Click to edit Master title style Health Information Technology: Driving Improvements in Medicaid Don Imholz Executive Vice President and Chief Information Officer

Provides health plans, programs and related services Centene Corporation Coordinated care of government sponsored programs Medicaid, TANF, SSI, CHIP, foster care, special needs plans Contracts with 81,000 physicians, 950 hospitals and 255 Federally Qualified Health Centers (FQHCs) Seven health management companies Health plan services offered in 12 states with multiple product lines* *In Arkansas, a Centene subsidiary acts as a Third Party Administrator (TPA). Kentucky and Louisiana health plans are currently in implementation.

1.6 million members Children Women who are pregnant Adults Foster care Long-term care programs 72% of our members are 18 years old or younger Our Members 0-18 Years old 18+ Years old 0-18 Years old 18+ Years old

Historical Relationship Payers and Providers Eligibles Claims Payments Payers Providers

Managed Care Mission Now Way Beyond Claims Managed Care Providers Care Gaps Risks History

Health IT is Vital to Improve Outcomes and Lower Costs Manual Task Automation – Routine – e.g. Keying in Information – Non-Routine – e.g. Identification of Exceptions Speed of Information Movement – Electronic versus Paper – Standards Quality of Information – Capture Electronically – e.g. Bar Codes – Edit at Source – Process Simplification – Integrate and Compare Data – Standards “Information is the lifeblood of modern medicine. Health information technology (HIT) is destined to be its circulatory system.” David Blumenthal, M.D., M.P.P One Medication Error per Day Per Hospital Patient Every 7 th Admission Unnecessary Every 5 th Lab Test Unnecessary Source: National Quality Forum

Four Broad Areas of Health IT Health IT Information AnalysisPoint of Care Technology Reduced Admin EffortInformation Sharing

Centene has Invested in Health IT Health IT Information AnalysisPoint of Care Technology Reduced Admin Effort Information Sharing

Centene Created EHR for Texas Foster Care Health Passport is a patient-centered, internet- based health record that allows healthcare providers to overcome the information barriers that exist within a transient population Using state-of-the-art technology, Health Passport improves care coordination, eliminates redundancy, and reduces provider errors by providing secure access to the member’s treatment history Including prescription drug utilization, immunization history, reported allergies, past doctor visits, behavioral health history, laboratory tests, vital signs and patient demographics

EHR Challenges Who Pays Who Manages Scalability Standards Privacy Measuring the Benefit

Inform Clinical Practice Personalize Care Improve Population Health Interconnect Stakeholders Involve patients more in their care Personalize Patient Care Expand public health knowledge localized to specific communities Improve Community Health Allow records to follow patients and reduce waste and errors Interconnect Providers Increase knowledge of past care episodes and outcomes Improve Clinical Outcomes Electronic Health Record EHR Benefits are Many Once Data Captured

12 Progress in Adoption is Accelerating Percent Source: 2009 Commonwealth Fund International Health Policy Survey of Primary Care Physicians. Electronic ordering of laboratory tests Electronic access to your patients' test results Electronic prescribing of medication Percent reporting ROUTINE:

“Network Effect” Will Drive Accelerated Usage/Value Source: 2008 Deloitte Survey of Health Care Consumers

Observations Funding Supports Strong Investments Standards Change Management Cost Drivers Technology Advancement Necessary but Not Sufficient

“That it will ever come into general use, notwithstanding its value, is extremely doubtful because its beneficial application requires much time and gives a good bit of trouble, both to the patient and to the practitioner because its hue and character are foreign and opposed to all our habits and associations.” from The London Times in 1834 Commenting on... the “stethoscope” Conclusion: Quality of Care will Drive EHR Adoption