Expanding Statewide Collaboration & Connectivity: A Network Update 1 Melissa Kotrys, MPH CEO, Arizona Health-e Connection (AzHeC) November 2015

Agenda Current State – What is The Network? – Services & Benefits – Who is The Network? Future State – New Service Opportunities – Collaborative Activities Questions? 2

What is The Network? 3

A Community Collaboration Community Providers Labs Health Plans HospitalsACOs Public Health Others 4

5 Network of Networks ⁻Direct connections ⁻Hospitals, health plans, community health centers, etc. ⁻Other provider-based networks ⁻ACOs, IDNs, clinically integrated networks, etc. ⁻National health information network (eHealth Exchange) ⁻VA, SSA, DoD, out-of-state HIEs, & IHS The Network currently supports a standard data set: ⁻ADT transactions (problem lists, allergies, procedures, insurance, etc.) ⁻Medications ⁻Lab results ⁻Transcribed reports ⁻Radiology reports What is The Network?

YTD Inbound Transaction Volumes 2015 Transaction Type October Totals YTD Monthly Average YTD Totals ADT 2,873,761 3,309,72133,097,213 Lab 2,344,806 2,502,45925,024,592 Radiology 183,741233,111 2,331,112 Transcription 714,080458,909 4,589,090 SIU – Scheduling 0 17, ,357 Totals6,116,3886,521,83665,218, million patients in the MPI 4.7 million patients with clinical data 6.5 million transactions processed monthly 75+ million transactions projected for

7 YTD Inbound Transaction Volumes

Participant Data Supplier Data Supplied Hospitals Banner Health All Benson Hospital All Carondelet Health Network All Copper Queen Community Hospital All Kingman Hospital All Little Colorado Medical Center All Maricopa Integrated Health System All except TRN Mt. Graham Regional Medical Center All Wickenburg Hospital All Yuma Regional Medical Center All except TRN Providers & Labs El Rio Health Center All Mariposa Health Center All Sonora Quest Laboratories All Multi-Specialty Interdisciplinary Clinics (CRS) - Phoenix ADT & SIU Multi-Specialty Interdisciplinary Clinics (CRS) - Tucson ADT & SIU The Network’s Data Supplier Status 8 TRN = transcribed reports ADT = admit/discharge/transfer SIU = scheduling info update

YTD Outbound Transaction Volumes Transaction Type October Totals YTD Totals CCD Transactions 1,3421,526 HL7 Outbound Transactions 66,41194,869 Query-Response Transactions 00 Alerts & Notifications 78,750186,799 Portal Access 2,5366,803 Totals149,039289,997

10 YTD Outbound Transaction Volumes

Services & Benefits 11

Network Services Bidirectional Information Exchange Push/pull or query/response functionality Provider Portal/Payer Portal Download and single-sign-on EHR integration capabilities Alerts & Notifications Delivery of ADT Alerts and Clinical Results Notifications in both human and machine readable formats Direct Secure Secure for clinical information exchange; DirectTrust certified and HIPAA compliant Public Health Reporting (coming soon!) ADHS connections for immunization registry, electronic lab reporting, syndromic surveillance and disease registries eHealth Exchange Supports exchange with VA, SSA, DOD, out-of-state HIEs, and IHS later this year 12

Network Services: A Bundled Approach Bundled package for all participants includes: Interface fees for Bidirectional Exchange (HL7v2, C-CDA) Unlimited Provider/Payer Portal access Unlimited Direct Secure accounts Unlimited Alerts & Notifications eHealth Exchange connectivity (query/response) Public Health Reporting connectivity 13

Network Fee Structure -- As more organizations participate, fees lower for everyone FREE services for community providers All payments bundled = no separate interface fees, add-ons, etc. -- After other funding sources incorporated, hospital and health plans split Network operational costs Hospitals pay based on discharges (per discharge rate) Health plans pay based on allocated share (agreed upon by plans) Fees for other stakeholder types under consideration Keeping rates low based on continued availability of AHCCCS HIE Subsidy Program funding to subsidize participant rates Many Network Participants are required to be an AzHeC member and pay AzHeC membership dues in addition to Network fees 14

Statewide HIE Benefits One Connection New Patient Information Timely Information to Coordinate Care Medical Histories from Out-of-State Sources Secure Communication 15

Who is The Network? 16

Current Participation Current participants* include 54 entities: 14 Health Systems/Hospitals (57% of all inpatient discharges) 22 Community Provider Organizations Including FQHCs & rural health clinics 12 Health Plans 2 Reference Labs 2 Counties (corrections, etc.) 1 Behavioral Health Provider 1 Behavioral Health HIE *Note: Participants are defined as organizations who have signed a Network Participation Agreement. This information is accurate as of September Specific information regarding which participants are supplying and using data is included in presentation. 17

Current Participants Banner Health Benson Hospital Carondelet Health Network Cobre Valley Regional Medical Ctr* Copper Queen Community Hospital Kingman Regional Medical Center Little Colorado Medical Center Maricopa Integrated Health System Mount Graham Regional Medical Center Northern Arizona Healthcare Summit Healthcare Regional Medical Center TMC HealthCare Wickenburg Community Hospital Yuma Regional Medical Center 18 Note: A Network “Participant” is an organization that has signed a Network Participation Agreement. These organizations are either already connected to The Network or in the process of connecting. Hospitals participating in the Medicaid EHR Incentive Program with AHCCCS are eligible to receive financial incentives for Network participation. Health Systems & Hospitals (14) - ~57% of all statewide inpatient discharges *New Participant within 90-days

19 Note: A Network “Participant” is an organization that has signed a Network Participation Agreement. These organizations are either already connected to The Network or in the process of connecting. Current Participants FQHCs and RHCs participating in the Medicaid EHR Incentive Program with AHCCCS are eligible to receive financial incentives for Network participation. Adelante Healthcare, Inc. Chiricahua Community Health Center* Desert Senita Community Health Center El Rio Community Health Center Marana Health Center Mariposa Community Health Center Mountain Park Health Center North Country HealthCare* San Luis Walk-In Clinic Sun Life Family Health Center* Sunset Community Health Center Arizona Sun Family Medicine* Children’s Clinics (Tucson) Barnet Dulaney Perkins Eye Center* District Medical Group MD 24 House Call, Inc. Med-Cure Internal Medicine* New Pueblo Medicine* Page Family Practice* Pima Lung & Sleep Center* Valley Anesthesiology & Pain Consultants Virginia G. Piper St. Vincent DePaul Clinics* FQHCs & Rural Health Centers (11)Community Providers (11) *New Participant within 90-days

20 Note: A Network “Participant” is an organization that has signed a Network Participation Agreement. These organizations are either already connected to The Network or in the process of connecting. Current Participants AZ Health Care Cost Containment System (AHCCCS) Bridgeway Health Solutions Care 1 st Health Plan Cenpatico Integrated Care Health Choice Arizona HealthNet Maricopa Health Plan Mercy Care Plan Mercy Maricopa Integrated Care Phoenix Health Plan United Healthcare University of Arizona Health Plans Behavioral Health Information Network of Arizona (BHINAZ) ConnectionsAz* LabCorp Maricopa County Pima County (Corrections) Sonora Quest Laboratories Health Plans (12)Other Health Care Organizations (6) *New Participant within 90-days

Connections Coming Soon! Data flowing by end of 2015 or early 2016: Tucson Medical Center Northern Arizona Healthcare Banner University facilities Verbal commitments to participate very soon: Abrazo Health Dignity Health Phoenix Children’s Hospital Other small and critical access hospitals 21

Future Network Activities 22

Upcoming Opportunities Expanded Network Participation The Practice Innovation Institute Integrated Physical & Behavioral HIE Expansion of HIE Services

Expanded Network Participation Hospital participation – 75-80% annual discharges by early 2016 – Close to 100% discharges by end of 2016 Health plan participation – Additional commercial plan participation in 2016 Community Health Centers – Close to 100% participation by early 2016 Community Providers & ACOs – Significant expansion expected in 2016

Expanded Network Participation Working with EHR vendors to support provider connectivity – athenahealth – eClinicalWorks – Greenway – NextGen Conducting regional events to connect community providers to local and regional hospitals – Kingman – Northern Arizona – Yuma Other interested stakeholder groups – West Valley Care Coordination Coalition – First responders – Corrections and justice transition activities

$3.6 million (October 2015 – September 2016) Arizona Wins! Performance Period October 2015 to September 2019 Potential of $14.6 million over 4 years Target 2,500 providers All practices to be active Network participants & users

Integrated Physical & Behavioral HIE State Innovation Model (SIM) HIT/HIE Plan AHCCCS received $2.5 million CMS grant AzHeC responsible for HIT portion of SIM Plan Final plan due late spring 2016 Statewide HIE Integration Plan for physical and behavioral health AHCCCS & RBHAs support fully integrated HIE Developing a plan for statewide HIE integration One statewide HIE platform – The Network One consistent communication strategy One financial model for physical and behavioral health Plan to be complete in January 2016 Crisis portal for Maricopa County – December 2015

Expansion of HIE Services Community collaboration for common technology needs benefits everyone… Expanded “Permitted Use” definition HIE Subsidy Program expansion – HIE workflow support coming in 2016! Future HIE services (based on community need) Quality improvement reporting (TCPI) Analytics & population health (TCPI) Personal health record Image sharing Referral management Secure text messaging And more… 28

Community Collaboration is Key! Community collaboration for common technology needs benefits everyone… To be most valuable to the community, need ALL hospitals and health plans participating Keeping rates low based on continued availability of AHCCCS HIE Subsidy Program funding to subsidize participant rates As we move forward, need to continue exploring long term sustainability options for statewide HIE 29

Arizona Health-e Connection Questions?