Better Health Care Delivered OPPORTUNITY FOR USING TECHNOLOGY TO IMPROVE CARE: ACCESSIBILITY, COORDINATION, QUALITY 42916CABENABC 12/13.

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Presentation transcript:

Better Health Care Delivered OPPORTUNITY FOR USING TECHNOLOGY TO IMPROVE CARE: ACCESSIBILITY, COORDINATION, QUALITY 42916CABENABC 12/13

Introducing LiveHealth Online Doctor’s care at the speed of life.

LiveHealth Online: Is available in most states including DC* Is available 24 hours a day, 7 days a week, 365 days a year Is available anywhere you have a computer or mobile device with Internet access (at home, in the office or on the go) Provides access to in-network, board-certified doctors Allows doctors to ePrescribe** utilizing local pharmacies (where applicable) Takes member payments via Visa, MasterCard and Discover Is secure, convenient and easy-to-use Visit with a doctor online, anytime. From work, at home or on the go. *LHO is not yet available in the following states: AK, TX, LA, AR, AL and NH. **In certain states, prescriptions cannot be issued as a result of an online interaction with a doctor. For state telehealth availability, check the map on 3 LiveHealth Online is the trade name of Health Management Corporation, a separate company providing telehealth services on behalf of Anthem Blue Cross and Blue Shield. Easier and less expensive than urgent care To learn more about how LiveHealth Online works, check out this video.video

LiveHealth Online goes where you go The mobile LiveHealth Online app is available on both iOS and Android devices. LiveHealth Online mobile solutions 4 LiveHealth Online is the trade name of Health Management Corporation, a separate company providing telehealth services on behalf of Anthem Blue Cross and Blue Shield.

Employer benefits Substantial savings* LiveHealth Online is the trade name of Health Management Corporation, a separate company providing telehealth services on behalf of Anthem Blue Cross and Blue Shield. 5 Emergency Room $1,270 Urgent Care $149 MD Office $126 Retail Clinic $73 LiveHealth Online $49 *National average allowed amounts; 2012 claims data based on Local Group and Ind, Non Refunding Members only, for LHO fully treatable diagnosis codes in WLP’s 14 Blue states.

Worksite solutions Employer-branded MedSuites and kiosks are available, offering: High-definition video — ensures best possible picture quality Touch-screen technology — makes it easy to use Connected biometric devices (blood pressure monitors, thermometers, a weight scale and more) — helps doctors diagnose patients 6 LiveHealth Online is the trade name of Health Management Corporation, a separate company providing telehealth services on behalf of Anthem Blue Cross and Blue Shield. Learn more. Talk with your Anthem sales representative to obtain details on pricing and ROI. MEDSUITE (ENCLOSED) MEDSTOP Console MEDSTOP Portable

What is unique about LiveHealth Online? 7 LiveHealth Online is the trade name of Health Management Corporation, a separate company providing telehealth services on behalf of Anthem Blue Cross and Blue Shield. UNIQUE PRODUCT FEATURE BENEFITS TO EMPLOYERS AND EMPLOYEES No PMPM cost to employers Greater value Visits are a covered benefit Benefit design flexibility Provider choice upfrontHigh member satisfaction Immediate or scheduled visits in HD video Superior, seamless member experience Physicians in-network for Anthem Clarity on the cost of the visit Automated claims submission Ease of use for members Ability to integrate with multiple payers One solution for all employees

Substantial savings Customer example LiveHealth Online is the trade name of Health Management Corporation, a separate company providing telehealth services on behalf of Anthem Blue Cross and Blue Shield. 8 Assumptions: 1) Claims data based on Local Group and Ind, Non Refunding Members only, for LHO fully treatable diagnosis codes. 2) % Visits to be Steered based on Q Consumer responses from 1.8K Online Care visits from LHO and BCBS MN platforms. 3) Online Care Cost of $28 reflects total cost of $49 less $10 Copay and $11 Deductible paid by the member. Alternative Visit Type Plan Cost (avg paid) Percentage of Avoidable Visits LiveHealth Online Cost Potential Savings by using LHO Emergency Room $8255%$28$797 Urgent Care$8318%$28$55 MD Office$7356%$28$45 Retail Clinic$416%$28$13 Weighted Average Savings per Visit$71

“I am very impressed and will continue to recommend this service to friends, family and co-workers.” patient satisfaction “I was able to get things taken care of in less than 10 minutes.” completely resolve their medical issue “I will definitely use it again. I saved at least three hours by not going in to the doctor — and a ton of cash!” saved time 90%85%90% A great consumer experience Say “ahhhh.” LiveHealth Online is the trade name of Health Management Corporation, a separate company providing telehealth services on behalf of Anthem Blue Cross and Blue Shield. 9

What we do… Proprietary & Confidential 11 Profile Target Engag e Our team uses clinical expertise along with Big Data to profile your population and each individual We then target health conditions, gaps, health actions specific to your population and each individual Finally, we engage individuals in a personal, effective way to educate, encourage and support change in health behavior At a high level, it’s fairly straightforward

Acuity Based Population Health Proprietary & Confidential 12 Exchange Leadership Total Cost of Care Transform Care Management 5% of population ~743 members 80% of costs 95% of population ~14,119 members 20% of costs Mobile & Social Risk ID, Behavioral Incentives, Analytics Managing Crisis Case Management with Enhanced Outreach Incentives for Participation Identification of Key Cost Drivers Predictive Modeling Proactive Mobile Outreach Managing Care Disease Management with Enhanced Outreach Prenatal Management Gap In Care Closure Mobile Outreach Incentives for Participation Managing Health Health Assessment Biometric Education Health Promotion/Risk Reduction Online/Mobile Platforms Health Coaching Challenges Health Goals Consumerism Incentives for Participation

Exchange Leadership 13 COMPANY CONFIDENTIAL | FOR INTERNAL USE ONLY | DO NOT COPY Western Digital Results - Clinical Finding – Cost & Utilization Outcomes Jul 2012 – Jun 2013Jul 2013 – Jun 2014% DiffAdjusted Norm% Diff Place of Service Summary (PMPM) Inpatient Hospital Plan Paid$84$78-7%$82-5% Outpatient Hospital Plan Paid$53$7542%$733% Office Plan Paid$45$5828%$5211% Emergency Room Plan Paid$6 4%$13-74% Utilization Metrics Inpatient Days Per %240-39% Total Admissions Per %56-35% ER Visits Per %192-48% Total Office Visits Per 10003,6783,532-4%3,681-4% Urgent Care Visits Per %- Pharmacy Scripts Per 10006,0826,014-1%9,712-38% Pharmacy Scripts(Generic) Per 10004,6044,6892%7,584-38% Pharmacy Scripts(Branded) Per 10001,3661,211-11%1,956-38% % Generic Drugs77793%790%  IP Paid per Admit & per Day are higher than adjusted norms.  OP & Office visits showing more costly mix of services over prior period for Hematological (61%), Malignant Neoplasm (43%) & Musculoskeletal (23%) diagnostic groups.

Exchange Leadership 14 COMPANY CONFIDENTIAL | FOR INTERNAL USE ONLY | DO NOT COPY Mobile Health supports improvements in Gaps in Care Implementing Mobile Health Consumer improves results on performance guarantee metrics. 100% Liver Tests 88% Colon Cancer Screening 59% Pap Smear Tests 58% Mammogram Screening 52% A1C Tests 50% Refilling ACE Inhibitor 45% Cholesterol Test 80.2% Mobile Engagement for At-Risk Members Gap in care closure rate:

Exchange Leadership 15 COMPANY CONFIDENTIAL | FOR INTERNAL USE ONLY | DO NOT COPY Functional Description Multi-Channel: - Mobile, Tablet, Web, , Push - Native iOS & Android Targeted eOutreach / Communications: - “Smart Data” Personalization - Secure Encrypted Inbox - Push Notification - - Dependent Engagement - Personalized Anthem Resources Wellness: - Device Integration – Fitbit, Healthkit (f), Fit (f) - Activity Tracking - Challenges - Health Goals - Wellness Calendar - Wellness Content - Incent Initial Engagement - Incent Sustained Engagement - Incent Preventive Care Cost of Care: - Gaps in Care Risk Mgt - Predictive Disease Risk Mgt - DM/CM Communication & Incentive Mgt - Diagnosed Disease Risk Mgt - Biometric Risk Mgt - Lifestyle Risk Mgt - Coaching – Digital, Video, Quizzes, Articles - Incent Personalized Medicine - Incent Adherence to Evidence Based Medicine Incentives: - Premium Differential Administration - Gym Reimbursement - Cash Administration - Points / Levels – Gamification - Defined Contribution Differentials (Exchanges) - Gift Cards, Raffles, Wellness Mall Integration Consumerism: - HSA Balance Integration - Deductible Balance Integration - ID Cards (Med, Den, Vision) - Benefit Descriptions (Med, Den, Vision) - Transparency – Provider Cost & Quality (f)=Future release

Building for the Future LiveHealth Online Payment Innovation Anthem Health Marketplace Web & Mobile Enhancements 16 Imaging Management Wellness Cancer management Transparency Primary Nurse Model Consumer Tools