Status of Health Reform

Shareh Ghani, MD

VP Medical Director

January 10, 2018

Magellan Health: One company, two unique platforms

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25%

30%

45%

Understanding behavioral health inpatient admissions

Excluding the 25% of members already in the IP system,

In BH OP systemmembers receiving BH OP treatment but with norecent IP admission

BH Inactiveadmissions are for members with no recent planned exposure to BH system

In BH IP Systemmembers with an admission in prior 6 months:

will be from members who aren’t engaged with the BH system

60% of admissions

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The intersection of behavioral health and primary care

52%

32%

43%

41%

42%

43%

64%

67%

44%

62%

48%

53%

51%

58%

68%

64%

70%

56%

Mood disorders(n=551)

Substance-related disorders(n=335)

Alcohol-related disorders(n=216)

Schizophrenia and other psychoticdisorders(n=41)

Adjustment disorders(n=31)

Anxiety disorders(n=28)

Attention-deficit conduct and disruptivebehavior disorders(n=14)

All Other (n=27)

Total (n=1243)

within 6 Months within 12 Months

(Out of BH Inactive members)

44% of members with no BH had a PCP visit 6 months prior to the admission

56% within 12 months

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Virtually Organized Digital Programs and ResourcesDriving Access to Evidence-Based Behavioral Healthcare

SmartScreenerTM

Primary care office screening, treatment recommendations

and follow-up tools

CBTApp- and web-based modules

for six most common BH issues

Resource LibraryHealth tips, videos and

self-help tools

Online ChatClinical specialists help with BH

issues, benefits & resources

Provider SearchRobust brick-and-mortar and

telehealth network

Multiple Deployment

Methods

Positive Impacts

• Improve immediate access and engagement into evidence-based behavioral health care

• Engage undertreated and underdiagnosed individuals not in BH care and offer treatment

• Meet members’ needs with preference-based care

• Integrate behavioral health into the primary care setting

• Lower the cost of behavioral healthcare and physical healthcare when behavioral health condition is present

Direct to member

Integrated into primary care

Integrated into disease and case management

Direct to web, Apple AppStore and Google Play store

ISI-3 (insomnia)

If positive, 4 more

PHQ-2 (depression)

If positive, 7 more

GAD-2 (anxiety)

If positive, 5 more

AUDIT -1 (alcohol)

If positive, 9 more

DAST-1 (drugs)

If positive, 9 more

PEG-3 (pain)

SmartScreener

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SmartScreener is described as “smart” because it uses an algorithm developed to quickly and efficiently screen and engage individuals with behavioral health symptoms as measured by clinical scales.

Color-coded system for the patient overview page so that clinical staff can quickly triage and refer patients using the administrative portal from their workstations

Data-plan enabled devices (iPads that maintain connectivity) are set up and delivered to clinical staff who are trained to deliver screening on the devices

Access and send screening results for clinical staff who are trained on the color-coded system and how to access, print and/or electronically send results

PCP Scorecard and Dashboard

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Ontobetterhealth.com

Depression

Insomnia

Anxiety

Substance use

Chronic pain

Opioid misuse and addiction added to substance use module (coming in 2018)

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Links to clinical team

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Alert to clinical team based on high-risk assessments for further outreach and triage

Live chat for ongoing clinical support

Clinical Integration

Patient takes SmartScreener™ on a tablet while waiting for PCP appointment

• Ontobetterhealth.com• Case management alerts• Doc to Psychiatrist consult• Flag to re-screen

• Referral to BH by clinic• Flag to re-screen

Instant recommendations provided to dashboard for PCP

Alert to BH case mgmt for high-risk cases

Integration into EMR Staff prints results and scans into EMR and provides scorecard to physician

Health plan members can receive access to:

Non-members can receive access to:

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Primary Care Clinic (First 8 weeks)

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Identification of patients with behavioral health problems 113 patients were screened. Approximately 48% of 113 patients screened positive for a

condition

Referral to CCBTAbout 37% of patients screened are deemed appropriate by the screening tool and the clinicians to be referred to CCBT.

36% of appropriate patients enrolled into CCBT 2% of patients referred to Magellan Case Management

No symptoms Mild Moderate High Severe

53% 26% 11% 2% 8%

53%

26%

11%

2% 8%

Low

Mild

Moderate

High

Severe

Screen and engage data collected by Magellan of a primary care practice in Philadelphia, Aug - Oct 2017.

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0%

10%

20%

30%

40%

50%

60%

Insomnia Depression Anxiety Alcohol Drug

Severe Risk

0%

10%

20%

30%

40%

50%

60%

Insomnia Depression Anxiety Alcohol Drug

Mild Risk

0%

10%

20%

30%

40%

50%

60%

70%

Insomnia Depression Anxiety Alcohol Drug

Moderate Risk

0%

20%

40%

60%

80%

100%

120%

Insomnia Depression Anxiety Alcohol Drug

High Risk

Primary Care Clinic (First 8 weeks)

Screen and engage data collected by Magellan of a primary care practice in Philadelphia, Aug - Oct 2017.

Evaluation Metrics

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Proof Point MeasurementIncrease screening of BH

conditions in primary careNumber of patients completing SmartScreenerRisk stratification of patients screened

Increase engagement inevidence-based care

Number of patients enrolled in CCBT% of improvement in patients who screened positive and engaged in CCBTNumber of patients with face-to-face outpatient visit after screening

Improve identification of depression, anxiety,

insomnia and substance abuse

Number of patients identified with depression, anxiety, insomnia, substance use with no prior diagnosis or who have BH conditions that are not improvingNumber referred to case managementNumber enrolled in case management

Reduce utilization and cost

Overall decrease in BH ER visits, admissions, readmissionsNumber of encounters for a script or modified script as appropriate therapyNumber of patients that filled the script

Clinical Implementation

Clinical Selection Criteria

• High-volume clinics

• Internal medicine clinics (focus on screening adults)

• High volume of health plan members

• Experience with integration of technology into practice workflow

• Dedicated clinical team to facilitate Screen and Engage workflow (e.g., hand out iPads to patients, print screening results, scan results to EMR system as “open document” for providers to review when seeing patient)

• Engaged providers who promote use of digital CBT programs and other resources –promote CBT to appropriate patients, check in with patients about programs during next visit

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SmartScreening Results

• 31% of FQHC patients who are screened with SmartScreening screen positive for a condition

• 68% of those patients are deemed appropriate by their clinicians to be referred to CCBT

• Once patients are enrolled, our CCBT programs engage participants in interactive sessions varying from four to ten sessions in length, with each session ranging from 25 to 50 minutes to complete. The programs provide feedback and encouragement to maximize self-management of behavioral health

• Over 20,000 patients have been referred to Cobalt CCBT in the last year and a half. Depending on the implementation and mode of distribution:− 35 – 75% of those who are referred will engage in the program− 10 – 50% of those who engage will continue with the program (2 or more sessions)

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Cobalt CCBT Software Received the Highest SAMHSA Rating

Effective…

(and) strong evidence of a favorable effect.

Status of Health Care Reform

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Status of Health Care Reform

• Create, validate and commercialize software as treatments

• Digital TherapeuticsTM are based on clinically validated platform

• Work independently or in conjunction with pharmacotherapies

• Data collected are used to continuously improve and personalize interventions

• Unique and robust intellectual property strategy and portfolio

• Better outcomes through user engagement and neurobehavioral change

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Advantages over other Cessation Strategies

Key Mechanisms of Action (MOA)Our MOAs are validated by clinical studies published in peer-reviewed medical journals

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Key Mechanisms of Action (MOA)

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Status of Health ReformFinancial Sustainability

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Legal disclaimer

This presentation may include material non-public information about Magellan Health, Inc. (“Magellan” or the “Company”). By receipt of this presentation each recipient acknowledges that it is aware that the United States securities laws prohibit any person or entity in possession of material non-public information about a company or its affiliates from purchasing or selling securities of such company or from the communication of such information to any other person under circumstance in which it is reasonably foreseeable that such person may purchase or sell such securities with the benefit of such information.

The information presented in this presentation is confidential and expected to be used for the sole purpose of considering the purchase of Magellan services. By receipt of this presentation, each recipient agrees that the information contained herein will be kept confidential. The attached material shall not be photocopied, reproduced, distributed to or disclosed to others at any time without the prior written consent of the Company.

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APPENDIX: Status of Health Reform

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