Dream, Empower, Achieve!

1. Dream, Empower, Achieve! April 26, 2012

2. Our Experience • Centene has 28 years experience • Currently serves over 1.6 million Medicaid members • This includes about 218,000 Aged, Blind and Disabled individuals • Has health plans in over 15 states Health Plans • Health Plans not yet pictured: • Home State Health Plan (MO) • Coordinated Care (WA)

3. IlliniCare’s Member with Developmental Disabilities Profile • The “average” IlliniCare member with a developmental disability has the following characteristics: • Is Male • Lives in Cook County • Is on average 34 years old • Population Break Down: • Sex • Male: 60% • Female: 40% • County • Cook: 67% • Will: 10% • DuPage: 8% • Lake: 7% • Kane: 5% • Kankakee: 3%

4. The Integrated Care Dream • Connecting a fragmented delivery system • Bringing together medical, behavioral and social services • Open communication between providers, member and health plan • Medical Home • Member sees one Primary Care Physician and builds a strong relationship with that provider • That provider oversees health needs, helps with referrals, specialty care, etc. • Coordinating Care • Linking members with needed services and providers • Ensuring members get the right care, at the right time, in the right setting

5. The Full Picture of Health Social Services Mental Health Physical Health Integrated Care

6. Making the Integrated Care Dream a Reality • Person-centered • Care plan is unique to each member’s goals for their own health • Services and programs are wrapped around the individual, customized to their needs and preferences • Integrated Team of Experts • Assist members to navigate the system • Work with current organizations/agencies as an additional advocate • If members do not have this additional support, we will provide it • Innovative Programs • MemberConnections • Connections Plus • CentAccount

7. IlliniCare’s Model of Member-Centered Care Medical Director Medical PCP Pharmacist CommunitySupports Connections Team MEMBER Behavioral Health Provider 24 Hr. Nurse Advice Line Community Liaison Integrated Care Teams

8. Integrated Care Team • Behavioral Health Service Coordinator • Licensed clinician with experience in service coordination • Medical Service Coordinator • Licensed RN clinician with experience in service coordination IlliniCare currently has nine Integrated Care Teams • Social Worker • Licensed and non-licensed with experience in directly coordinating and integrating the social/community needs of members • Program Coordinator • Helps the member navigate the system; assists in coordinating care, setting up appointments, identifying physicians, etc.

9. Integrated Care Team – Focused on Members with Developmental Disabilities • Specialized experience with individuals with developmental disabilities • Each individual is touched by every member of the team • Team works together to find solutions for members Meet the Team: • Noelle Ficarello, Program Specialist – Social Work • 10 years of Social Services experience • Licensed Clinical Social Worker • Worked at residential treatment center for children with emotional and behavioral disabilities, adults with chronic mental illness, and adults with mental illness and a developmental disability

10. Meet the Integrated Care Team • Elizabeth Audiffred, Program Coordinator • 18 years experience • Worked with low income families, care management and case worker programs providing services to Medicaid enrollees • Kathy Schneider, Medical Care Coordinator • 19 years experience • Registered Nurse • Worked in SNF, home health care and hospice. Worked for six years as the Health Services Director for Community Living Services at Little Friends, Inc. • Stacey Stewart, Behavioral Health Care Manager • 15 years experience • Licensed Professional Clinical Counselor • Worked directly with children, adolescents and adults with developmental disabilities providing therapy and case management • Providing counseling and support groups for caregivers of people with developmental disabilities

11. Covered Benefits – Medical • Doctor Care • Yearly Physical Exams • Specialists Visits • Wellness Visits • Diagnosis and treatment • Immunizations (shots) • Prenatal and postpartum care • Medical Supplies: • Durable Medical Equipment • Disposable medical supplies • Prosthetic devices • Hospital Care • Inpatient services • Outpatient services • Laboratory • X-ray • Diagnostic studies • Emergency care • Surgeries • Other Covered Services: • Physical Therapy • Chiropractic care • Occupational therapy • Hospice

12. Covered Benefits – Dental & Vision • Dental covers: • Fillings • Crowns (caps) • Root canals • Dentures • Extractions (pulling) • X-Rays • Annual cleaning for adults • Practice visits if needed • Vision covers: • Yearly eye exam • 1 pair of glasses per year • IlliniCare Extra Benefits: • Enhanced Frame Selection • Contact Lenses

13. Physical Health – How We Help • Integrated Care Team ensures members are in good physical health. We help members with: • PCP Relationship • Assist in finding a PCP • Working with providers that are both in and out of network • Educating providers on ICP, continuity of care • Annual Doctors Visits • Educate members about procedures and assist them to feel comfortable • Explain tests, next steps • Practice Visits for dental services and OBGYN appointments • Additional needs: • Medical Equipment • Dental • Optical • Preventive Health Screenings: • Flu shots • Immunizations • Annual pap and mammogram • Colorectal cancer screenings

14. Covered Benefits – Behavioral Health • Behavioral Health services include: • Mental Health assessments • Psychological evaluations • Treatment plan development • Substance abuse treatment • Crisis intervention • Therapy • Counseling • Developmental testing • Medication training

15. Behavioral Health – How We Help • Mental health affects physical health. By addressing behavioral health and medical issues together, we help members be healthier. • Connect members with behavioral health services they need: • Psychiatry • Psycho-social rehab • Group therapy • Individual therapy • Connecting with community agencies – the member’s local care management team • Integrated Care Team doesn’t replace member’s current supports • Additional advocate if needed • Coaching – helping member understand services and process of behavioral health appointments • Medication management • Substance abuse • Smoking Cessation • Support Groups

16. Covered Benefits – Pharmacy • Preferred Drug List • Includes list of medications that are covered by IlliniCare. • Providers must prescribe the medications on the PDL • Exceptions made if it is medically necessary • Ensure covered medications are used to treat a variety of conditions and diseases • Entire Preferred Drug List is available online • Over the counter drugs on preferred drug list • We will cover the cost if you have a prescription from your physician • Filling a prescription • Use an in-network pharmacy • Receive 90 day supply by mail with RxDirect

17. Covered Benefits – Transportation • IlliniCare will provide transportation when needed. This includes: • Reimbursement of personal mileage • Door-to-Door service • PACE Service • Medi Transport • Public Transportation • We will select the best transportation method for the member’s needs based on: • Proximity to the home/provider • Accessibility needs • Cost effectiveness • Contact Member Services at 866-329-4701 to arrange transportation. • Member Services will ask a series of questions to determine the best transportation option • Please contact us at least 72 hours before the appointment

18. Social Health – How We Help • Having the proper support through family members, friends and the community and living fulfilling lives • Having a safe home and access to social resources • Safety in the Home • Electricity • Running Water • Providing Resources • Support Groups • Advocacy Organizations • Social Services • Financial Assistance • Housing • Food Assistance

19. Helping Members Achieve THEIR Dreams • Goal Setting • Part of Care Plan • Not just health goals, but life goals • Goal Examples: • Following the treatment plan • Going back to school – GED/College • Remaining independent • Living in the community • Reaching their full potential • Employment • How IlliniCare helps: • Coaching, guiding, empowering • Finding resources • Assistance in navigating the system

20. Empowering Members • PCP Selection • Allowing members to choose their provider • Involved in Care Plan Creation • We involve member in every step of the process along with PCP and community care team • Member’s health and personal goals contribute to overall care plan • Coordinating Transportation • Giving member the freedom and power to travel to/from their appointments • Connections Plus Program • If qualified, give member access to cell phone to connect with IlliniCare, Care Team, PCP and familial supports • CentAccount Program • Reward members for healthy behaviors • Empower members to purchase health-related items with a pre-paid debit card

21. What does Integrated Care Achieve? • Care that is delivered at the right time, in the right setting • Improved Health Outcomes • Access to Preventive Care • Independent Living in the Community

22. Success Stories “I want to write, here, how happy and pleased I am with IlliniCare. I had to choose a new plan and I am so grateful I chose yours.” - Mary Y., in response to receiving the member newsletter “It is good to know IlliniCare is so dedicated to the health of its members. Thank you as well for assisting me with this housing dilemma. As you (so rightly) said, ‘housing is a part of health.’” -Veronica, after working with the integrated care team “I just wanted to take a quick minute and let you know, as a marketer myself, how refreshingly impressed I was. I wasn’t looking forward to having to deal with an HMO for one of our patients for PA, until I started dealing with the employees. And one that particularly stands out is Lisa Kimbrough –but they are all great. Everybody’s very efficient, they call you back, there’s no attitude; it doesn’t drag out. Blue Cross should hire your staff.” - Sharon Ballor, Applewood Rehab, Marketing & Admission Director “He should get some sort of employee of the year award just for taking care of my problems. I can’t thank him enough for all the rigmarole he had gone through on my behalf.” - Debbie L., after working with the Integrated Care Team on behalf of her daughter, an IlliniCare member. “We really, really do appreciate the transportation service provided through the IlliniCare Plan. You guys are way ahead of the competition. In fact, there is no competition because other companies will be following you.” - Katrina T., caregiver of IlliniCare member

23. Dental Success • Member Name: Derrick* • Stats: 23 years-old, male • Diagnosis: Autism, mental retardation and epilepsy • Derrick’s mother contacted ICT. he was experiencing pain, fever and mouth swelling. She requested help from the ICT. • Directed Derrick to his PCP to treat the infection; member had a tooth abscess. • Unable to tolerate dental exam, needed IV sedation. • Next step was to treat the abscess. Worked with the members preferred dental provider. • SCA put into place for the member’s preferred anesthesiologist. Terri, a program specialist with IlliniCare worked with the member and his mother to get him the care he needed. • The entire process involved a collaboration of the Integrated Care Team, IlliniCare management and contracting, providers, and the member's mother working together for the optimal outcome for the member. • The end result was the member received the necessary treatment on February 22nd.  *Members name changed to protect confidentiality

24. Encouragement is a part of health • Member Name: Angela* • Stats: 56 years-old, female • Diagnosis: Traumatic brain injury, multiple brain aneurisms, seizure disorder • Chris contacted Angela to complete the HRA. She was in need of DME, including a shower bar and a C-PAP machine. Chris was able to refer her to the appropriate providers to get what she needed. • Angela did not like the PCP she was automatically assigned to, so Chris helped her find a new PCP. She has been seeing her doctor regularly, and likes him a lot. • Angela explained that she felt lonely; she has never met someone in her situation before. Even when she spoke to others that have had an aneurism, she felt they couldn’t understand her. • Chris encouraged Angela by explaining that she could help other people who are having a hard time recovering, since she’s been through two aneurisms. Chris gave her the information for the Brain Injury Association of Illinois, so she could join a support group. She had never considered that perspective, and is contacting them to join a support group. Chris, a program specialist, helped a member with her medical needs, as well as her emotional needs. • Angela is a great advocate for herself, so Chris also referred her to Equip for Equality. • Chris is currently helping Angela work with the Department of Rehabilitation in order to get the services she needs such as a homemaker and meals on wheels. • Angela recently went to one of our members-only health events. At that event she raved about Chris, and how much he was doing on her behalf. *Members name changed to protect confidentiality