall and make it very clear that we are committed to an environment where all people can progress personally and professionally, and work in a positive, uplifting workplace. Our differences are to be celebrated; they are absolutely key in helping us in “leading humanity to healthy, vibrant lives.”

Thank you for the great work you do. I am proud to be associated with you.

The past decade has seen some remarkable changes in technology, which has ushered in an era where we are always “on,” always connected and where most everything that was analog now is digital. Many of us walk around with powerful computers in our pockets –also known as smartphones–that are more powerful than the computers that help put a man on the moon only a few decades ago. Today, we can order car rides from our phones, pay for our groceries, watch movies or do just about anything from a smartphone or network-connected device from anywhere across the globe. Yet for many of us, we go through a time warp when we move from our personal lives to our work environments.

Magellan: a Digital Healthcare Company

At Magellan, we have an inspired leadership team that is building a workforce of the future. We recruit the best talent wherever we can find it across the globe and provide them with great work-life integration by providing flexible working arrangements. Over 40 percent of our workforce does not work in one of our offices, and many of our employees are mobile and on the road helping our member and providers. This kind of a workforce requires the collaboration platform of the future.

During the summer of 2016, we assembled and rolled out Magellan’s next generation collaboration platform. This platform was built with a mobile-first, cloud-first, always digital mindset designed to provide secure, seamless and context-aware experiences within the enterprise. This new platform is all about providing choices: it works across Macs and PCs, across browsers, across Apple and Android mobile devices and can work across a 4G connection and high-speed wifi alike.

The platform uses five technologies that we use in our personal lives on a daily basis:

• Workplace and Workchat for desktop and mobile devices. These are the enterprise- grade versions of Facebook and Facebook Messenger, complete with networking, group collaboration and social sharing capabilities.
• A cloud-based document and content management solution from Box.
• Enterprise-quality HD video conferencing and desktop sharing through Zoom.
• Productivity applications from Microsoft through Office 365.
• An integrated access portal tied together by a robust security and identity management solution from Okta.

Okta acts as a gateway to every other application, website or solution provided by Magellan. It simplifies password management and provides secure multi-factor authentication – in short it makes our applications accessible to everyone, anywhere, at any time over any network or device. It allows an employee to take a video call from her home office and collaborate with her colleagues in a Workplace group and continue that conversation on a mobile device as she takes the train into see a customer for an afternoon meeting – secure, seamless and context-aware collaboration.

 Technology leading culture; culture leading technology

One of the interesting developments in our culture is the use of desktop and mobile video conferencing which allows us to personalize each call, read body language and emotions and share the true benefits of face-to-face communications, instead of being on nameless, faceless, monotonous conference calls.  This is changing the cultural fabric of Magellan by making the enterprise more personal and more social.  It is challenging our management orthodoxies and help reinvent management.

With this new platform, we are building communities that span geographies, business units, departments and even companies. In the past year, we have seen over 700 groups evolve organically on this platform.  Some of these groups focus on specific projects, initiatives or events, and others focus on communities of users and social groups. We even have a community of musicians at Magellan. In short, the platform helps people stay connected in a personal way without having to be located in the same spot.

Ultimately, our technology is a means by which we can help improve the experience – and quality of care – for our customers and members. Our objective for this new platform is to make the technology invisible to the user and allow them to seamlessly play their part to help individuals live healthy, vibrant lives.

Download a copy of this infographic here.

There is often confusion about Memorial Day relative to Veterans Day, which was first observed in 1926, to recognize and appreciate all veterans who have served our country- particularly those who are still with us. Memorial Day, which began in 1868, is focused on honoring those individuals who have made the ultimate sacrifice preserving our country and the freedom for which it stands.

The first large observance for Memorial Day was held in 1866 at Arlington National Cemetery, across the Potomac River from Washington, D.C. Various Washington officials, including Gen. and Mrs. Ulysses S. Grant, presided over the ceremony. After speeches, children from the Soldiers’ and Sailors’ Orphan Home made their way through the cemetery, strewing flowers on both Union and Confederate graves, reciting prayers and singing hymns.

More than one million American servicemembers have died in wars since the first colonial soldiers took up arms in 1775. All Americans are direct beneficiaries of these sacrifices. Some specific actions you might take on this special day might include:

• Visiting memorials
• Visiting one of the 135 veterans’ cemeteries across the nation that protect the remains of our country’s fallen
• Flying the U.S. flag at half-staff until noon
• Volunteer or donate to non-profits serving survivors
• Reading to children about the meaning of the holiday. Some books that are appropriate for children four to eight include:
  • Memorial Day by Mir Tamim Ansary
  • Memorial Day Surprise by Theresa Martin Golding
  • The Wall by Eve Bunting

While this weekend is often considered the unofficial kickoff to summer, it’s important not to forget its true meaning and sentiment. We must never forget what these heroes have done and what their loved ones have lost.

***

Magellan Federal has a long legacy of service to military survivors which dates back 1879. We are honored to be a leader in supporting military survivors, providing surviving military families with information and compassionate case management that helps them navigate a very complex set of issues and benefits.

Thirty years ago, President Ronald Reagan deemed March to be Developmental Disabilities Awareness Month. Awareness months are an important advocacy tool, as they provide opportunities to reflect on progress and continue meaningful conversations about the future. For many people with developmental disabilities, ensuring these discussions take place can be the difference between being invisible and living as full citizens in their communities.

Developmental disabilities awareness is something near and dear to me, not only as the president of TMG by Magellan Health—supporting the largest self-directed long-term services and supports program of its kind in the country—but also because of my graduate work. During my practicum, I worked on the South side of Chicago, assisting low-income families who had children with developmental disabilities. Too often, these families, many of them single mothers, struggled to find the necessary services to help their children live as independently and inclusively as possible. The isolation the children experienced was heartbreaking.

Fortunately, in the 20 years since then, I’ve seen wonderful strides in the resources available for people with developmental disabilities, as well as greater expectations for community inclusion. Self-direction has played a crucial role in this progress. With self-direction, individuals choose not only the services they receive and who provides them, but also how they live their lives. This means people have control over things many of us take for granted: living where and with whom we want; making our own schedule; having meaningful, lasting relationships; pursuing our hobbies and passions; and finding meaningful work or volunteer opportunities. There’s been an amazing nationwide movement towards self-direction, which is not only a best practice, but also the cornerstone of TMG’s work in Wisconsin’s innovative IRIS (Include, Respect, I Self-Direct) program.

While there’s been great progress in raising expectations and increasing opportunities and resources for individuals with developmental disabilities, there’s still much to overcome on the path towards greater acceptance and inclusion. Thankfully, as community inclusion and self-direction are becoming more commonplace, society increasingly recognizes the contributions that people with developmental disabilities can make. As a leader in helping individuals create healthy, vibrant lives, Magellan Health is at the forefront of self-direction with its Wisconsin program, and is building a strong self-direction component in its new managed long-term services and supports (MLTSS) program, Magellan Complete Care of Virginia.

So as you make your way through March, take time to think about the people in your life and in your community and how we can all support one another. Learn how to be a better advocate for individuals with disabilities at sites such as ACL.gov and NACDD.org, and read stories of self-direction in TMG’s The Path Ahead. Encourage and support inclusion and independence whenever you can. But mostly, take the time to get to know people for who they are and appreciate their individual gifts and talents.