1. Integrated Disease Management at HealthPartners Health Care Transformation Task Force Meeting August 16, 2007 N. Marcus Thygeson, MD Associate Medical Director, and VP Consumer Health Solutions HealthPartners

2. Integrated Disease Management Strategies Member engagement (the traditional approach) Provider engagement –Pay for performance –Select networks (centers of excellence)

3. Partnering with Providers Agree on Best Care ICSI Measure What’s Important Composites, Outcomes Set a Target ‘Aim High’ Align Incentives PFP, Compare Peers, Tier Support Improvement Registries, ICSI, public policy Publicly Report Results CI Report, MNCM Focus

4. The Power of Pay for Performance Improving Diabetes Care 2005 Targets 25% Excellent 30% Superior BP < 130/80, Daily Aspirin Use, LDL < 100, A1c ≤ 7, Non Smoker

5. Optimal Diabetes Care

6. Optimal Care Prevents Complications

7. Coronary Artery Disease Managing All Risk Factors 2005 Targets 55% Excellent 60% Superior BP < 140/90, Daily Aspirin Use, LDL < 100, Non Smoker

8. Improving Population Averages

9. Improving Depression Care Thorough diagnosis –Meets DSM-IV Monitoring response to treatment Treated effectively –Meds for 6 mos Good Access

11. Disease Management Improves Optimal Care (BP<130/80, LDL<100, A1c<7.0, No Tobacco, and 1 Aspirin a day)

12. Excellent Asthma Results

13. Other Disease Management Results Best Heart Failure results in the U.S. On average, 6.4% of members participate in one of our programs. –Participation = actively involved, not just getting some information in the mail. ROI 2:1 Decreased complications, including heart attacks, amputations, and blindness.

14. Better Care Means Healthier Employees and Members Better Care Means Healthier Employees and Members

15. Estimated Savings HealthPartners savings estimation methodology validated by external expert Average Disease Management ROI = 2:1 Study with David Cutler estimated savings from pay for performance through 2002 –Diabetes: > $18 PMPM per patient –Coronary Artery Disease: > $54 PMPM per patient

16. Summary Effective pay for performance and disease management programs –Improve patient care –Enhance health –Save money