Health Information Technology: Driving Improvements in Medicaid

1. Health Information Technology: Driving Improvements in Medicaid Don Imholz Executive Vice President and Chief Information Officer

2. Provides health plans, programs and related services Centene Corporation • Coordinated care of government sponsored programs • Medicaid, TANF, SSI, CHIP, foster care, special needs plans • Contracts with 81,000 physicians, 950 hospitals and 255 Federally Qualified Health Centers (FQHCs) • Seven health management companies • Health plan services offered in 12 states with multiple product lines* *In Arkansas, a Centene subsidiary acts as a Third Party Administrator (TPA). Kentucky and Louisiana health plans are currently in implementation.

3. 1.6 million members Children Women who are pregnant Adults Foster care Long-term care programs 72% of our members are 18 years old or younger Our Members 18+ Years old 18+ Years old 0-18 Years old 0-18 Years old

4. Historical Relationship Payers and Providers Payers Providers Eligibles Claims Payments

5. Managed Care Mission Now Way Beyond Claims Providers Managed Care

6. Health IT is Vital to Improve Outcomes and Lower Costs • Manual Task Automation • Routine – e.g. Keying in Information • Non-Routine – e.g. Identification of Exceptions • Speed of Information Movement • Electronic versus Paper • Standards • Quality of Information • Capture Electronically – e.g. Bar Codes • Edit at Source • Process Simplification • Integrate and Compare Data • Standards • One Medication Error per Day Per Hospital Patient • Every 7th Admission Unnecessary • Every 5th Lab Test Unnecessary • Source: National Quality Forum “Information is the lifeblood of modern medicine. Health information technology (HIT) is destined to be its circulatory system.” David Blumenthal, M.D., M.P.P

7. Four Broad Areas of Health IT Information Analysis Point of Care Technology Information Sharing Reduced Admin Effort

8. Centene has Invested in Health IT Information Analysis Point of Care Technology Information Sharing Reduced Admin Effort

9. Centene Created EHR for Texas Foster Care • Health Passport is a patient-centered, internet-based health record that allows healthcare providers to overcome the information barriers that exist within a transient population • Using state-of-the-art technology, Health Passport improves care coordination, eliminates redundancy, and reduces provider errors by providing secure access to the member’s treatment history • Including prescription drug utilization, immunization history, reported allergies, past doctor visits, behavioral health history, laboratory tests, vital signs and patient demographics

10. EHR Challenges • Who Pays • Who Manages • Scalability • Standards • Privacy • Measuring the Benefit

11. EHR Benefits are Many Once Data Captured • Increase knowledge of past care episodes and outcomes Inform Clinical Practice Improve Clinical Outcomes Interconnect Stakeholders Interconnect Providers • Allow records to follow patients and reduce waste and errors ElectronicHealthRecord • Expand publichealth knowledge localized to specific communities ImprovePopulation Health ImproveCommunity Health Personalize Care Personalize Patient Care • Involve patients more in their care

12. Progress in Adoption is Accelerating 12 Percent reporting ROUTINE: Electronic ordering of laboratory tests Electronic access to your patients' test results Electronic prescribing of medication Percent Source: 2009 Commonwealth Fund International Health Policy Survey of Primary Care Physicians.

13. “Network Effect” Will Drive Accelerated Usage/Value Source: 2008 Deloitte Survey of Health Care Consumers

14. Observations • Funding Supports Strong Investments • Standards • Change Management • Cost Drivers • Technology Advancement Necessary but Not Sufficient

15. Conclusion: Quality of Care will Drive EHR Adoption “That it will ever come into general use, notwithstanding its value, is extremely doubtful because its beneficial application requires much time and gives a good bit of trouble, both to the patient and to the practitioner because its hue and character are foreign and opposed to all our habits and associations.” from The London Times in 1834 Commenting on ... the “stethoscope”