© 2008 WellCare Health Plans Inc. All rights reserved. January 14, 2009 WellCare of Florida, Inc HealthEase of Florida, Inc. Well-Child visits in the Third, Fourth, Fifth and Sixth Years of Life External Review Quarterly meeting Best Practices

p 1 5/13/2015 6:43 PM Reform WellCare rates 2007 Well-Child visits in the Third, Fourth, Fifth and Sixth Years of life

p 2 5/13/2015 6:43 PM NonReform WellCare rates Well-Child visits in the Third, Fourth, Fifth and Sixth Years of life

p 3 5/13/2015 6:43 PM Well-Child Visits in the Third, Fourth, Fifth and Sixth Years of Life Identified Barriers Members: non-compliance, lack of knowledge Providers: lack of tracking systems, lack of knowledge, incomplete data submission, not performing all services for a well-child exam Systems: incomplete data capture of claims/encounters from providers, member demographic information not current thus reminders/educational materials not received *HEDIS 2009, Volume 2

p 4 5/13/2015 6:43 PM Well-Child visits in the Third, Fourth, Fifth and Sixth Years of life Provider Interventions Network Improvement Program (NIP) visits to targeted PCP’s with high non-compliant HEDIS rates Distribution of non-compliant reports to PCP’s listing members non- compliant with targeted HEDIS measures including well-child visits Monthly membership lists mailed to PCP’s which includes preventive care needed for each member Newsletter articles regarding the importance of well-child visits Distribution of training material and Well-child forms for physicians

p 5 5/13/2015 6:43 PM Well-Child visits in the Third, Fourth, Fifth and Sixth Years of life Member Interventions Special mailing to noncompliant members during 4 th quarter Contracted with different HEDIS data collection vendor due to identified challenges with previous vendor; nurses with new vendor were trained on specifically assigned measures Trained contracted WellCare nurses on-site to perform overreads on HEDIS sample of non-compliant records to determine if visits done or to identify alternate sites Automated member outreach phone calls to non compliant members reminding them to obtain a well-child visit Calls to noncompliant members in the sample to determine where services were received. Periodicity letters mailed to parents of members non-compliant with well-child visits reminding them of the importance of well-child visits

p 6 5/13/2015 6:43 PM Well-Child visits in the Third, Fourth, Fifth and Sixth Years of life 2008 Interventions to continue to improve the rate of well-child visits: Database developed to include non-compliant members for well- child in all age groups; reports generated from this database included provider specific non-compliant scores and listing of non- compliant members. As a result of working these lists, capitated providers were identified who had not submitted encounters to WellCare Workgroup established to identify providers submitting encounters and monitor submission of encounters monthly Hiring of additional quality improvement staff per plan region to intensify collaborative quality efforts with providers

p 7 5/13/2015 6:43 PM Well-Child visits in the Third, Fourth, Fifth and Sixth Years of life 2008 Interventions to continue to improve the rate of well-child visits: Well-child educational materials developed for distribution to providers to include coding ‘cheat sheet’ and other well-child requirements such as examples of anticipatory guidance Provider resources developed such as a medical record tracking tool for well-child visits and a well-child provider toolkit for posting on the provider web portal Targeted provider office education on HEDIS measures to include well-child visits requirements