Annual Payor Conference Welcome! Lakeland Care Network Annual Payor Conference October 17, 2018

Lakeland Care Network - Update Spectrum Integration Affirmant Blue Cross Blue Shield – Medicare Advantage PPO Blue Care Network – Medicare Advantage HMO ACO Managed Care Distributions 2017 $900,000 2018 Better Monthly Payor Meetings – 4th Tuesday

Quality & Care Management Team What we do: We are SMEs in the following programs: CPC+ PGIP Payer programs CMS programs Patient satisfaction Practice transformation Dual eligible groups – Aetna & Meridian Care management onboarding Etc. Provide quarterly outreach Update EBGs and protocols for Quality Committee approval Contact sheet is available on the Lakeland Care table

Occupational Medicine Occupational medicine is the medical specialty devoted to prevention, treatment and management of workplace injury and illness and the promotion of health and productivity of workers, their families, and communities. Dr. Cathy Boomus, MD, MPH Ursula Adent – Supervisor Amanda Stevens - Manager 2500 Niles Ave, St. Joseph Open late November, 2018

Spectrum Health Lakeland – Benefits 1/1/19 Medical Plan: Priority Health will be our new third-party administrator replacing ASR. Prescription Drug Plan: Express Scripts will replace EnvisionRx as pharmacy benefit manager. Flexible Spending Accounts: Infinisource will become our new administration replacing ASR. ID Cards Will be re-issued by mid to end of December Medical ID Card – Issued by Priority Health Prescription Drug Card – Issued by Express Scripts Flexible Spending Account Debit Card – 2 new debit cards will be sent from Infinisource

Spectrum Health Lakeland – Benefits 1/1/19 Medical Plan Group Number: 792792 Employee premiums will increase slightly in 2019 Spectrum will become as tier 1 provider, no extended network referral required Emergency Room Co-Pay The ER co-pay will increase from $150 to $200 for 2019

Spectrum Health Lakeland – Benefits 1/1/19 Deductible and Out of Pocket Changes The changes to the Traditional Plan deductible and out of pocket maximus are outlined below. There are no plan changes to the High Deductible plan.

Spectrum Health Lakeland – Benefits 1/1/19 Prescription Drug Plan Express Scripts will become our new pharmacy benefit manager effective January 1, 2019. You will be receiving a new pharmacy benefit ID card by mid-December. the burden of covering these medications has become increasingly difficult. Lakeland has put several programs in place such as step therapy, pre-authorizations to help contain costs.

Spectrum Health Lakeland – Benefits 1/1/19 2019 PRESCRIPTION DRUG PLAN OVERVIEW Lakeland Pharmacy Non-Lakeland Pharmacy Prescription Type 30 Day Supply 90 Day Supply 30 Day Supply Only Generic 15% Cost of Rx Min: $2 / Max: $100 15% Cost of Rx Min: $5 / Max: $200 30% Cost of Rx Min: $10 / Max: $400 Preferred Brand 25% Cost of Rx Min: $10 / Max $200 25% Cost of Rx Min: $20 / Max: $600 35% Cost of Rx Min: $25 / Max: $400 Non-Preferred Brand 35% Cost of Rx Min: $20 / Max: $300 35% Cost of Rx Min: $40 / Max: $600 35% Cost of Rx Min: $35 / Max: $400 Specialty 35% Cost of Rx Min: $100 / Max: $400 Not Available Rx Out of Pocket Maximum-Traditional Plan: $2,900-single $5,800-2 person/family

Lakeland Care Operations List of contracted payors Credentialing News: Midlevels Mental Health CAQH Reminders in the mail Notification of Changes / Workday CHAMPS deadline 1/1/19 GMS reminder Update requests www.lakelandcare.com News Search for providers Print a directory Contracted payor list Provider portal links Team contacts