1. HealthBridge is one of the nation’s largest and most successful health information exchange organizations. An Overview of the HealthBridge Data Analytics & IT Infrastructure Keith Hepp, CEO July 13, 2012 1

2. HealthBridge Background One of the nation’s largest, most advanced and successful health information exchanges (HIE) Provides HIE connectivity for Greater Cincinnati tri-state area and five other HIEs – including Greater Dayton Connection Statistics Participants: 50 hospitals, 7500 physicians, 800 practices Delivers 3-6 million clinical messages per month More than 60 million messages annually Clinical information for 3+ million unique patients 2

3. Shared IT & Data Background HealthBridge implemented new CPC-ready Shared Community IT Infrastructure over the last two years that can: Patient and Physician Attribution Translate and combine data across different IT systems Risk stratification Enables consistent community measures Support quality and population health improvement Assist plans in understanding which providers are delivering value vs. volume 3

4. 4 Infrastructure Components Impact Intelligence Provider Claims Analytics & Reports Impact Intelligence Provider Claims Analytics & Reports Impact Pro Patient Claims Analytics & Reports Impact Pro Patient Claims Analytics & Reports Provider & Payer Data Translation Master Patient & Provider Index Claims Analysis Tools (Optum Symmetry) Claims Analysis Tools (Optum Symmetry) Claims and Clinical data warehouse CPC Required Measures Custom Analytics & Reports Available Today Optional Applications Optional Applications

5. Infrastructure Components Translation Tool Semantic Data Normalization Master Patient and Provider Index Community Master Patient Index Patient & Provider Identification Clinical and Claims Repository Data Warehouse & Clinical Analytics Covers 16 of the 18 CPC Measures OPTUMInsight’s Symmetry Data Analytic Engines Patient Attribution Methodologies 5 Match patients across data sets accurately Combines big data sets – both clinical and claims Combines big data sets – both clinical and claims Helps data speak the same language Patient Attribution, Risk Assignment, & Cost Aggregation

6. 6 Translation Top half of screen is a source catalog of lab test codes & descriptions Bottom half of screen are candidate LOINC codes for the term highlighted on the top (blue row)

7. PCP Attribution Methodologies 1) Direct Assignment Provider is ASSIGNED as the PCP 2) Based upon Primary Care Core (PCC) Services E & M Coding in claims Provider with the highest Activity count is the PCP If there is a tie, Provider with the highest Cost is the PCP If there is a tie, Provider with the most recent date of service is the PCP 3) Most Recent PCP Provider who was last identified as a Primary Care Provider in the claim record

8. 8 Tracking Patient/Provider Attribution Attribution Method A John Doe, 1/1/12 -12/31/12 Attribution Method B Sue Smith, 1/1/12 -12/31/12 Attribution Method C Adam Doe, 1/1/12 -12/31/12 Attribution Method D Betty White, 1/1/12 -12/31/12 Attribution Method A John Doe, 1/1/13 -12/31/13 Attribution Method B John Doe, 1/1/13 -12/31/13 Multiple attribution methods could be simultaneously used and tracked in the MPI The Patient/Provider attribution is also time-bound with beginning and ending effective dates

9. 9 Medical Neighborhood Tracking

10. Clinical and Claims Repository CPC Measure NQF #59 Diabetes Mellitus: Ha1c Poor Control (>9%) Summary

12. Risk Stratification Episode Risk Groups basis Factors in age and gender Prospective Factors in projected future costs Retrospective Population Rollup CMS-HCC (Hierarchical Condition Categories) Can be captured Utilized for analytics, projections, and reporting

13. Episodic Risk Score Computation

14. 14 Questions and Discussion