Building a mobile member assessment

& engagement program

Program Goals & Objectives

Improve health outcomes and close gaps in care Identify new diagnoses through assessment and advanced diagnostics Improve member access and engagement rates Reduce cost for risk assessment programs Improve HEDIS and quality scores Improve patient satisfaction and convenience Optimize revenue through appropriate HCC coding

About HealthFair

Company founded in 1998 Largest fleet of mobile medical centers operating nationwide Over 1,000,000 patients assessed Clients include health plans, corporations, and hospitals Accredited by American College of Radiology (ACR) First to offer member assessments in mobile clinical setting Clinical services lead by a panel of Board Certified Physicians

HealthFair assists Health Plans and ACOs identify and reduce gaps in care through a unique member engagement and

assessment system using our fleet of mobile medical centers.

Some of Our Clients

Current Options for Member Assessments

1. Build/Operate Fixed Sites− Most expensive option− Limited number of locations makes it less convenient for member− Only partially resolves access problem

2. Send Nurses for Home or Office Visits− Limited throughput and diagnostic testing capabilities− Expensive and inefficient− CMS has contemplated restrictions on this practice

3. Sending Members Back to Primary Care Physicians− Provider engagement issues; disruptive to daily routine− Limited throughput and diagnostic testing capabilities (i.e. imaging)− Inconsistent coding and compliance

HealthFair: A New Solution

1. Five times the capacity and up to 40% lower cost than home assessments

2. Ability to perform advanced diagnostics during same visit

3. Consistent, specialized, and highly accurate coding

4. Highly compliant solution reducing audit risk; physician reviewed

5. Conducted in a clinical setting

6. Significantly improve patient access, convenience, and satisfaction

Services Available on Mobile Unit

Diagnostics & Imaging− Digital Mammography− Carotid Artery Ultrasound− Abdominal Aortic Aneurysm Ultrasound− Echocardiogram− Lower Extremity Arterial Doppler (LEAD)− Electrocardiogram (EKG)− Osteoporosis Screening− Peripheral Vascular Disease (PAD) Test− Diabetic Retinal Exam (DRE)

Laboratory Testing− Full Blood Draw - Colorectal Cancer− Lipids - Metabolic Panel− A1C - Glucose− PSA - hsCRP

Primary Care Services− Comprehensive Evaluation− Vision & Glaucoma Testing− Hearing Screening− Spirometry (COPD)− Immunizations− Body Mass Index− Cognitive Assessment− Family/Health History Review− Medication Review− Gait Analysis− Diabetic Foot Exam− Alcohol Misuse Screening− PHQ9 Depression Screening− Intensive Behavioral Therapy

Sample Testing Packages

Level 1 - At the Unit Level 2 - At the Unit Level 3 - Other Facilities

Test Name Test Name Test Name

Comprehensive Evaluation Ankle Brachial Index Colonoscopy

  Diabetic Foot Testing Echocardiogram Chest X-Ray

  CAGE Testing Glaucoma Screening Prostate Exam

  Cognitive Assessment Abdominal Aneurysm Ultrasound PAP Smear

  PHQ9 Depression Screening Bone Mass Measurement Alcohol Behavior Therapy

  Medication Review Carotid Ultrasound Intensive Behavior Therapy

  Family/Health History Review Vision & Hearing Test Medical Nutrition Therapy

  Gait Analysis EKG Smoking Cessation Therapy

  Blood Pressure / Pulse Pulmonary Function Test

  Body Mass Index  Flu Shot Blood Draw/Labs

 Lipid Panel Diabetes Screening

 Digital Mammography

Capture Gaps in Quality Scores (HEDIS,STAR,…)ACO

Measure DescriptionACO

Measure Description

1 Getting Timely Care, Appointments & Information 18 Depression Screening

2 How Well Your Doctors Communicate 19 Colorectal Cancer Screening

3 Patients' Rating of Doctor 20 Mammography Screening

4 Access to Specialist 21 Portion of Adults who had blood pressure screened in past 2 years

5 Health Promotion & Education 22 Hemoglobin A1c Control (HbA1c) (< 8 percent)

6 Shared Decision Making 23 Low Density Lipoprotein (LDL) (< 100 mg/dL)

7 Health Status/Functional Status 24 Blood Pressure (BP) < 140/90

8 Risk Standardized, All Condition Readmissions 25 Tobacco Non Use

9 ASC Admissions: COPD or Asthma in Older Adults 26 Aspirin Use

10 ASC Admissions: Heart Failure 27Percent of beneficiaries with diabetes whose HbA1c in poor control (> 9 percent)

11Percent of PCPs who Qualified for HER Incentive Payment 28 Percent of beneficiaries with hypertension whose BP < 140/90

12 Medication Reconciliation 29Percent of beneficiaries with IVD with complete lipid profile and LDL control < 100 mg/dL

13 Falls: Screening for Fall Risk 30Percent of beneficiaries with IVD who use Aspirin or other antithrombotic

14 Influenza Immunization 31 Beta-Blocker Therapy for LVSD

15 Pneumococcal Vaccination 32 Drug Therapy for Lowering LDL Cholesterol

16 Adult Weight Screening & Follow Up 33ACE Inhibitor or ARB Therapy for Patients with CAD & Diabetes &/or LVSD

17 Tobacco Use Assessment & Cessation Intervention    

The HealthFair Process4. TESTING & ASSESSMENT

3. APPOINTMENT SETTING

1. ANALYTICS & PLANNING

2. MEMBER OUTREACH

• Generate Suspect List for Targeting

• Analyze Member Demographics

• Develop Event Calendars

• Direct Mail Campaign• Outbound Phone Calls• Emails & Texting (if available)

• Primary & Specialty Care Services Performed

• Onsite Results Provided• Identification of Emergent Results

• Call Center Scheduling• Confirmation Email• Reminder Phone Call

The HealthFair Process

7. CARE MANAGEMENT

5. RESULTS INTERPRETATION

6. DATA SUBMISSION

• Reviewed by Board-Certified Physicians

• Proper Coding of Encounter• Claims Data Sent to Plan• Member Receives Results

• Results Integrated with Care Management Program

• Send results to PCP/Medical Home• Outreach to Members

Next Steps

1. Define patient selection criteria (gaps and risk analysis)

2. List of members by zip code

3. Develop calendar of events and proposal for a demonstration project