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Magellan Rx Management and Health Partners Plans Achieve 5 Stars for the Medicare Star Ratings Measure: Statin Use in Persons with Diabetes

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Magellan Health, Inc. (NASDAQ: MGLN) announced its pharmacy benefit management division, Magellan Rx Management (MRx), received a 5-Star rating from CMS for its Statin Use in Persons with Diabetes (SUPD) program. This achievement is attributed to significant improvements in care for diabetic patients through a comprehensive clinical initiative launched with Health Partners Plans. By 2019, 91% of diabetic members were on statin therapy, signifying a solid performance as CMS increases Star Ratings thresholds annually. The program aims to enhance care quality while minimizing complications and costs.

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  • Achieved 5-Star rating from CMS for Statin Use in Persons with Diabetes (SUPD).
  • 91% of diabetic members on statin therapy reported in 2019.
  • Significant improvement in quality of care for diabetic patients.
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Magellan Health, Inc. (NASDAQ: MGLN) today announced that Magellan Rx Management (MRx), the pharmacy benefit management division of the company, has achieved 5 Stars from the Centers for Medicare & Medicaid Services (CMS) for its Statin Use in Persons with Diabetes (SUPD) measure as a result of a clinical program launched for Health Partners Plans (HPP), a not-for-profit managed healthcare organization offering a broad range of health coverage options through Health Partners Medicare, Health Partners (Medicaid) and KidzPartners (Children’s Health Insurance Program).

“Since program inception with Health Partners Plans, we’ve significantly improved the quality of care for patients with diabetes, solidifying 5-Star performance for the SUPD Star Rating measure as the CMS 5-star threshold significantly increased,” said Sagar Makanji, PharmD, vice president of clinical strategy and programs, Magellan Rx Management. “We continue to achieve additional improvement for this measure, which is critical since the Star Ratings thresholds typically increase year over year.”

The SUPD program was launched in the Health Partners Medicare population to improve the quality of care for diabetic patients. The primary goal was to initiate and increase statin utilization for primary prevention of cardiovascular events in members 40–75 years of age with diabetes. MRx and HPP finished 2019 with 91 percent of individuals with diabetes on statin therapy, earning 5 stars in this measure for the 2021 Star Ratings (based on the 2019 measurement year), released by CMS.

“Health Partners Plans is deeply committed to meeting the needs of our members and we are incredibly proud of our performance for SUPD,” said HPP President and Chief Executive Officer Denise Napier. “We look forward to continuing our 5-Star performance and know our programs will help improve our members’ overall health outcomes.”

The SUPD program aims to enhance overall quality and continuity of care for persons with diabetes by coordinating with prescribers, members, and pharmacies while minimizing preventable complications and costs. Given SUPD’s high weighting towards the overall Star ratings calculation in the past, this measure has been on the forefront of many plans’ agendas.

“MRx leverages a high-touch, multimodal outreach strategy with a team of pharmacists, certified medication therapy management specialists, nurses, PharmD candidates, pharmacy technicians, and customer care associates to help members with diabetes live healthy, vibrant lives,” said Makanji.

About Health Partners Plans: Health Partners Plans is a not-for-profit managed health care organization serving more than 259,000 members in Southeastern Pennsylvania. It provides a broad range of health coverage options through Health Partners Medicare, Health Partners (Medicaid) and KidzPartners (Children’s Health Insurance Program). Founded more than 30 years ago, Health Partners Plans is one of the few hospital-owned health plans in the country. To learn more about how to PartnerUp with Health Partners Plans, visit HealthPartnersPlans.com, twitter.com/HPPlans and Facebook.com/healthpartnersplans.

About Magellan Rx Management: Magellan Rx Management, a division of Magellan Health, Inc., is shaping the future of pharmacy. As a next-generation pharmacy organization, we deliver meaningful solutions to the people we serve. As pioneers in specialty drug management, industry leaders in Medicaid pharmacy programs and disruptors in pharmacy benefit management, we partner with our customers and members to deliver a best-in-class healthcare experience.

About Magellan Health: Magellan Health, Inc. is a leader in managing the fastest growing, most complex areas of health, including special populations, complete pharmacy benefits and other specialty areas of healthcare. Magellan supports innovative ways of accessing better health through technology, while remaining focused on the critical personal relationships that are necessary to achieve a healthy, vibrant life. Magellan's customers include health plans and other managed care organizations, employers, labor unions, various military and governmental agencies and third-party administrators. For more information, visit MagellanHealth.com.

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FAQ

What did Magellan Health announce on February 16, 2021?

Magellan Health announced its pharmacy benefit management division achieved a 5-Star rating from CMS for its Statin Use in Persons with Diabetes (SUPD) measure.

What is the significance of the 5-Star rating for Magellan Health?

The 5-Star rating indicates high performance in diabetes care, which is critical as CMS Star Ratings thresholds increase year-over-year, impacting funding and performance metrics.

How many diabetic members were on statin therapy in 2019?

91% of diabetic individuals within the Magellan Rx Management program were reported to be on statin therapy by the end of 2019.

What is the main goal of the SUPD program initiated by Magellan Health?

The SUPD program aims to improve the quality of care and increase statin utilization for primary prevention of cardiovascular events among diabetic patients aged 40–75.

How does the SUPD program relate to Magellan Health's business performance?

The SUPD program's success in improving care quality contributes to Magellan Health's overall performance metrics and can positively impact its financial standing by aligning with CMS rating systems.

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