CareFirst BlueCross BlueShield is an independent licensee of the Blue Cross and Blue Shield Association. ® Registered trademark of the Blue Cross and Blue Shield Association. ®' Registered trademark of CareFirst of Maryland, Inc. Expanding Medication Therapy Management Services beyond the Part D population Winston Wong, Pharm.D. Associate Vice President – Pharmacy Management

Program Part D Results Since 2006 – 7,492 patients were touched – 768 in 2006 – 4,027 in 2010 – Estimated cost avoidance $5,342,616 – Average cost avoidance per patient: $ per patient overall $1, per patient in 2010 Participating Pharmacist: Pull:Push ratio – 43%:57% – TIP response rate: 9% 2

Program Recognition National Recognition – American Pharmacist Association 2009 APhA-APPM Pharmacy Practice Merit Award – CMS – QIO Delmarva Foundation for Medical Care Local Recognition – Maryland Pharmacist Association 2009 MPhA Honorary President’s Award 3

4 The CareFirst Approach to Medical Management Healthy Population 50% Population; 7% of Cost Advanced Illness 3% Population; 29% of Cost Multiple Chronic Conditions 7% Population; 23 of Cost At-Risk Population 10% Population; 19% of Cost Stable Population 30% Population; 22% of Cost Medical Management Infrastructure Primary Care Physician/Providers No one better positioned to be the quarterback and central point of coordination for the care of most people. Engaged, longstanding relationship between member and PCP goes hand in hand with a patient centric approach that is essential to achieving the best possible outcomes. Medical Management Coordination Care coordinators will interface between CareFirst and the physician provide the tools and needed information to that will allow the physician to care for their patient Pharmacy Management will interface into this process with the Medication Management Services program

5 5 CareFirst Rx Book of Business MMS Personal Care Pharmacists Search Light Data Mining/Screening CareFirst Pharmacy Management/MMS Clinical Pharmacist Hospital Transition Coordinator CareFirst Regional Care Coordinator Local Care Coordinator Primary Care Medical Home Practice (PCMH) Delivery Source: Searchlight Pharmacist Practices Your Rx Advisor Program– Process Flow Hospitalized Member