Study Shows How Improving Quality of Psychotropic Prescribing Reduces Hospital Utilization
November 16 2005 - 9:00AM
PR Newswire (US)
Innovative program gives patients better care while cutting
inefficiencies JEFFERSON CITY, Mo., Nov. 16 /PRNewswire-FirstCall/
-- An innovative program appears to play a role in the overall
reduction in hospital utilization and cost of care for Missouri
Medicaid recipients with severe mental illness. 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. "This is a model on how
states can increase the quality of care that Medicaid residents
with severe mental illnesses receive while encouraging more
efficient use of taxpayer dollars," said Joseph Parks, M.D.,
medical director of the Department of Mental Health. "We are
excited that we can start sharing data about the success of the
program at national medical meetings." The poster, "Improving
Quality of Psychotropic Prescribing Reduces Hospital Utilization"
was presented at the recent American Psychiatric Association
Institute on Psychiatric Services meeting and the Disease
Management Association of America meeting, where it received the
Gold Award for first place. Awards are presented to recognize
excellence in program design and implementation and leadership in
outcomes research and the positive impact on individual health and
the disease management industry. 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. (CNS). Eli Lilly and Company,
an Indianapolis-based pharmaceutical company, has been providing
the financial support for this program in an effort to promote
excellence in patient health care. The pharmacy partnership program
began with the evaluation of Medicaid prescribing records. With
this information, the state identified a small number of doctors
who weren't following recommended guidelines for prescribing and
reached out to them with educational materials to help change their
prescribing habits. This information is designed to help them make
patient care decisions based on the latest medical evidence. "These
changes in prescribing have resulted in better patient care and
savings for our Medicaid program. We begin to see change within 90
days of the first mailing," Parks said. The study presented at the
psychiatric services meeting highlights the success of the program.
Dr. Richard Surles, CNS executive vice president, explained that
1,911 Medicaid recipients whose physicians received notification
for at least one of the program's quality indicators during two
consecutive mailings were used for the analysis presented at the
medical meeting. Individuals similar to those patients were
selected for the comparison group. They compared a number of
factors six months pre-intervention and six months
post-intervention. The researchers found: * A 43% decrease in the
hospital admissions for those in the intervention group, compared
to a .1% decrease in the comparison group. * A 1,813 decrease in
total hospital days for all cases in the intervention group
compared to a 689 decrease in the comparison group. * A $1,238
decrease in cost per person for the intervention group and a $312
decrease in the comparison group. "We were very pleased with the
results. Not only do they show that there was not a disruption in
patient care, but the program appears to play a role in the overall
reduction in hospital utilization and cost of care for patients,"
Parks said. "Thus, this program helps control costs for the states,
while it ensures that the patients have access to the appropriate
medications and treatments they need." One factor in the cost
reduction was the identification of inefficient prescribing
patterns, including: * 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; * Premature, rapid switching from
one medication to another. Earlier data from the program also is
indicative of its success. 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. "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," Parks said.
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. The program also has proven to be popular outside
of Missouri. Twenty- five other states have signed contracts to
develop similar programs. 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 . (Logo:
http://www.newscom.com/cgi-bin/prnh/20041209/DMHLOGO )
http://www.newscom.com/cgi-bin/prnh/20041209/DMHLOGO DATASOURCE:
Eli Lilly and Company CONTACT: Janice Chavers of Eli Lilly and
Company, +1-317-651-6253,
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