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Michigan Department of Health and Human Services

Committees • Behavioral Health

Whole Health Rx

Effective August 2015, the Magellan Pharmacy Quality Improvement Program, known as EnhanceMed, that has been in place since May 2012, will be known as Whole Health Rx.

Whole Health Rx is a clinical quality management program that uses medical diagnosis, behavioral, pharmacy claims and lab data, when available, to identify patients taking behavioral health medications who also have common co-morbid conditions such as heart disease, diabetes, asthma, etc. It then works with providers to identify and resolve inappropriate prescribing, gaps in care and potential drug interactions to drive member safety and cost savings.

The newly improved program, not only includes redesigned reports, but providers now have access to an online pharmacy portal. The Portal has many services available including educational information, clinical resources, as well as the ability to request a clinical consultation. It also has a pharmacy search tool to provide access to prescription data on patients as a tool for care management activities. Providers who have secure logins to the website may access this information on patients that they are treating. For more information on how to create a secure login, please see the Whole Health Rx Pharmacy Search manual.

The Magellan Whole Health Rx Behavioral Health Pharmacy Consultation Program

As part of the Magellan WHRx Behavioral Health Pharmacy Consultation Program, providers may have recently received a letter that included a report listing Children/Adolescents Taking 5 or More Psychotropic Medications.

The algorithm that was used to identify these patients looked for 5 or more behavioral medications at any time in the last 365 days. As a result, patients may not have been on 5 active medications when letters were mailed out. We have updated the look back period to 30 days to ensure that patients are actively taking 5 medications at the time of the letters are mailed.

These changes will be in place for the March 2016 mailings.

If you have any questions or would like to schedule a clinical consultation with a pharmacist specialized in behavioral health, please contact:
Email: pharmacyconsultation@magellanhealth.com
Phone: (517) 243-4132

Whole Health Rx Last Modified
Whole Health Rx Last Modified
About Whole Health Rx 02/22/2013
Publications04/30/2013

 
Contact Us02/13/2014

 
Links12/19/2014

 

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