1. UCare Dual Eligibles – MSHO Experience Ghita Worcester Sr. VP, Public Affairs and Marketing SNP Leadership Forum November 2, 2012 1

2. UCare’s Minnesota Senior Health Options (MSHO) 2  Members are dual eligible and over age 65  9,290 members as of October 2012 ( 8,671 CY 2010)  35% of members are over age 85  75% are women  Significant diversity (Hmong, Somali and Latino)  Risk score of 1.47  57- county service area  Provides additional supplemental services (dental, fitness benefits and fitness kits)  All members have a Care Coordinator

3. Comparison of UCare Members by Disease 3  5% higher Chronic Obstructive Pulmonary Disease  50% higher Alzheimer’s  11% higher Diabetes  5% higher Congestive Heart Failure  12% higher Stroke Compared to Medicare FFS Dual Eligibles:

4. SNP Alliance Survey UCare Utilization Results 2011 4  Physician visits are slightly higher compared to Medicare FFS Dual Eligibles  Hospital inpatient days: 35% lower admits than FFS Dual Eligibles  Lower: Admissions Observation days Re-admits within 30 days  Emergency room rate is 44% less than FFS Dual Eligible rate

5. UCare MSHO Member Satisfaction Survey Results 5 93% know their Care Coordinator 91% are satisfied/very satisfied with their Care Coordinator 92% said they are asked for input by their Care Coordinator 66% saw health improvement since working with Coordinator 93% discuss ways to improve their health with their Care Coordinator

6. MSHO Initiatives 6  Strong & Stable Fitness Kit  Health guide for MSHO members  Address health care disparities through supporting, developing, and building cultural competency

7. “Your Health Guide” Routine screenings, immunizations, healthy tips 7

8. Supporting Culturally Competent Care 8 UCare funds the Culture Care Connection, an online resource with demographic information to help all providers deliver culturally competent care to a changing population Knowledge = engagement = improved care compliance and health outcomes

9. Models of Care Delivery for Dual Eligibles 9  Lakewood Health System  Critical Access Hospital system  Rural patient centered ACO  Focus: - primary care - proactive coordinated care  Joint initiative with the health plan Fairview Partners  Hospital Care System/Nursing Home partnership  Primary care to NH and Assisted Living  Proactive and coordinated care model  NH and Assisted Living required to take a portion of the risk CareChoice  39 member consortium of non profit skilled nursing facilities  Includes “in-lieu” of day payment model  P4P payments: Flu vaccines Falls prevention POLST Form use Palliative Care use In-patient Days

10. Models of Care Delivery for Dual Eligibles 10 Lakewood Health System  Clinic visits trended downward by about 42%  Total cost of care per clinic visit, per enrollee, decreased by 37%. Includes Lakewood system visits and out-of-system referrals  Inpatient admissions reduced by 18%  Medication costs per enrollee trended downward by 38% Fairview Partners  Risk-sharing arrangement includes nursing homes  Model allows for annual risk-sharing of both gains/losses of total revenue excluding Part D benefits  261 MSHO members CareChoice  Reduction of inpatient days per 1,000 by 12%  95% of UCare MSHO members in CareChoice facilities offered a flu shot  Falls prevention program maintains a ratio of falls with injury of less than 1% per year – ultimately saves dollars

11. Provider Strategies 11  Engage providers with P4P program - focus on preventive care and health outcomes - aligns with Star Ratings measures  Outstanding P4P providers honored at annual Salute to Excellence! event  Prepare providers for increased patient interest in specific health topics, prompted by our direct outreach to members in support of Star Rating goals  Feedback to providers on percentage of UCare members receiving recommended preventive care and disease management measures

12. Thank You Ghita Worcester Senior Vice President of Public Affairs and Marketing at UCare 612-676-3634 gworcester@ucare.org MSHO video with member story: http://bit.ly/Tf25kp 12