Medicare Star Quality Initiatives

1. Medicare Star Quality Initiatives HCC�s the Revenue Driver to Success

2. Medicare Star Ratings P4P for Medicare Quality Metrics HEDIS Driven National Initiative for all Medicare Advantage Health Plan Centric Consolidation of Medical Group Results

3. Star Measures Differentiator for Health Plans Significant Financial Drivers- 5% of Bid Revenue Differentiates Excellent versus Poor Performers The goal is to obtain the 5 Star Rating - Year long Open Enrollment for 5 Star Health Plans

5. Medicare Star P4P Medical Groups that excel will: Collect data Self-report Perform well on Commercial P4P Programs

8. The Key to Success HCC�s The most successful initiative for Medical Groups who excel Financial driver BUT CLINICAL INITIATIVE WINS TEAM PLAY

9. HCC�S Quality Initiative Clinical Excellence in Differential Diagnosis Physician Led Entire Health Care Team Not just a data game Not a coding game

11. HCC = Medicare Star Every Star Quality Initiative is associated with and HCC Clinical Quality Initiative Bi-directional Quality Initiative Senior Evaluations

12. COPD Spirometry Screening for COPD Detection for HCC Dx On COPD Dx- without COPD- Spirometry to confirm and or stage the Disease HCC = Medicare Star

13. Rheumatoid Arthritis HCC = Increase Diagnostic Detection Medicare Star= HCC increase diagnosis drives improved Treatment with DMARD HCC = Medicare Star

14. Osteoporosis Screening and Prevention HCC= Pathologic Fractures and Underlying Osteoporosis Bi-directional Clinical Initiative Pathologic Fractures = screening + staging Improved Disease recognition and prevention

15. Falls Prevention and Risk Assessment HCC= Senior Evaluation and Geriatric Focus Team Care Screen all seniors and intervene appropriately

16. Flu and Pneumonia Vaccine Senior Assessment Quality Driven HCC= Pneumonia and Respiratory Illness and Evaluation Yearly Evaluation

17. Incontinence HCC= Senior Assessment Quality Driven ACOVE Protocols Dollars + Quality Bi-directional = Urologic Focus and Senior Prevention

18. Senior Yearly Evaluation Improved HCC Diagnosis Improved Medicare Star Screening HCC= Medicare Star Improved Quality

19. Disease Treatment HCC improved Diagnosis Medicare Star Improved Treatment Diabetes CHF COPD Medication Reconciliation and Adherence Program

20. HCC + Medicare Star Revenue + Quality Patient Focused Care Physician By in Organizational support Aligned Incentives Improved outcomes