Chronic Care Management The Future Is NOW.

58 Million 58 MillionIn 2017,

Medicare Beneficiaries1

~66%Approximately 2 out of 3 Medicare beneficiaries have multiple chronic conditions.2

$709.4 Billion Gross Medicare Spending in 20171

14%

23%32%

32%

Number of Chronic Conditions

6+4 to 52 to 30 to 1

% of Medicare Beneficiaries by Number of Chronic Conditions3

IMPACT Care Quality and Grow Revenue with CCM.

CMS establishes CCM program CPT Code 99490to address chronic conditions in Medicare patients

CMS lifts administrative burdens presented in 2015 & 2016 as barriers to entry and improve payment accuracy

CMS adds FQHCs and RHCs, and they are now able to bill CPT Code 99490

CMS enhancespayments and simplifies billing for FQHCs and RHCs. New HCPCS codesfor CCM service for theseorganizations

Medicare Pays for Non-Face-to-Face Chronic Care Management Services (CPT Code 99490)

Note: Overall healthcare spending per beneficiary has decreased year over year from 2015 to 2016.5

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Number of Physicians in the Practice

$42.842018 National Average

Reimbursement4

CPT Code 99490

5

3,279

21.85%

66%

National Average Patients Per Physician

National Average of % of Physicians’ Patients Covered by Medicare

% of Medicare Patients with 2+ Chronic Conditions

CPT Code 99490Revenue Potential Example

= ~$1,200,000Total Annual Revenue Potential

(~$101,000 x 12 Months)

CPT Code 99490Program Highlights

Medicare Beneficiaries Requirements2 or more chronic conditions expected to last 12+ months

Technology RequirementsStructured recording of demographics, problems, medications, and allergies

Service Requirements20+ minutes of non-face-to-face care management services a month; access to urgent care service 24/7; medication reconciliation; build comprehensive care plan

Billing RequirementsOnly one provider per patient can bill;CCM services can be billed only once per member per month

Download the 2018 CCM eQGuide

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1 https://www.hhs.gov/about/budget/fy2017/budget-in-brief/cms/medicare/index.html2https://www.hhs.gov/ash/about-ash/multiple-chronic-conditions/about-mcc/index.html 3https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Chronic-Conditions/Downloads/2012Chartbook.pdf 4https://www.cms.gov/apps/physician-fee-schedule/search/search-results.aspx?Y=0&T=0&HT=0&CT=3&H1=99490&M=55https://innovation.cms.gov/Files/reports/chronic-care-mngmt-finalevalrpt.pdf