1. Medicare Health Support Using Health Care IT to Reduce Health Risk
Presented by Scott Kozicki
Chief Technology Officer
September 9, 2005

2. Who is American Healthways?
Largest and most experienced Disease Management (DM) company in the US: over 1.6 million members managed
Proven clinical and financial outcomes: returned over $1B in health care savings
Support 53 health plans and over 450 employer groups
Have longitudinal data on over 55M members, 3B+ claims rows
Offer programs for 22 chronic diseases and conditions
Participating in 2 of 9 Medicare Health Support Pilots
Operate 9 care enhancement centers across U.S.
Nearly 2,000 employees nationwide
$315 million in revenues projected for FY05
40% CAGR (Revenue & EPS) past 4 Years
Among Fortune, Forbes, and BusinessWeek’s fastest growing companies in America three years running
MHS - Using HIT to Reduce Health Risk
Friday, September 9, 2005

3. Why do we use technology?
Outcomes! Outcomes! Outcomes!
Scale! Scale! Scale!
Surround member with support by using:
unified messages
multiple channels to communicate
bi-directional communications
at the point of change
Any Person, Any Place, Any Time
MHS - Using HIT to Reduce Health Risk
Friday, September 9, 2005

4. How do we use technology today?
Predictive Model
Eligibility
Business Rules
Stratification
CIS
PopWorks
Claims
Pharma
Labs
CUPS
CONTEXT
SOC Data
Nurses Notes
Physicians Notes
Self Care Goals
Validated Meds
Validated Labs DW
eMetrix
MHS - Using HIT to Reduce Health Risk
Friday, September 9, 2005

5. How do we use technology today?
Remote Physiological Monitoring
Predictive Model
Eligibility
Business Rules
Stratification
CIS
PopWorks
CONTEXT
HealthWise
ExcelleRx
etc
LTC
Cigna
MHS - Using HIT to Reduce Health Risk
Friday, September 9, 2005

6. How will we use technology tomorrow?
Health Plan
Physician
Postal Mail
Instant Messaging
Care Manager
Caretaker
Telephony
Web
RPM
Devices
Television
F2F
Clinician
Employer
Government
MHS - Using HIT to Reduce Health Risk
Friday, September 9, 2005

7. Questions to Ask What job needs to be done?
Does the process drive outcomes?
Will technology help scale or hinder process?
Do your partners share your philosophy?
Is it absolutely necessary to have ubiquity before you’ll invest?
MHS - Using HIT to Reduce Health Risk
Friday, September 9, 2005

8. Conclusion Outcomes are the key, not technology
So far, for AMHC, so good!
Sometimes we’ll lead, sometimes we’ll follow
All arrows point to good things
AMHC’s confident about the future
MHS - Using HIT to Reduce Health Risk
Friday, September 9, 2005