UPlan Medication Therapy Management (MTM) MTM Marketing Seminar – 3/15/2011

1. UPlan Medication Therapy Management (MTM)MTM Marketing Seminar – 3/15/2011

2. MTM Discussion Topics • UPlan Pharmacy Program • UPlan decision to add MTM • MTM program and structure • MTM communications and target marketing • MTM Preliminary Information

3. UPlan Pharmacy Program

4. UPlan Medical Program • Two Medical Administrators — Medica & HealthPartners / Five Plan Types • Carve Out Pharmacy Program — Prime Therapeutics (originally RxAmerica/CVS Caremark) • Wellness Program — through Healthways and StayWell

5. UPlan Pharmacy Program • Pharmacy Contract is completely pass through / transparent • Formulary Development • Utilize PBM formulary with University input • Rely on College of Pharmacy Expertise • New Specialty Program effective 1/1/2011 • High cost medications for complex conditions • Fairview Specialty Pharmacy, Fairview hospital or clinic pharmacies • SMDC or St. Luke’s in Duluth

6. Pharmacy Program Statistics • 39,000 Members • 30,300 Members with Prescriptions • 370,800 Prescriptions • $33 Million Total Drug Cost • Focus on Generic Medications • 50.4% : January – December 2005 • 74.2% : January – December 2010 • 75.1% : December 2010

7. Pharmacy Benefit Design

8. UPlan Decision to Add MTM

9. Decision to Add MTM • UPlan decisions: • Made by administration committee — AWG • Reviewed with employee committee — BAC • UPlan focus on evidence-based medicine • Outcomes & ROI • Ashville, NC Results • 2008 U of M Study — Isetts, Schondelmeyer et al • BCBS/Fairview MTM Patients • Pilot Program: UMD, November 2007 to February 2009 • Helped determine structure & operation of new MTM program • All UPlan MTM program — March 2009

10. MTM Program & Structure

11. MTM Eligibility • UPlan active employees, early retirees, dependents • Four or more UPlan covered medications • Not specific disease focused but most patients have chronic conditions • 10,000 Eligible Members • Physician Referral

12. $8 MTM Copay Reductions

13. Participating in MTM • Participants select MTM pharmacist from Directory and make appointment • Participants sign Participation Agreement and enroll through PBM • Pharmacy visits are face-to-face • Option for tele-med visits for out of area participants • Encourage three or more visits first year / two or more visits subsequent years • No cost to member for Pharmacy visits • Pharmacist claims paid by two medical plans using MTM procedure codes

14. UPlan MTM Network • Developed internally with College of Pharmacy • Same MTM network for both Medical Plans • 101 Pharmacists, 146 locations, 30 contracting entities • Includes pharmacists for U of M, major local care systems, and local chain & independent pharmacies

15. MTM Program Structure • MTM Network Manager & Coordinator • Credential and contract network pharmacists for the University • Manage activities of Peer Advisory Committee • MTM pharmacist coaching • Peer Review process • MTM Executive Committee • College of Pharmacy and Employee Benefits • Responsible for: • MTM program operations • Communications and target marketing, • Program evaluation

16. MTM Communications & Target Marketing

17. MTM General Communications • Written Communications • Newsletters, brochures, letters • Emails • Employee Benefits website • www.umn.edu/ohr/benefits/pharmacy/mtm/ • Network Directory, Enrollment Form, PowerPoint Presentation • Customer Service Communications • Employee Benefits, Health Plans, PBM • Pharmacy Network Communications • Emails, newsletters, website • www.umn.edu/ohr/benefits/pharmacy/mtmproviders/

18. MTM Target Marketing • Target Marketing — Pilot Program • University of MN — Duluth • Letters & brochures, plus 2 follow-up phone calls • Handled by RxAmerica as PBM • Target Marketing — UPlan-wide Program • Letters & brochures, plus 2 follow-up phone calls • Handled by each member’s medical plan • Better response through medical plan target marketing • Enrollment results • 722 members (about half from target marketing) • 10,000 eligible / 7% overall participation • 56 of 722 still have incentives remaining

19. MTM Preliminary Information(data from Medica members only)

20. Comparative Predicted Risk Score +340% Source: Johns Hopkins Adjusted Clinical Group Analysis

21. Chronic Disease Comorbidity % of members with multiple chronic conditions number of chronic conditions Source: Johns Hopkins Adjusted Clinical Group Analysis

22. Types of Visits Source: Claims review Jan – Aug 2010

23. MTM – from a Patient’s Perspective Initially enrolled due to copay reductions True value — excellent advice from MTM pharmacist Helped me understand how medications work Side-effects Interaction with over-the-counter medications Communicated regularly with my physician Helped me make important decisions about my medications and my health care

24. UPlan Medication Therapy Management (MTM)MTM Marketing Seminar – 3/15/2011