JEFFERSON CITY, Mo., Dec. 9 /PRNewswire-FirstCall/ -- An innovative program to increase the quality of care that Missouri residents with severe mental illnesses receive while encouraging more efficient use of Medicaid dollars appears to have achieved both its goals, a recent analysis shows.
The Missouri Mental Health Medicaid Pharmacy Partnership Program (MHMPP), the first program of its kind in the United States, evaluates Medicaid mental health prescribing practices. The program seeks to improve care for Missouri residents by educating doctors about evidence-based best practices for mental health medications and reducing inefficient and ineffective prescribing patterns.
"Not only did the MHMPP program positively affect the quality of care received by Missourians suffering from severe mental illness, it also allowed Missouri to save $7.7 million in costs the Medicaid program would have incurred in state fiscal year 2004 had the inefficient prescribing patterns not been identified," said Joseph Parks, M.D., medical director of the Department of Mental Health.
"We were pleased to see that most Missouri doctors are following the recommended guidelines when prescribing medications. We have identified the small number of doctors who aren't and are reaching them with educational materials to help change their prescribing habits. These changes have resulted in better patient care and savings for our Medicaid program," said Parks.
Some of the inefficient prescribing patterns the program identifies include: duplicative prescribing of medication by different doctors for the same patient; prescribing multiple medications from the same therapeutic class; children on three or more psychotropic medications; and premature, rapid switching from one medication to another.
After reviewing, identifying and analyzing problematic prescribing patterns, the program provides doctors deviating from best practices with information to help them make patient care decisions based on the latest medical evidence.
The MHMPP program is entirely voluntary for Missouri doctors. All decisions regarding treatment and medications are made privately between the physician and the patient and are completely individualized.
An analysis from the program's first year shows:
* 98 percent reduction of patients who are prescribed the same mental health medications from multiple doctors;
* 64 percent reduction of patients who are on two or more mental health medications of the same type;
* 43 percent reduction of children on three or more psychotropic medications; and
* 40 percent reduction of patients receiving an unusually high dosage of medication.
The MHMPP was developed by the Missouri Department of Mental Health and Missouri Department of Social Services, Division of Medical Services, in collaboration with Comprehensive NeuroScience, Inc. Eli Lilly and Company, an Indianapolis-based pharmaceutical company, has been providing financial support for this program in an effort to promote excellence in patient health care.
"The program is a model of cooperation among state agencies. It represents a collaboration of the clinical resources of our staffs, the industry and our providers. Most importantly, it assures our most vulnerable citizens the greatest access to best medical practices and current therapies, while being sensitive to our limited resources," said Christine Rackers, director of the Missouri Department of Social Services, Division of Medical Services.
The program also has proven to be popular outside of Missouri. Fifteen other states have signed contracts to develop similar programs, buoyed by the increasing awareness that mental health is integral to physical health. This project demonstrates two traits other states are eager to copy:
* That management of mental health drugs should be based on nationally recognized standards and guidelines, as well as individual patient needs, to ensure the highest quality care; and
* That Medicaid dollars for mental health drugs can be wisely managed by focusing directly on the quality of prescribing practices.
"We fully support cost-effective programs like this that focus on improving patient care while encouraging more efficient use of taxpayer dollars," said Jack Bailey, Lilly vice president, Business to Business. "We believe a significant opportunity exists within the Medicaid system to reduce costs by improving the quality of care and patient outcomes, and we applaud Missouri's leadership and innovation with this project."
For more information on this project, visit the DMH Web site at http://www.dmh.missouri.gov/index.htm and DMS at http://www.dss.state.mo.us/dms .
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