RowdMap, Inc. soke with HCSC Health Care Service Corporation at America’s Health Insurance Plans, 2015 National Conferences on Medicare and Medicaid and Dual Eligibles Summit on using government benchmark data to create a risk-ready network to succeed in value-based market. Bryant Hutson, Senior Client Strategist at RowdMap, Inc., and David Goodson, Vice President, Enterprise Medicare, Health Care Service Corporation, spoke together on how health plans can use newly released government data to create a risk-ready network to succeed in value-based markets. The presentation entitled, “Network as Strategic Advantage: Curating a Risk-Ready Network to Succeed in a Value-Based Market” was delivered at the America’s Health Insurance Plans (AHIP), 2015 National Conferences on Medicare and Medicaid and Dual Eligibles Summit.

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What RowdMap Does
Risk-Readiness SM and You
BCBS as Best Practice

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What RowdMap Does
Risk-Readiness SM and You
BCBS as Best Practice

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WHAT WE DO
It’s Time for Risk
CMS: 50% of FFS will
be gone by 2018
CMS Means
Business!
These are just the first pieces
to move and transforming
payment across the system!
Current payment models aren’t changing provider
behavior.
Providers need help.
Effectsof Health Care Payment Models on
Physician Practice in the United States, May 2015.

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Featured Nationally US CTO on
RowdMap:
“Visionary
Genius”
WHO WE ARE
Founders & Team

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Melanie Rosenthal – Chief Executive Officer
Co-Founder & CEO @ Sprigley [acquired by Eliza Corporation, 2008]; VP of Product Ops @ Eliza
[Majority Equity Investment Parthenon Capital, 2011]; Health Dialog, Yale, Human Genome Project, Tufte, Solstice Capital
Burak Sezen – Chief Information Officer
Co-Founder & CTO @ Sprigley [acquired by Eliza Corporation, 2008]; Platform Architect @ Eliza [Majority Equity
Investment Parthenon Capital, 2011], Health Dialog, Pricewaterhouse Coopers; Ernst & Young; Standards Committees
Joshua Rosenthal, PhD – Chief Scientific Officer
Co-Founder & CSO @ Sprigley [acquired by Eliza Corporation, 2008]; VP of Product Ops @ Eliza
[Majority Equity Investment Parthenon Capital, 2011], Fulbright, Sorbonne (Applied Institute for Advanced Studies),
HHS/CMS/ONC/NCHVS Public Adviser (Technology & Innovation, Market & Policy, Data Access) and HCTTF
Speaker/Guest Lecturer/Guest @ Harvard, Johns Hopkins, MIT , SXSW, HDI, RWJ, AF4Q, NPR (with US CTO and HHS CTO)
Henriette Coetzer, MD – Chief Clinical Risk Officer
Clinical Transformation, NHS (National Health Service, United Kingdom); Global Medical Director, Towers Watson; Senior Medical
Director and Clinical Analytics, BUPA and Health Dialog; Product Development, Healthways; Practicing Physician; Patent Holder
Kimberly Spalding, CPA – Chief Financial Officer
Co-Founder Tech Republic [acquired by CNET, 2001]; Co-founder & CFO Narrowcast
[acquired by QuinStreet, 2011]; Ernst &Young’s Entrepreneurial Services
Bryant Hutson & Ashley Distler – Senior Client Strategists
Cornell, Xavier; Cincinnati Children’s Hospital, Optimity Advisors, Presence Health; Skydiver, Travel Connoisseur
WHO WE ARE
Founders & Team
Industry Leading
Advisory Board

7. WHO WE ARE
Where It’s Worked
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RowdMap Success Stories
• Increaseda 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 competitivemetro by 20%
• Launched high-end conciergeplan that broke member price sensitivity and
generatedsignificant profit, doubling original membership goal
• Launched a purpose-built plan for a curatedprovider network
• Increaseda plan’s Star scores by a full point through provider-centric growth
• Designed product strategy and corresponding benefits for a major metro area
that lead to plan’s first profitable product portfolio in three years
• Aligned a plan’s sales and networkteam strategyaround providers
• Tripled a plan’s original goal of contracting with targetedproviders
(and in some cases, out of exclusivity arrangements)
• Shifted a plan’s majority of membershipfrom PPO to HMO, doubling original goal
• Moved a plan’s membershipin targetproviders from 2% to 30%
in target providers in 12 months
• Articulatedclear data-drivenMA strategy for board-levelpresentations
that resultedin additional investments
• Developed comprehensive strategyfor governmentaffairs that created
an advantageous environment for plan and members
Where we’ve done it…

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What You Get with RowdMap
Technology and Professional Service
Enterprise
Platform
License
License covers
entire
enterprise
across all
functional units
and all
(reasonable)
users and
usage
RowdMap U
Online
Learning
Center
One of a kind
web-based
resource with tips,
tricks, tutorials
and functionally-
oriented
resources to help
users understand,
and interpret the
information
Benchmarks
Drill Downs
and Profiles
Payer Profiles,
Provider Profiles,
Market and
Geographic
Profiles Including
Social
Determinants
and Health
Behaviors
On-site
Analytic
Workshops
RowdMap
prepares an
analysis across
functional
areas and
presents data,
interpretation
and
recommendati
ons
Auto-
Generated
Reporting
Self-serve
dashboards and
reporting with
tagging and
sharing that
export as PDF or
PPT
Enrichment
Client Data
RowdMap
accepts and
integrates your
data and
incorporates it
within the
RowdMap
platform
Risk
Readiness
Your Provider
Profiles,
Available Risk
Arrangements,
Risk Arrangement
Matching,
Payer/Provider
Risk Profiles
Year in the
Life Custom
Analyses &
Support
Provider Performance
Profiles and Risk-
Readiness
Analysis
New Payment Model
Opportunity Analysis
Reimbursement
Opportunity and
Payer Profile Analysis
Policy and
Regulatory Analysis

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without the prior written consent of the Company, is prohibited.
What RowdMap Does
Risk-Readiness SM and You
BCBS as Best Practice

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without the prior written consent of the Company, is prohibited.
Risk-Readiness℠ looks at a
different category of spending
30 Cents of Every Dollar You Spend
Goes to No-Value Care
Clinically Appropriate,
but Unnecessary Care
(30% of spend)
Claims Spend for a Health Plan /
Government Program
Necessary Utilization
(70%)
“Bigger than higher prices, administrative expenses, and fraud, however,
was the amount spent on unnecessary health-care services.
Now a far more detailed study confirmed that such waste was pervasive.”
In just a single year, up to 42% of patients receive “No Value” Care.
Dr. Atul Gawande,Professor, Department of Health Policy and Managementat the
Harvard School of Public Health & the Department of Surgery at Harvard Medical School.
“It’s generally agreed that
About 30 percent of what we spend on
health care is unnecessary.
If we eliminate the unneeded care, there
are more than enough resources in
our system to cover everybody.”
-Dr. Elliott Fisher,
Dartmouth Institute for Health Policy

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At the core of Risk-Readiness SM is
Unwarranted Variation:
Every provider has a unique practice pattern
that informs Risk-Readiness SM
Low and Now Value Care Defined by Decades of
Publicly Available Research
Apply the Dartmouth Atlas for Unwarranted
Variation methodologies to the newly
released CMS data. This research has been
repeatedly validated over the last 30 years
and we now have a national data set to
apply the methodologies at a large scale.
Grey area outside of obvious fraud but based on choice of two
options for care that yield same outcomes, but one at marked
higher costs. Definitions across PCP care, specialties.
Provider with High Intensity
Practice Pattern
Maximizing Fee for Service
Provider with Low Intensity
Practice Pattern Maximizing Pay for Value

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Medicare DocGraph
Referral file
(Patient flows between
PCPS, specialists, hospitals
and post acute centers)
Dartmouth Atlas of Health Care &
Choosing Wisely
(Decades of research and data on
unwarranted variation by condition
and geography to keep things
apples-to-apples for comparisons)
CMS FFS Data Sets, CDC Data Sets
(MEDPAR, Part B, Part D, BRFSS)
(Individual providers, groups,
hospitals and post acute centers)
Provider Pattern Intensity Profiles and
Risk Readiness for every provider,
hospital, post acute center in the US.
All preloaded with no IT.
New Government Benchmark Data
Particularly powerful when pulled together
Affordable Care Act data to determine
Risk-Readiness SM of Providers / Networks
CMS Historic Releases of Largest Provider Data;
Virtually Every Provider, Group, Hospital, Etc.

13. Here’s why these benchmarks are so powerful
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without the prior written consent of the Company, is prohibited.
Government benchmark data serves as the common language
necessary 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
CMS Benchmarks Work across all Geographies,
Populations, P&Ls (Care, Caid, Commercial, etc.)

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without the prior written consent of the Company, is prohibited.
Where are populations,
and how healthy are they? Who are Risk-Ready SM providers?
How do we match the right providers
to the right risk arrangements and
manage variation to contain costs?
How do we design products, clinical
programs, and networks around risk?
WHAT WE DO
Risk-Readiness SM in Four Questions

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without the prior written consent of the Company, is prohibited.
UNDERSTAND POPULATIONS
What type of populations?
Diabetes Prevalence PCP Density
Income
Obesity
Depression
Demand vs. Supply
Sick and underserved
Westchester, NY
Allocate providers and care management resources around
condition-specific population needs by zip. Focus contracting on PCPs
and/or locate retail clinics, RVs and health fairs based on chronic needs.

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without the prior written consent of the Company, is prohibited.
UNDERSTAND GEOGRAPHY
What’s Going on in Your Market?
Largest Counties in CA
Regional
Benchmarks
Risk
Scores
Total
Cost
PMPM
Reimbursement
Overall
Star
Chronic
Star
Health
Rank
Network
Opportunity
Profit
Opportunity
MA
Profit
Opportunity
Exchange
Medicare
Eligibles /
MA Enrolled
Exchange
Subsidy Eligibles /
Exchange Enrolled
Medicaid
Beneficiary Eligibles /
Beneficiaries
What drives profitability in your geography?
Consider:
CMS reimbursement and risk models, population cost share thresholds,
clinical performance outcomes, population health behaviors,
network performance, product eligibles & penetration.

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without the prior written consent of the Company, is prohibited.
Risk-Readiness SM
Practice Profiles
Orange County, CA
Regional Benchmarks
Identify highly efficient, Risk-Ready practices to profitably grow
into. Improve profitability of lower performing practices with
large panel sizes through modified arrangements or performance
improvement plans.

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without the prior written consent of the Company, is prohibited.
Risk-Readiness SM
Physician Profiles
PCPs
Identify low cost, highly efficient physicians and make them your
stars. Grow into them. Make them the featured doctor in
marketing collateral.
Regional Benchmarks
Louisville, KY

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without the prior written consent of the Company, is prohibited.
Risk-Readiness SM
Hospital Profiles
California
Regional Benchmarks
Use benefit designs and network designs to send members to the highest
performing hospitals within your geography.
EOL Hosp Days: Which hospitals have fewer end-of-life days than their peers?
Chronic Admits: Which hospitals see their most chronic population repeatedly/ with the most frequency?
Cardiac Imaging: Which hospitals are more likely to over-utilize cardiac imagingcompared to their peers?

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Decreased
Cost
Average
Increased
Cost
LessEfficient
1
2
3
4
5
MoreEfficient
Miami Dade, Florida
Risk-ReadinessSM
Benchmark
Impact on
Spend
MANAGE VARIATION
Quantify No Value Spending by Provider
$ PMPY per Specialty & Efficiency Score
Networks can be optimized by excluding specific doctors or shifting
members/patients within a network.
Tactic 1: 'Manage' the red dot doctors
Tactic 2: Create curated networks with varsity providers.

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without the prior written consent of the Company, is prohibited.
MANAGE VARIATION
Provider Value Chains
Primary Care
Docs
Specialist
Post Acute
Facility
Thickness of lines indicates
the number of referrals.
Note: Some markets are
oversupplied. This market is
controlled by one provider.
Less efficient
More efficient
Identify PCPs that refer to higher intensity specialists.
Consider new contracting arrangements and provider education to
improve overall care efficiency.

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MANAGE ACROSS FUNCTIONS
Product, Growth & Clinical
After developing an overall Risk-Readiness
SM Strategy, plans use RowdMap to…
Manage product portfolios and
design benefits
Identify areas for growth
and expansion
Design and manage clinical
programs

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without the prior written consent of the Company, is prohibited.
CMS: 50% of FFS will
be gone by 2018
What if you knew which
providers would
drive your success?
What if you knew which
providers would sink you? WHAT WOULD YOU DO IF YOU KNEW
who will win and who will lose in
value based arrangements

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without the prior written consent of the Company, is prohibited.
What RowdMap Does
Risk-Readiness SM and You
BCBS as Best Practice
David Goodson
Vice President, Enterprise Medicare
at Blue Cross and Blue Shield of Illinois,
Montana, New Mexico, Oklahoma & Texas

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without the prior written consent of the Company, is prohibited.
Blue Cross and Blue Shield of Illinois,
Montana, New Mexico, Oklahoma & Texas
Best Practice at Risk-Readiness SM
Blue Cross and Blue Shield of Illinois,
Montana, New Mexico, Oklahoma & Texas
Using data to answer all four major questions including:
1 - Where are the populations and how healthy are they?
2 - Who are Risk-Ready Providers?
3 - How do we match the right providers to the right
arrangements and manage variation to contain costs?
4 - How do we design products, clinical programs
and growth strategies around risk?

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without the prior written consent of the Company, is prohibited.
Blue Cross and Blue Shield of Illinois,
Montana, New Mexico, Oklahoma & Texas
Best Practice at Risk-Readiness SM
Questions for David Goodson,
Vice President Enterprise Medicare,
at Blue Cross and Blue Shield of Illinois,
Montana, New Mexico, Oklahoma & Texas
1 – What have you done to achieve this Risk-Readiness SM ?
2 – What does this data allow you to do and what are your plans?