An Overview of the HealthBridge Data Analytics & IT Infrastructure Keith Hepp, CEO

1. An Overview of the HealthBridgeData Analytics & ITInfrastructureKeith Hepp, CEO July 13, 2012

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

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

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

5. Infrastructure Components Match patients across data sets accurately Combines big data sets – both clinical and claims Helps data speak the same language Patient Attribution, Risk Assignment, & Cost Aggregation • 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

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. 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. Medical Neighborhood Tracking

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

11. Clinical and Claims RepositoryCPC Measure NQF #59Diabetes 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. Questions and Discussion