1. Connections for Increasing Revenue Payer – Provider Connect
Kelly Gregg, FHFMA, Chief Financial Officer, Diagnostic Clinic, Largo, Florida
Donna Maddox, Product Director, Integrated Care, GE Healthcare IT

2. Track Owners: Zinc Instructions Please update the chart to the right before submitting the presentation into Active
Individual Page Use?: No
Are all Uses and Applications Discussed or Referenced in the Proposed Material on Label for the Product?:
Yes
Relates to a Major new Product/Services Launch?:
Includes Product or Service Claims, Features, Benefits or similar information?:
Contains Competitive or Comparative Claims?:
Includes Return on investment (ROI), quantifiable cost of ownership, reimbursement, or meaningful use claim or reference?:
Include References to Market / Segment Share or Market / Segment Leadership?:
Include identifiable Patient Information / Data?:
If Customer Names are Used, are Necessary and Appropriate Permissions in Writing and on File?:
Yes – customer presenting
Include Customer Testimonials?:
If any non-GE Stock Images are Used, are Necessary and Appropriate Permissions in Writing and on File?:
NA – customer presenting
Do the Proposed Materials Contain Images of GE Products?:
Do all Product Images Depict the Device(s) Being Promoted in the Piece?: NA
This is a Translation of a Previously Approved Piece in Which no Changes Have Been Made?:
This is a Revision of a Document Previously Approved for Ad / Promo Use?: no
Following review and approval in Active, each presentation given by GE employees or customers at Centricity LIVE must be approved through Zinc
Jessica Diniz will be uploading each presentation into Zinc following Active review
Before submitting this presentation in Active for review, Track Owners must select the appropriate answer to each Legal and Regulatory question
ALL QUESTIONS MUST BE ANSWERED
If further substantiation is required, please the appropriate permissions, sources, or citations to so she can upload to the Zinc Gallery
Once the presentation is approved in Zinc, please delete this slide from the final deck before presenting at Centricity LIVE

4. The content of this section represents the views of the author and presenters. GE, the GE Monogram, Centricity and Imagination at Work are trademarks of General Electric Company.

5. Diagnostic Clinic
Multi-specialty medical practice with over 100 providers on staff
Serving over 400,000 patients
5 northwest Florida locations – Largo, Countryside, Palm Harbor, and St. Petersburg (2)
On-site laboratory and imaging services including x-ray, PET, MRI, and CT scan
Optical shop, audiology, podiatry, interventional spine care and physical therapy
Walgreen’s pharmacy on-site
H. Charles Cambell, M.D., FACS
President and CEO
Kelly Gregg, FHFMA,
Chief Financial Officer
James F. Rivenbark, III, M.D.  Chief Medical and Operations Officer

6. Medicare Advantage Members
Services and processes to maximize outcomes both Clinical and Financial
Advantage Care Center
Care Coordination – Transition Services
Value Based Revenue & Quality Management Department
Diagnostic Clinic is engaged in multiple risk and shared savings programs. We have to be nimble and responsive – patients and payers make choices that impact our bottom line.

7. Medicare Advantage
Private plan option accounts for over 30% of all Medicare enrollment. 1
Payments
CMS adjusts payments to MA plans based risk adjustment factor (RAF) which measures beneficiaries’ estimated relative costs based on demographics and health characteristics
Quality Bonus Payments based on Star rating system
Payers have information that can provide insight for improving clinical quality and financial outcomes for providers
Physicians are the owners of the clinical care quality and clinical documentation that are used to set premium levels for payers in capitated risk
1 ASPE Issue Brief, April 2014

8. Discovery

9. It’s Complicated and Important
Extract data from multiple systems
Transfer to paper check lists and spreadsheets
Update check lists and spreadsheets
Data entry into multiple systems

10. Florida Blue Owned by GuideWell Mutual Holding Company
850,000 + enrollees, 42 % market share
HMO, PPO, and regional PPO Medicare Advantage plans

11. Data Exchange Payer Data
Medicare Advantage members attributed to the provider organization
Patient Care Summary
Gaps in Care codified
Diagnosis
Diagnosis codes by member that have not been submitted in claims in the current calendar year (for HCC)
Member suspected diagnosis
Members expected and not completed quality codes ( Gaps in Care )
ADT data from BayCare
Provider Data
Service-based claims (already happens today)
Member Gap in Care resolutions (eg. service rendered, not medically relevant, etc.)
Member HCC resolutions (eg. diagnosis code, no longer medically relevant)
Members Quality Code resolutions
Member CCDAs (can include lab data)

12. Integrate Critical Information in Provider Workflow
ICD 9 association with HCC, visible in all work flow
Problem list ( diagnosis) reconciliation
Quality indicators codified including resolution
Coder support for quality reporting
Transition of care management
Patient and provider population metrics displayed in dashboard

13. Proof of Concept Demonstration
Proprietary and confidential. Proof of Concept – Not a current offering or product. Concept shown represents ongoing product research and development efforts. These research and development efforts are not products and may never become products. Not for sale.

14. Questions

15. Thank you for joining us For further information: Donna Maddox donna
Thank you for joining us For further information: Donna Maddox