Clinical Focus
Magellan’s ICM Program Supports Providers and Families
The coordination of care following discharge from an inpatient facility often determines the successful outcome of member treatment. When a child is admitted for an inpatient hospital stay, the urgency to provide timely and well-planned care—including follow-up—is even more vital. At Magellan, we want to provide additional support to facilitate a smooth transition of care to an outpatient provider when a member is discharged, especially when the member is a child.
This is one of the reasons we developed the Intensive Care Management (ICM) program. Anyone age 12 and under who is admitted to an inpatient program meets the Magellan criteria for ‘high-risk,’ and is automatically eligible for the ICM program—regardless of his or her diagnosis.
We staff our ICM program with a team of behavioral health professionals working in collaboration with providers to support high-risk members and their families. This collaboration is an essential part of ICM—helping to establish the plan of care, ensure follow-up and monitor progress. ICM staff helps ensure the discharge and aftercare plans are developed early in the hospital stay, and that aftercare appointments are made prior to discharge from the hospital.
ICM Works for Members and Providers
From the first contact by the ICM care manager, the member and the family are the focus. During the intake process, the care manager determines the current status of the member’s health and completes a psychosocial assessment. In support of the treatment process, the ICM care manager works diligently with the caregiver to define both short-term and long-term goals that work in concert with the outpatient provider. By developing a well-designed aftercare plan, the ICM care manager helps the member and caregiver focus on steps to overcome barriers that often impact treatment outcomes.
We support our ICM effort with the use of Magellan’s Outcomes360SM—a proprietary health analytics and outcomes performance appraisalsystem that employs a comprehensive approach to outcomes measurement and reporting—which enables the member, the caregiver, and the provider to measure the member’s status at the beginning and during the course of their involvement in the ICM program.
Outcomes360 is supported by a suite of tools including the:
- Behavioral Health Assessment (SF-BH)
- Adult-focused Consumer Health Inventory (CHI)
- Consumer Health Inventory – Child version (CHI-C)1.
For a child, the CHI-C provides a physical and psychosocial health status from his or her caretaker’s perspective. The tool and member results are available to the provider in real time at no charge and results also are reviewed by the Magellan care manager. This facilitates rapid adjustment of the treatment plan during the course of treatment. The CHI-C can empower members and caregivers with quantifiable data for planning and discussion with providers. For additional information on the Magellan Outcomes360 system and the measurement tools, visit our Outcomes Library.
Positive Results Documented
Between September 2008 and June 2009, Magellan care managers administered the CHI-C to 2,747 caregivers of youth enrolled in the ICM program. The CHI-C results reported at the end of the second quarter of 2009 indicate improvement in all four domains and in school attendance. Even more importantly, in the psychosocial, distress symptoms and strengths domains, the improvements were all clinically significant between intake and 30 days, intake and last administration, and intake and discharge. This means the overall measures in these domains improved by five percentage points or more. Some Highlights from the most recent quarter are as follows:
- Almost three quarters of the population reported clinically significant improvement in psychosocial scores between intake and discharge.
- Between intake and discharge, 68 percent of participants reported improvement in physical health.
- Strength scores reported for intake and discharge reflected clinically significant improvement for 75 percent of participants.
- Ninety-one percent of participants reported improvement in distress symptoms between intake and discharge, with 79 percent showing clinically significant improvement.
- Between intake and discharge, school absences due to health reasons dropped from an average of 4.1 days to an average of 0.9 days. For the same measurement period, school absences not related to health reasons dropped from an average of 3 days to an average of 0.7 days.
Magellan’s ICM Program Works
Magellan is proud of the effort and the measurable results produced by the ICM team.
One child’s mother wrote to us to express her gratitude. She said she felt the ICM program was extremely helpful.
At the time of discharge, her son was:
- Attending daily AA meetings
- Working with a sponsor
- Meeting with his therapist weekly and his psychiatrist monthly
- Working on his GED
- A Louisiana representative to the Young Peoples State Convention
- The guest speaker at the Awards and Recognition Program through the Juvenile Justice Program.
The member told his mother that this drug-free period of his life is the happiest he has ever had.
“Our ICM team does excellent work, as the member comments indicate. It is gratifying to see the positive results of their work demonstrated with outcomes data,” said Dr. Joann Albright, senior vice president of Quality and Outcomes. Due to specific state regulations, effective dates for Molina Healthcare of Florida and Indiana Medicaid programs will be delayed; Magellan will send separate notifications to affected providers.
1QualityMetric Incorporated developed the CHI-C for Magellan to support children ages 5-17 and their caretakers during the process of building the child’s resiliency. The CHI-C was constructed with provider and consumer input and is based, in part, on the SF-10™ Health Survey for Children (SF-10; Saris-Baglama et al., 2007). CHI-C results are intended to be utilized in interactive discussions between a provider and the child and his or her caretaker in an open and positive environment.