1. Trends in Disease Management Quality Improvement THE QUALITY COLLOQUIUM August 22, 2006

2. Speakers Carolyn Hartley, MLA, Moderator Michael Bryant, MD, FACS, President Sandhills Physicians, Inc., Doctors Direct Heatlhcare, LLC Harry Spring, Chairman and CEO InforMed Medical Management Services

4. Introduction

5. Objectives Identify trends in disease management Improve competency in using technology to capture and process relevant health data Identify high risk patients using secure access Develop care plans to manage chronic care patients. Understand how quality care directly affects employer health costs through a dynamic case study.

6. Trends in Disease Management Michael Bryant, MD, FACS, President, Sandhills Physicians, Inc. Doctors Direct Heatlhcare, LLC

7. Trends in Disease Management: Data is King  Refined data collection and reporting  Detailed costs in Category of Care (COC)  Evaluation of financial and clinical data  Education of patient, physician and employer

8. How Technology Improves Competency  Focuses on clinical areas of improvement  Allows immediate reference to clinical guidelines  Allows provider evaluation  Collective data for Pay for Performance (P4P)

9. Identify High Risk Patients  Disease Risk Profile (HRA)  KNOW YOUR NUMBER KNOW YOUR NUMBER  High dollar claimants  Identifies and categorizes diseased populations  Identify high cost cases (both long term and short term services)

10. Care Plans  Development of specialty specific clinical guidelines  Monitoring patients with specific disease states  Physician and patient compliance with evidence based medicine guidelines  Foundation of P4P initiative

11. Sandhills Physicians’ Story  Data management and repository  Informed  Clinical guidelines/EBM connect  Healthy Living program  Physician directed disease mgt/ case mgt  IPA initiated P4P

12. Case Study

13. Pay for Performance Performance of Internal Medicine Providers

14. Summary Identify trends in disease management Improve competency in using technology to capture and process relevant health data Identify high risk patients using secure access Develop care plans to manage chronic care patients. Understand how quality care directly affects employer health costs through a dynamic case study.