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without the prior written consent of the Company, is prohibited.

Providers as Keys to Success in Your ACA Markets:

The Impact of Government Benchmark Data for Your Government Businesses

AGENDA

2

The Plan

What’s Out There?

What to Do With It?

Govt Benchmarks in Action

About RowdMap

Q&A

All contents are proprietary to RowdMap, Inc. and are being provided on a confidential basis.Any use, reproduction or distribution of this information, in whole or in part, or the disclosure of any of its contents

without the prior written consent of the Company, is prohibited.

3All contents are proprietary to RowdMap, Inc. and are being provided on a confidential basis.

Any use, reproduction or distribution of this information, in whole or in part, or the disclosure of any of its contents without the prior written consent of the Company, is prohibited.

WHAT’S OUT THERE?

There’s a lot of data and talk out there

4All contents are proprietary to RowdMap, Inc. and are being provided on a confidential basis.

Any use, reproduction or distribution of this information, in whole or in part, or the disclosure of any of its contents without the prior written consent of the Company, is prohibited.

WHAT’S OUT THERE?

Let’s cut through

the buzz

5

Government performance

data

Government provider etc.

data

Government socio-demo

data

Consumerweb / social

data

Analysis-based deriveddata

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without the prior written consent of the Company, is prohibited.

Sentiment as a Key Driver (psychographic) - measured by Index scores for: - Domains (chronic, wellness, quality of care, customer satisfaction, customer service);- Brands (WellPoint, BCBS, your brand)[Managed via Buoy Platform]

Market Growth; Census; Healthy Food; County Health Rankings & Indicators; Behavioral Health Factors; etc.*

Dartmouth Atlas; STAR; Hospital Compare; Actual, Expected & Predicted Readmissions; Part B & D, etc.*

STAR; Price, Bid, Rebate;Hospitals, Nursing Homes; Market, etc.*

* Dozens of Primary Data Sets, updated at various frequencies

WHAT’S OUT THERE?

When we say a lot…we mean a lot.

6

And it’s powerful, disruptive, game changing

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without the prior written consent of the Company, is prohibited.

David Wennberg,RowdMap Advisory Board

Government Data Outperforms Risk Adjustment for MA!

WHAT’S OUT THERE?

7

a world where you had access to…

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without the prior written consent of the Company, is prohibited.

WHAT’S OUT THERE?

Referral patterns for your hospitals

8

a world where you had access to…

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without the prior written consent of the Company, is prohibited.

WHAT’S OUT THERE?

Referral patterns for your hospitals

Well, that world is here, today.

• Even though the AMA fought data releases for 30 years, the day has finally come.

• You have access to all of these data through government benchmarks.

• CMS understands data like these are necessary for a competitive, direct-to-consumer health care market.

• No IT, no integration, no data warehouses—it’s here today.

9

Shift to Direct-to-Consumer

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without the prior written consent of the Company, is prohibited.

WHAT TO DO WITH IT?

Health plans have to start behaving like

these guys to succeed in the Government-

sponsored DTC world.

Now you have data to win!

10

Direct-to-Consumer Q & A

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without the prior written consent of the Company, is prohibited.

WHAT TO DO WITH IT?

Q: How do you compete in direct-to-consumer, government sponsored health care?

A: You need new / DTC analytic concepts and accessible benchmark data.

Retention

Market Share Product Funnel

Profit Opportunity

Profit Opportunity

Price Sensitivity

You have both now!

11

WHAT TO DO WITH IT?

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without the prior written consent of the Company, is prohibited.

Most data projects…

12

WHAT TO DO WITH IT?

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without the prior written consent of the Company, is prohibited.

Most data projects…

All the pieces are there, but it’s still hard.

• Data project are time-consuming and complex

• Almost always questions about where the data is from

• Depending upon who generated it, data is subject to mistrust between stakeholders

13All contents are proprietary to RowdMap, Inc. and are being provided on a confidential basis.

Any use, reproduction or distribution of this information, in whole or in part, or the disclosure of any of its contents without the prior written consent of the Company, is prohibited.

FFS Motto:“Amortize Investment”

WHAT TO DO WITH IT?

14All contents are proprietary to RowdMap, Inc. and are being provided on a confidential basis.

Any use, reproduction or distribution of this information, in whole or in part, or the disclosure of any of its contents without the prior written consent of the Company, is prohibited.

ACA Motto:“Transparency is the new black”

WHAT TO DO WITH IT?

15All contents are proprietary to RowdMap, Inc. and are being provided on a confidential basis.

Any use, reproduction or distribution of this information, in whole or in part, or the disclosure of any of its contents without the prior written consent of the Company, is prohibited.

Client / Your Data

Gov Data

Client / Your Data

Gov Data

Client / Your Data

Gov Data

Client / Your Data

Gov Data

Client / Your Data

Gov Data

Client / Your Data

Gov Data

Benchmarks and your data:a great match

WHAT TO DO WITH IT?

Here’s why these benchmarks are so powerful

16

GOVT BENCHMARKS IN ACTION

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without the prior written consent of the Company, is prohibited.

Government benchmark data serves as the common languagenecessary to build relationships with providers to improve the member experience and profitability

The benchmarks are available today with no IT involvement

The data already have a level of analysis on top, so you can see if a provider is over/under benchmarks

It’s from CMS; it’s a standard; it’s already used to day to drive reimbursement

17

Evaluate Your Position in your Market

with National Benchmarks

Growth Strategy

Product Design

Contracting Strategy

Post-Discharge Interventions

Use information to inform:

GOVT BENCHMARKS IN ACTION

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without the prior written consent of the Company, is prohibited.

18All contents are proprietary to RowdMap, Inc. and are being provided on a confidential basis.

Any use, reproduction or distribution of this information, in whole or in part, or the disclosure of any of its contents without the prior written consent of the Company, is prohibited.

Example Strategy & Tactics:

HMO Mindset – Grow into the right providers (Your Network is disproportionately important to your success in MA - both in PPO and HMO)

Provider BootCamp - Cultivate a mutually beneficial relationship around a common language (CMS data)

Commercial Conversion - Age-in to the right providers by leveraging the strength of your commercial population

Benefit optimization - Design plans in the right geographies around the right providers

GOVT BENCHMARKS IN ACTION

19

Provider Profiles Fairfax County, VA

GOVT BENCHMARKS IN ACTION

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without the prior written consent of the Company, is prohibited.

Focus on medical management

using the PlayBook

These are good Candidates to focus on Growth using the PlayBook

Where are providers delivering the most efficient and appropriate care?

20

Intensity of Back Procedure Funnels

GOVT BENCHMARKS IN ACTION

All contents are proprietary to RowdMap, Inc. and are being provided on a confidential basis.Any use, reproduction or distribution of this information, in whole or in part, or the disclosure of any of its contents

without the prior written consent of the Company, is prohibited.

Where are providers delivering the most efficient and appropriate care?

National Benchmark

Owensboro, KYLouisville,

KY

21

Network Opportunity Index (NOI)

Illinois

GOVT BENCHMARKS IN ACTION

All contents are proprietary to RowdMap, Inc. and are being provided on a confidential basis.Any use, reproduction or distribution of this information, in whole or in part, or the disclosure of any of its contents

without the prior written consent of the Company, is prohibited.

Where are providers delivering the most efficient and appropriate care?

22

County Profiles

Maryland

GOVT BENCHMARKS IN ACTION

All contents are proprietary to RowdMap, Inc. and are being provided on a confidential basis.Any use, reproduction or distribution of this information, in whole or in part, or the disclosure of any of its contents

without the prior written consent of the Company, is prohibited.

Which counties are high/low performers? What are the characteristics of my counties?

Focus on medical management

using the PlayBook

These are good Candidates to focus on Growth using the PlayBook

23

Success Opportunity Index (POI)

GOVT BENCHMARKS IN ACTION

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without the prior written consent of the Company, is prohibited.

Which counties are high/low performers? What are the characteristics of my counties?

24

Success Opportunity Index (POI)

GOVT BENCHMARKS IN ACTION

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without the prior written consent of the Company, is prohibited.

Which counties are high/low performers? What are the characteristics of my counties?

25

Evaluate your Provider Footprint

Hospital Profiles

GOVT BENCHMARKS IN ACTION

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without the prior written consent of the Company, is prohibited.

Where are providers delivering the most efficient and appropriate care?

26

Provider Network Patterns

Evaluate your Provider Footprint

GOVT BENCHMARKS IN ACTION

All contents are proprietary to RowdMap, Inc. and are being provided on a confidential basis.Any use, reproduction or distribution of this information, in whole or in part, or the disclosure of any of its contents

without the prior written consent of the Company, is prohibited.

Where are providers delivering the most efficient and appropriate care?

27

Understand your Portfolio’s Position

Market Cost Footprint

GOVT BENCHMARKS IN ACTION

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without the prior written consent of the Company, is prohibited.

What price points do I need to hit to be able to grow quickly?Where do I run the risk of commoditization?

28

Understand your Portfolio’s Position

Price Sensitivity Map

GOVT BENCHMARKS IN ACTION

All contents are proprietary to RowdMap, Inc. and are being provided on a confidential basis.Any use, reproduction or distribution of this information, in whole or in part, or the disclosure of any of its contents

without the prior written consent of the Company, is prohibited.

What price points do I need to hit to be able to grow quickly?Where do I run the risk of commoditization?

29

Understand your Portfolio’s Position

Price Sensitivity Thresholds

GOVT BENCHMARKS IN ACTION

All contents are proprietary to RowdMap, Inc. and are being provided on a confidential basis.Any use, reproduction or distribution of this information, in whole or in part, or the disclosure of any of its contents

without the prior written consent of the Company, is prohibited.

What price points do I need to hit to be able to grow quickly?Where do I run the risk of commoditization?

30

Understand your Portfolio’s Position

New York, NY

United

WellPoint

HealthFirst

GOVT BENCHMARKS IN ACTION

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without the prior written consent of the Company, is prohibited.

Winning Patterns

What are the winning patterns that draw growth?What trade offs should I make?

31

Understand your Portfolio’s Position

Benefit Design Patterns

GOVT BENCHMARKS IN ACTION

All contents are proprietary to RowdMap, Inc. and are being provided on a confidential basis.Any use, reproduction or distribution of this information, in whole or in part, or the disclosure of any of its contents

without the prior written consent of the Company, is prohibited.

What are the winning patterns that draw growth?What trade offs should I make?

32

RowdMap Answers Four Questions

1 - How do we Grow and intelligently expand around providers?

2 - How do we work with providers to improve and drive meaningful STAR & internal Performance?

3 - How do we use provider and county clusters to price products, contract with CMS and create profit & maintain Value?

4 - How do we tune our provider Network and develop strong business partnerships with our key groups?

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without the prior written consent of the Company, is prohibited.

ABOUT ROWDMAP

33All contents are proprietary to RowdMap, Inc. and are being provided on a confidential basis.

Any use, reproduction or distribution of this information, in whole or in part, or the disclosure of any of its contents without the prior written consent of the Company, is prohibited.

Success Using this Data• Increased a plan’s membership through smart growth by 40,000

in 12 months; and another plan’s by 40% in the same time

• Reduced membership attrition for a SNP plan in a competitive metro by 20%

• Launched high-end concierge plan that broke member price sensitivity and generated significant profit, doubling original membership goal

• Launched a purpose-built plan for a curated provider network

• Increased a plan’s Star scores by a full point through provider-centric growth

• Designed product strategy and corresponding benefits for a major metro areathat lead to plan’s first profitable product portfolio in three years

• Aligned a plan’s sales and network team strategy around providers

• Tripled a plan’s original goal of contracting with targeted providers (and in some cases, out of exclusivity arrangements)

• Shifted a plan’s majority of membership from PPO to HMO, doubling original goal

• Moved a plan’s membership in target providers from 2% to 30% in target providers in 12 months

• Articulated clear data-driven MA strategy for board-level presentations that resulted in additional investments

• Developed comprehensive strategy for government affairs that created an advantageous environment for plan and members

Where we’ve done it…

ABOUT ROWDMAP

34All contents are proprietary to RowdMap, Inc. and are being provided on a confidential basis.

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Featured nationally… US CTO on RowdMap: “Visionary

Genius”

ABOUT ROWDMAP

35

Who are we?

Bryant Hutson – Senior Client Strategist, RowdMapRecovering health care strategy consultant

Senior Associate @ Optimity Advisors, Washington, DC; Information Risk and Privacy Research Analyst @ Corporate Executive Board; B.S. Information Science and Communication @ Cornell University

Ashley Distler – Senior Client Strategist, RowdMapThought AHIP was a joint replacement conference… still not sure

Administrative Fellow @ Presence Health, Chicago; Financial Analyst & Director of Internal Control @ HCA, Nashville; Research Assistant @Cincinnati Children’s Hospital Medical Center, Cincinnati; B.S. Economics @ Centre College, MHSA/MBA @ Xavier University

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without the prior written consent of the Company, is prohibited.

ABOUT ROWDMAP

36All contents are proprietary to RowdMap, Inc. and are being provided on a confidential basis.

Any use, reproduction or distribution of this information, in whole or in part, or the disclosure of any of its contents without the prior written consent of the Company, is prohibited.

ABOUT ROWDMAP

Want to see insights RowdMap has on your plan, your geography, and your competitors?

RowdMap is holding one-on-one sessions at AHIP’s 2014 National Conferences on Medicare and Medicaid

We can schedule a time at the conference to walk through the benchmark data we already have about your plan and geography (no IT involved!)