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Program helps docs improve prescribing for Medicaid patients
A program funded by Eli Lilly in 19 states is improving the quality of care Medicaid patients receive by aligning physician prescribing of mental health medications with national, evidence-based best prescribing practices.
The Behavioral Health Pharmacy Management Program, carried out by Comprehensive NeuroScience Inc. and state agencies, evaluates Medicaid pharmacy claims for all mental health medications to identify prescribing patterns that are inconsistent with national evidence-based prescribing practices. The program educates doctors who deviate from the best practices.
Some of the inconsistent prescribing patterns addressed include duplicative prescribing of medication by different doctors for the same patient; premature, rapid switching from one medication to another; failure of patients to fill their prescriptions in a timely manner; prescribing multiple medications from the same therapeutic class; and prescribing above or below recommended dosing levels.
Since its implementation, the program has resulted in 190,000 prescriber and 1.3 million patient care improvement interventions nationwide. In addition to information about specific patients, doctors receive regular information bulletins about special topics related to mental health medications, such as behavioral health medication for children. Doctors who continue to experience the same issues over time are offered a peer consultation to discuss prescribing practices.
"We know that educating physicians on prescribing patterns for drugs that treat mental illness is an excellent way to improve the overall quality of mental health treatment within our Medicaid program," says Michigan Department of Community Health director Janet Olszewski. "Through this project, many opportunities for coordination of care have been identified, resulting in improved quality of care and enhanced quality of life for [people] with mental illness."
Each program is customized to meet the needs of the participating states. Comprehensive NeuroScience provides these examples of program results: