Medicare Advantage Stars

Health Advocate Overview Nation’s leader in healthcare advocacy and assistance Distinguished roster of 10,000+ nationwide clients Serving over 40 million eligible lives Broad product spectrum Outstanding, experienced management team Expert staff of healthcare and insurance professionals Powerful and proprietary infrastructure Strong brand recognized as objective and well-respected A subsidiary of West Corporation

The Context Plans that achieve Star ratings of 4, 4.5, or 5 Stars can earn back bonus revenue Ratings are based on 46 standard performance objectives from Medicare Advantage Stars measures Star ratings are achieved by encouraging wellness and preventive services, boosting member satisfaction and customer service Start improving ratings now for revenue opportunity 2015 activities determine ratings for 2017

At-a-Glance Health Advocate Approach 6-part, fully integrated program that helps plans meet quality-based objectives Provides opportunity to win a 5-Star rating required to secure millions available in bonuses and the ability to market their plan year round Multipronged, interrelated approach that fully engages members and supports the plan on multiple levels Blends personalized, telephonic healthcare help, clinical coaching, Dashboard informational architecture and data-driven tailored communications Ensures better compliance with quality-based measures to achieve the highest ratings and opportunity for increased revenue

Health Advocate Approach 6 Integrated Parts Health Advocate Approach Feature #1: Medicare Advantage Stars Advocacy Service. Personalized member support, problem resolution and coaching to meet quality-based measures supported by proprietary informational Dashboard tool. Feature #2: Personalized Member Communications. Targeted communications to drive members to meet requirements. Feature #3: Targeted Outbound Calls. An outreach program using “smart targeting” technology to increase compliance and address gaps in care. Feature #4: Carrier Agent Dashboard. Provides the health plan with the proprietary Dashboard and training for staff in its use to engage members to meet measurements.

Health Advocate Approach 6 Integrated Parts Health Advocate Approach Feature #5: Personalized Member Online Dashboard. Custom tool highlighting the member’s Medicare Advantage Stars profile designed to encourage better compliance. Feature #6: Comprehensive Monthly Reporting. Summarizes performance measures including participation and outcomes. Improves Medicare Star ratings – Helps generate earn-back bonuses for health plan

Feature #1: Member Advantage Stars Health Advocacy Service Personalized help to navigate range of healthcare and insurance-related issues One-on-one relationship with Personal Health Advocates, typically registered nurses supported by medical directors and benefits and claims specialists Assists with senior-related issues (e.g., finds living facilities, in-home care, locates durable medical equipment, cost-saving generic equivalents to brand-name drugs, etc.) Clarifies Medicare Advantage benefits Uses informational Dashboard with member’s profile for “teachable moments” Guides members to preventive services and recommended care Finds in-network doctors; schedules appointments Advocacy service available 24/7; Personal Health Advocate remains with member

Health Advocacy Solution Close-up Highly personalized We do the work for the member Helps members navigate healthcare and insurance-related issues Experts who know the ins-and-outs of the healthcare system Saves time and money

How We Help Obtain unbiased health information about complex medical conditions to help make informed decisions Answer questions about test results, treatments and medication prescribed by the physician Assist in the transfer of medical records, X-rays and lab results Locate and research the newest treatments for a medical condition Explain benefits and help facilitate access to appropriate care Find qualified doctors, dentists, hospitals, other healthcare providers anywhere in the country Expedite appointments including those with hard-to-reach specialists; arrange for specialized treatments and tests Help resolve insurance claims Negotiate billing and payment arrangements Assist with eldercare such as finding adult daycare, assisted living and other related issues facing parents, parents-in-law Work with insurance companies to obtain appropriate approvals for needed services

Feature #2: Personalized Member Communications All members receive personalized communications encouraging preventive services, tailored to their profile Disease-specific communications for members identified with chronic conditions, tailored to the best management of their condition Ongoing reminder communications during the year reinforce prevention actions All communications are tailored to seniors (e.g., large print)

Feature #3: Targeted Outbound Calls Uses “smart targeting” technology driven by member utilization Personal Health Advocates reach out to members who meet criteria for specific screenings and other Medicare Star measures Reminds and encourages Medicare Advantage members to follow through to meet measures Call coordinated with physician appointments with confirmation that the appointments took place Member data is updated to reflect improvement in success rates Coordinated with health plans Improves compliance and closes gaps in care

Feature #4: Carrier Agent Dashboard Health Advocate provides proprietary information Dashboard to health plan Enables health plan staff to leverage “teachable moments” when member calls plan directly Key Medicare Advantage Stars measures highlighted Spotlights focusing on required member actions Integrated into ongoing customer service experience Coordinated with appointment scheduling process by Personal Health Advocate Increased Medicare Advantage Stars compliance Training provided for health plan staff in the effective use of Dashboard Helps increase Member Satisfaction measure

Feature #5: Personalized Member Online Dashboard Online, secure member Web portal Customized with member-specific Medicare Advantage Stars measures Dashboard shows recommended tests and procedures, benefits information, physician contact, etc. “Alerts” messaging when action is required or data updated Access to health information and other member-centric information Access anywhere internet connection is available

Feature #6: Comprehensive Monthly Reporting Engagement – members contacted and coached Preventive and chronic condition management Topics discussed Conditions addressed Outcomes – physician appointments, exams scheduled, etc. Member feedback

Benefits: How Health Advocate Helps Health Plans Personalized, ongoing engagement on multiple levels to optimize compliance; help plans reach a 4, 4.5, or 5-Star rating One-on-one support for increased member satisfaction Highly knowledgeable about specific Medicare Advantage Stars measures Tailored, targeted communications to help meet specific quality-based measures Fully integrated—help for a spectrum of needs, including scheduling appointments; locating senior services Low-cost solution Significant ROI Complete, turnkey solution