Caroline Carney, MD, is the CMO of payer services company Magellan Health. A board certified internist and psychiatrist, she and her team are overseeing multiple initiatives designed to target the mental healthcare landscape at depths a simple smartphone app can't reach.
"Apps for screening and treating mild to moderate symptoms have a place in the ecosystem of diagnosing and treating behavioral health conditions. However, individuals with moderately severe and severe symptoms that impact their daily lives and prevent role functioning may need to have a fuller continuum of care wrapped around them," she said. "The premise that an app alone can cure opioid addiction or serious mental illness is not in the best interest of the individual or the patient. At Magellan, we believe in an ecosystem of solutions and aligning the level of risk to the right level of solutions."
Some of her main areas of focus include a collaborative care model and the use of data algorithms to facilitate early detection, treatment and symptom management of mental illnesses.
"One of the cornerstones of treatment of behavioral health conditions today is medication management," Dr. Carney said. "And what we see when we look at pharmacy data is that about half of those persons with schizophrenia or bipolar disorder have medication possession ratios of only 50 percent, meaning that they are without evidence-based treatment half the time. This leads to higher symptom burden, more inpatient care and potentially suicide. In many companies, the pharmacy benefit is managed outside of medical care management programs, and typically these programs don't speak to each other. So when we can bring this knowledge together across a company, the use of data becomes potent in helping members stay on treatment and have better outcomes."
The combined use of medical, pharmacy and behavioral health data has formed the foundation of Magellan's suicide prevention and whole health programs. The payer has collaborated with Arine, a data science company that supports Magellan by analyzing data to find individuals at risk for suicide and those not receiving evidence-based treatments.
"So in a population of a hundred, the analytics find the 15 people who have an elevated risk for a suicide attempt at some point in the future," she said. "This allows care managers to proactively reach out to members and providers, helping to wrap that ecosystem of support around them. For persons in the hospital with suicide attempts, we've collaborated with NeuroFlow to use their app to help care managers monitor and support those at hightest risk for the worst of all outcomes."
The team is also harnessing data to identify effective cancer treatments.
"Published research has shown that in oncology, only about half the time are providers providing the right kind of treatment based on tumor genomics," Dr. Carney said. "We've partnered with Trapelo to not only direct providers to the right tests to analyze tumors but also to the right treatment based on the tumor's genomic profile. This not only helps streamline the process of prior authorization, it ensures that those persons suffering from malignancies get the right treatment every time."
Dr. Carney's advice to other CMOs is to read beyond the headlines.
"There is a lot of hype in the headlines," she said. "And unless you take the time to go in and read the primary literature, or have people on your team read the primary literature and inform you about what the study really said, you'll be misinformed every single time. Use the right information to guide and direct medical policy and create programs that really will support your members."