1. What Does Capstone Do? Kim Browning TRHC Executive Vice President
Mercy Life of AL
What Does Capstone Do?
Kim Browning TRHC Executive Vice President
Richard O. Schamp, MD Chief executive officer
George w. brett md chief medical officer
David a. wilner MD senior medical consultant
Indira kanouka md medical consultant
Principles & Practice of Utilization Management -- Richard Schamp, MD

2. Capstone Performance Systems
Leaders and staff at Capstone have >300 client-years of experience in guiding dozens of PACE programs through the complex maze of risk adjustment
Thirteen years of risk adjustment consulting experience
Purchased April 2014 by Tabula Rasa Healthcare

3. Locations of Our Valued Clients

4. Why Capstone?
PACE Programs are devoted to providing multidisciplinary care to the frail elderly.
However, they must also function as a health plan.
Though they insure only a few hundred, the process and procedures required are no different than that for a major health plan insuring thousands of lives
Capstone exists to assist PACE in health plan management from proper documentation & coding, to RAPS submission and ultimately to timely payment

5. Who Are We? Richard Schamp MD: Founder and CEO
Kim Browning BS/BA, CHC,PMP : Executive Vice-President, TRHC
John Stolze BS: Senior Vice-President
George “Mike” Brett MD: Senior VP Consulting, CMO
Andrew Schamp BA, BS, MS: Principle Software Architect
Indira Kanouka, MD: Medical Consultant
David Wilner MD: Senior Medical Consultant
Matt Zimmerman BA: Director Client Success
Angie Hlad BSN CRN-C: Director Coding/Auditing Services

7. 1/17/2019
Data Collection
Data Submission
Data Analysis

8. Capstone Services…Historically
Situation Assessments
Provider Trainings
Monthly Auditing
Ouarterly Analytics
Front-end coding
Retrospective Review
Prospective Review
Internal Validation Audit
Custom Audits
Gap Analysis
Mock Audit
Education & Consulting

9. Health Plan Management Operational Consultation Retrospective Reviews
“Core
Services”
Risk Adjustment Consulting, Analytics, Auditing
Health Plan Management
(Former Peak PACE Solutions)
Operational Consultation
U.M./Q.M.
Marketing & Enrollment Consultation
Capstone
Expands
Concurrent Coding
“GuardDx”
Medical Director & New Provider Training
U.M./Q.M.
Retrospective Reviews
“SucceeDx”
Pharmacy:
Medication Risk Mitigation
Prospective Reviews
“ProDx”
Medicare Part D Consultation
Gap Analysis
Prep for 1/3 Financial Audit

10. Capstone Desires
To Invest
In Relationships

11. gbrett@cpstn.com Mercy Life of AL
Principles & Practice of Utilization Management -- Richard Schamp, MD