CareEnhance Review Manager (CERMe) InterQual 2011 For HomeTown Health, LLC

1. CareEnhance Review Manager (CERMe)InterQual 2011 For HomeTown Health, LLC Richard Gentry Sale Executive McKesson Health Solutions Version Date 10/2011

2. Agenda • McKesson Background • InterQual Criteria Overview • CareEnhance Review Manager (CERMe) Software • Interrater Reliability (IRR) • Q&A

3. Thank You!!! • Bleckley Memorial Hospital • Effingham Hospital • Burke Medical Center • Smith Northview • Irwin County Hospital • Washington County • Dr. Hospital of Tattnall • Jefferson County Hospital • Wills Memorial Hospital • Ty Cobb

4. Agenda • McKesson Background • InterQual Overview • CareEnhance Review Manager (CERMe) • Interrater Reliability (IRR) • Q&A

5. A 360o View of HealthcareTouching Healthcare Players at Every Point of Care Manufacturers 400 Pharmaceutical 2,000 Medical-Surgical 950 Consumer Product Healthcare Providers 200,000 Physicians 10,000 Long-Term Care Facilities 5,000 Hospitals (including VA and DoD) 750 Home Care Agencies Retail Pharmacies 26,000 Locations Health Plans 600 Payor Organizations (Public and Private) Consumers 25 Million Covered Lives

6. Agenda • McKesson Background • InterQual Overview • CareEnhance Review Manager (CERMe • Interrater Reliability (IRR) • Q&A

7. Payor Overview Provider Overview Government Overview InterQual is the most widely used EBM criteria in Payors • 300 payor organizations • 7 of the top 10 payors • 54% of Blues plans license InterQual* • 90% of the Top 10 Managed Medicare Plans • 80% of the Top 10 Managed Medicaid Plans *According to the list of 39 Blues plans by corporate roll up, according to BCBS Association Website InterQual is the most widely used EBM criteria in Providers • 3700 hospitals; 60% of all hospitals in the USA • Gold standard since 1978 • Clients Include: • Tenet • Kindred Healthcare • HCA • Select Health • UPMC InterQual is the most widely used EBM criteria in Government • 47 QIOs [of the 53], representing 44 states plus DC, VI and PR • All 9 Medicare administrative contractors conducting audits • The Iowa Foundation • Military Health Systems • Department of Veteran Affairs, 21 VISNs, with 175 total facilities • Federal Bureau of Prisons InterQual Promoting Collaboration of Care for > 35 years Key  Payor  Provider Government Alignment

8. InterQual® Strengths Market leader and pioneer in evidence-based care management Unparalleled scope of objective clinical content National consistency Unsurpassed quality of clinical content Inter-rater reliability tools Promoting transparency of content

9. InterQual The Most Comprehensive Guideline Set InterQual Content Clinical Evidence Summaries Physician White Papers Support 2nd Level Review Assists with the Controversial Issues Level of Care Criteria Behavioral Health Criteria SIMplusRetrospective Monitoring Criteria Care Planning Criteria Acute Care Molecular Diagnostics Psychiatry Adolescent Child Long-Term Acute Care Imaging Adult Geriatric Rehabilitation Procedures Chemical Dependency & Dual Diagnosis Subacute & SNF Specialty Referral Home Care Residential & Community-Based Treatment Durable Medical Equipment Outpatient Rehab & Chiropractic

10. Agenda • McKesson Background • InterQual Overview • CareEnhance Review Manager (CERMe) • Interrater Reliability (IRR) • Q&A

11. Challenges Remain for end users using criteria manuals • Workflow efficiencies • Documentation, communications and collaboration with physicians and multi-disciplinary teams using criteria • Consistency, Standardization and Comfort in review outcome determinations and reporting outcomes

12. SOFTWARE MAKES IT EASY CareEnhance Review ManagerCERMe

13. Workflow efficiencies from software makes it easy for you to: • Schedule, identify and prioritize cases in your caseload that you need to review today • Request a secondary review on a case from a supervisor or physician advisor with a key stroke • Eliminate phone queue waits to payors • Facility-wide access to InterQual Guidelines • Accurately reflect active patient co-morbidities by key stroke using criteria • Document a review summary in the time it takes to read criteria

14. Patient Review Work List

15. Begin Review Process Select Level of Care

16. Select Category • Condition Specific • Observation • Critical Care • Intermediate Care • Acute Care • Quality Indicators

17. Select Subset

18. Red Box Means Criteria Not Met Begin Review

19. Green Box Means Criteria Met Check Off Appropriate Conditions

20. Review Summary Auto Fax to Payor

21. Clinical Evidence Summary

22. Quality Indicators

23. Risk Factors

24. Expected Discharge Level of Care

25. Full Patient History Easily View Past Reviews

26. Standard Reports

27. Enhanced Reports

28. CareEnhance Review Manager (CERMe)Web Demo Scheduled for Monthly Richard Gentry 704-483-4872, richard.gentry@mckesson.com Sale Executive McKesson Health Solutions Version Date 06/22/2010

29. Online Interrater Reliability SuiteWhy? • Accreditation requirements • NCQA, • Consistency in decision making • Competency assessment • Assurance that your organization is getting value from the InterQual criteria Footnote area: Arial 9pt

30. Online Interrater Reliability Tool SuiteStandard Offering Description Drive the maximum value out of your staff’s use of InterQual. Assess a group and/or an individual reviewer’s ability to consistently apply InterQual Criteria, via case studies, for the most current release of InterQual Criteria; document results with standard reports. • Online IRR tool, accessed from any browser • Content is reviewed and updated annually in June • One system administrator account is issued • 10 Tests Available Procedures Imaging BH Adult Psych BH Adolescent /Child Psych BH Chemical Dependency & Dual Diagnosis-Adult and Adolescent • Acute, Adult & Pediatric • Long-term Acute Care • Rehab • Sub acute Care / Skilled Nursing Facility • Home Care

31. Agenda • McKesson Background • InterQual Overview • CareEnhance Review Manager (CERMe) • Interrater Reliability (IRR) • Q&A