Telehealth Pilot Project

1. Telehealth Pilot Project Mark Schweyer, BSN, MBA Director of Telehealth Programs

2. California Health & Wellness California Health & Wellness is a Medi-Cal managed care organization • Established in 2013 • 19 Rural Counties • Most providers and members are new to managed care concepts • Subsidiary of Centene Corporation

3. ACA Impact on Medi-Cal • Pre-ACA Medi-Cal Population • Traditionally TANF (Womenand Children) & SPDs • Post ACA Medi-Cal Population • Expanded Medi-Cal eligibility • Added new populations • Duals • MCE • 12.5 million enrollees • 1 out of 3 Californians

4. Provider Network in Rural Counties Heavy reliance on FQHCs and RHCs Continued access & availability challenges Historic low levels of providers that see Medi-Cal patients Alternate approaches required to meet the needs of the members Contracted outside of county Enhanced provider network to align with existing travel patterns Enhanced transportation benefit Promoted use of physician extenders and community health workers Telehealth Solutions Rural California Post ACA

5. Three Core Objectives:

6. Telehealth Solutions ELECTRONIC CONSULTATION STORE-AND-FORWARD LIVE VIDEO

7. Telehealth Solutions VIDEO REMOTE INTERPRETATION

8. Centralized Scheduling • A single point of contact for our members, primary care practitioners, and multi-specialty provider groups • Alignment with our extensive array specialty companies that offer assistance with coordination of transportation benefits, case-management, behavioral health services, and member connection services • Scheduling coordination acrossmultiple primary care sites and multi-specialty groups that enhancing care coordination and allows for opportunities to ensure that we are meeting our access and availability standards.

9. Centralized Scheduling • Coordination of clinical documentation transfer from primary care sites to specialty providers • Creates workflow efficiencies at both the primary care sites and for specialty groups • Reduces incidence of member no-shows through timely and personalized scheduling that connects members with resources needed to attend appointments

10. Goals • Increase provider and member satisfaction through the offering of easy, secure and efficient programs and services. • Increase access to quality specialists and optimize face to face visits. • Develop new models of care that build capacity within the community, reinforce existing programs and increase the ability of PCPs to manage basic specialty services. • Improve the management of disease/chronic illness among high-risk members. • Ensure that service offerings enhance the affordability of the network and do not increase care delivery costs. • Reduction in ER utilization and long-distance travel expense.

11. Measuring and Ensuring Success • Development of specific performance metrics • Continuous quality oversight through data analysis • Working closely with the State of California to ensure alignment of telehealth efforts with Medi-Cal payment models • Starting with less complex service deliverables: Store-and-Forward technologies, video remote interpretation • Developing new solutions based on historical lessons learned

12. A New World • Health plan payer support • Provider partnerships • Thoughtfully designed pilot program