Rosa Clark Medical Clinic A Hybrid Free Clinic in Oconee County, S.C.

1. Hybrid Clinic Model Rosa Clark Medical Clinic A Hybrid Free Clinic in Oconee County, S.C. Board of Directors Ken Nix, President Mike Smith, Vice President Maeve Binder, Treasurer Marlene Edlund, Secretary Audrey Hall Ham Hudson Barbara Logan, Ph.D. Jerry Mize Mike Pearson Vicki Thompson, Executive Director rosaclark2@aol.com 864-882-4664, ext. 7

2. Hybrid Clinic Model • The Purpose • The Benefits To Free Clinics • The Application Process • The Implementation Phase – What to Expect

3. SC Free Clinic Association Meeting November 2010andNational Free Clinic Association Meeting November 2011 The Purpose of the Hybrid Clinic Free Clinics Will: • Have reduced hours • Merge with other free clinics • Close down • Become hybrid clinics, part Medicaid, part free clinic

4. The Purpose of the Hybrid Clinic The Welcome Mat Effect 162,000 currently Medicaid Eligible but unenrolled will join Medicaid

5. The Purpose of the Hybrid Clinic Meeting The Needs of the Free Clinic • To remain strong now and in the future for those people who will always need the free clinic • To maintain operating hours so that the quality of care for patients remains high. • To create a steady stream of dependable income

6. Meeting The Needs of the Community The Purpose of the Hybrid Clinic • Inability to find a medical home with Medicaid • Increased lack of access for Medicaid recipients in the future

7. The Benefits of Becoming a Hybrid Access To the Webtool

8. Medicaid ReimbursementFor Volunteer Services The Benefits of Becoming a Hybrid Volunteer Physicians

9. The Benefits of Becoming a Hybrid Medicaid ReimbursementFor Volunteer Services Volunteer Support Staff

10. The Benefits of Becoming a Hybrid More Appointments For Free Clinic Patients • The average Medicaid reimbursement for an office visit is $42. • The average cost of a nurse practitioner is $45/hr. • On average a nurse practitioner sees 3 patients an hour • For every Medicaid patient that is seen, approximately two free clinic patients can be seen.

11. The Benefits of Becoming a Hybrid

12. Medicaid ReimbursementFor Pharmacy Services The Benefits of Becoming a Hybrid

13. The Benefits of Becoming a Hybrid $21,120 - $ 3,000 costs Profit was approximately $18,000

14. The Benefits of Becoming a Hybrid

15. The Benefits of Becoming a Hybrid TotalMedicaid Reimbursement$27,518

16. The Application Process Terminology

17. The Application Process • The Magnificent Seven Medical Home Networks Community Health Solutions Carolina Medical Homes Palmetto Physician Connections Absolute Total Care Blue Choice Health Plan First Choice United Health Care

18. The Application Process • Med Solutions Medical Necessity Pre-Authorization Numbers

19. Implementation Phase Auto Assignment of Patients From Free Clinic Patientsto Medicaid Customers Walk-In patients Referrals from DSS and other physician offices

20. Implementation Phase Changing The Infrastructure Cash Register

21. CMS-1500 Detail Total Claim Charge: $50.00 CMS-1500 Insurance Detail Total Insurance: $0.00 Implementation Phase Claim Type: CMS-1500 Claim ID: 912743 Beneficiary Information Beneficiary Last Name: XXXXXXX Beneficiary First Name (MI): XXXXXXX Medicaid ID: 7374228201 Address: , , SC, Date Of Birth: 06-08-1962 | Gender: U | Medical Record Number: | Beneficiary Account Number: | Billing Provider Information Billing Provider ID: 1508903394 Provider Last Name or Organization Name: Rosa Clark Medical Clinic Billing Provider First Name: Billing Provider Taxonomy: 261Q00000X Billing Provider Zip Code: 296783416 Billing Service Facility Location: 296783416 Rendering/Attending Provider Information Rendering Provider ID: 1477587038 Provider Last Name or Organization Name: Axson Rendering Provider First Name: Frank Rendering Provider Taxonomy: 261Q00000X Rendering Provider Zip Code: 296783416 Miscellaneous Claim Information Prior Authorization Number: Original CCN: Bill Frequency: 1 Accident Date: Accident Indicator: Auto State: SC Diagnosis Codes CMS-1500 Detail Total Claim Charge: $50.00 CMS-1500 Insurance Detail Total Insurance: $0.00 Entitlement Specialists

22. Implementation Phase Pharmacy Software and Retail Pharmacy Techs

23. Implementation Phase Problems Unique To Free Clinics Sample Purchased

24. Implementation Phase From Start-up Funding to Medicaid Funding

25. Implementation Phase Problems Unique To Free Clinics

26. Implementation Phase Daring To Compete • No wait time to get back in • Can remain a free clinic patient until their plan is changed • Perks such as dental coupons • Prescriptions beyond Medicaid at no cost

27. Removing The Obstacles FTCA

28. Hybrid Clinic Model The Sustainable Medicaid Income Allows Us To:

29. Hybrid Clinic Model SCDHHS SCFCA