1. Telehealth Advisory Council, Florida Blue Experience
February 21, 2017

2. Table of Contents Florida Blue History in Telehealth 3
Florida Blue Approach
Current Offerings View
Current Offerings & Results
Current Offerings & Results – Care Management Pilots
Former Experience
Summary of Results Experienced and Barriers to Entry 12
Reimbursement
Questions 2

3. Florida Blue History in Telehealth
2009 – Florida Blue was an early adopter of e-visits, using Relay Health vendor to support
2013 – Researching opportunities within remote monitoring
2014 – Florida Blue partnered with provider to support kiosk offering
2014 – Began working with vendors for vendor based telemedicine offering
2015 – Present - Working with providers for telehealth video consultation pilots 3

4. Florida Blue Approach
Listen to customer needs and wants.
Evaluate, develop pilots and test opportunities in Telehealth
Monitor. Looking for improved quality outcomes which are beneficial for all. Interested in market needs driving offerings.
Find solutions that increase quality outcomes for members 4

5. Current Offerings Telehealth at Florida Blue Remote Monitoring
Telehealth pilots with Florida Blue Network Providers
In Progress
Broader Telehealth pilots with Florida Blue Network Providers
Telemedicine pilot (vendor offering network and technology)
(Teladoc)
Equipment / Kiosks
Remote Monitoring
Telehealth at Florida Blue 5

6. Current Offerings & Results
Telemedicine offering through Teladoc to self-funded employer groups
Two employer groups purchased the benefit for 2016
Utilization was 2.2% and 2.22%
228 total visits from both groups’ employees and dependents
Currently, a total of 11 employer groups (8 %) have added the benefit .
Telemedicine pilot (vendor offering network and technology)
(Teladoc) 6

7. Current Offerings & Results – Care Management Pilots
Pilot with Nicklaus Children’s Hospital and Neuro Network Partners
Population of fully insured & Federal Employees epileptic & migraine pediatric patients
Access to care for acute episodes
Aligned quality metrics
No utilization to date
4% have accepted the access offering and registered for potential future events
18% of targeted patients have declined to participate
Currently evaluating barriers to participation .
Telehealth pilots with Florida Blue Network Providers
In Progress 7

8. Current Offerings & Results – Care Management Pilots
Pilot with Nemours
Population of fully insured and Federal Employee asthma and diabetes patients
Access to care for chronic condition management and acute episodes
Aligned to quality metrics
No utilization to date
We will evaluate barriers to participation
Telehealth pilots with Florida Blue Network Providers
In Progress 8

9. Current Offerings & Results – Care Management Pilots
Two additional telemedicine virtual visit pilots with implementations expected soon
Others in exploratory stage .
Broader Telehealth pilots with Florida Blue Network Providers 9

10. Current Offerings & Results – Care Management Pilots
Remote Monitoring
Monitoring equipment for COPD and CHF patients
Early identification and preventative/quick treatment
Population of Medicare Advantage members
540 engaged
Quality improvement results are to be determined
Remote Monitoring 10

11. Former Experience Kiosk Offerings
Partnered with provider to offer kiosk telehealth access offering in Miami
Utilization was low with approximately 100 visits over 12 operational months
Kiosk company filed bankruptcy, as such Florida Blue is no longer involved in the pilot .
Equipment / Kiosks 11

12. Summary of Results Experienced and Barriers to Entry
Utilization for new offerings is low
We are experiencing this trend with our telehealth offerings
We are working to better understand the market
Of the providers with whom we have collaborated, technology setup is a barrier
Approximately half do not prioritize the infrastructure
One quarter have and/or are moving forward with a pilot
One quarter have the technology, but have other barriers to moving forward at this time (capacity, program design)
Mainly large systems have the capabilities . 12

13. Reimbursement
Focus is on gaining knowledge to find appropriate use cases for telehealth
Pilots are a successful test vehicle
Currently, we do not reimburse for telehealth outside of our pilots
As with other services, we need the ability to negotiate rates with all providers for all services on behalf of our members
Collaboration with provider partners has enabled pilot implementations without the need for regulation . 13

14. Reimbursement
Florida Blue reimburses for the same services via telehealth within the pilots as we do for face-to-face
For example, if our policy is that a prescription refill is not a reimbursable event on its own (without additional monitoring, evaluating, and assessing), this policy would hold true for a telehealth visit as it does for face to face. 14

15. Questions
??? 15