MyHealth AdvantageProgram Overview

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Comprehensive Wellness Benefits– Fully Insured

Better Health = Financial Advantage

Care Management• 24/7 NurseLine• Future Moms• ComplexCare• ConditionCare• Healthy Lifestyles• MyHealth AdvantageOnline Tools and Resources• MyHealth@Anthem

• MyHealth Assessment• MyHealth Record• Condition Centers• Online Community

• Specialoffers@Anthem• AudioHealth Library• Time Well Spent

Core Programs – Included in your benefits

• ConditionCare: Support• ConditionCare: Kidney• MyHealth Coach• Worksite Wellness• EAP• Pharmacy Benefit Management• Staying Healthy Reminders• Incentives

Also Available

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MyHealth Advantage: Program Overview

MyHealth Advantage provides actionable and individualized messaging to members and providers about potential opportunities to:

Avoid criticalhealth issues

Optimize theirhealth carespending

Improvehealth

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MyHealth Advantage: Goals

The MyHealth Advantage program seeks to help:Improve member health and safetyImprove compliance with evidence-based guidelinesIncrease early detection of health issuesEnable members and physicians to make more informed care management decisionsEnhance results from synergistic 360o Health® programsReduce costs for both plan sponsors and members

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MyHealth Advantage

The MyHealth Advantage program communicates to members when gaps in care, safety issues and opportunities for saving money are identified.

89% of recipients think the MyHealth Note is easy to understand and 72%perceive MyHealth Advantage as valuable.

Q4 2009 Member Satisfaction Survey

MyHealth Notes mailed to applicable members(approximately 1 in 5 members)

Recommendations for members to help improve health and save moneyListing of most recent medical, lab and pharmacy

claimsLinks to educational information and resourcesSpecific ways they may be able to help save money

on health carePreventive reminders (if space allows)

Health Coaches field inbound callsMonthly Provider letters for clinical issues

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MyHealth Advantage: Benefits

Both members and employers benefit from MyHealth Advantage:Members

Early identification of potential health issuesHelps to improve health via targeted recommendationsPotential pharmacy and out of pocket cost savingsHelps to monitor and respond to dangerous drug issues

EmployersHelps to reduce costsHelps to increase savings from generic equivalent drugsHelps to improve productivity; reduced absenteeism and ‘presenteeism’Helps to reduced incidence of more serious and costly complications in the future

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MyHealth Advantage: Advantages & Differentiators

Attention getting, easy to understand MyHealth NoteLists recent claimsIf benefit & formulary info is available, MyHealth Advantage can alert members to actual dollar savings. 360o Health program integration – all information is included in the members profiles so nurses can view Pharmacy claims reviewed daily. Staff member calls with critical issuesEducational information provided by the Harvard Medical SchoolOnly program of this type to incorporate benefit information andrecommend money-saving changesProgram supports the total client population, not just those in disease management programsProven increase in member compliance

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MyHealth Advantage: How it works

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MyHealth Advantage: The Personal Health Picture™

Demographic• Age 43• Female• 1 Dependents

Biometrics• Height 5’6”” (May 23 2008)• Weight 165 (May 23 2008)• BMI 26.63 (May 23 2008)• Abdominal Girth 31in (May 23

2008)• Blood Pressure 145 / 90 (May 23

2008)

Medical History• ER Visit (March 28, 2008)• Office Visit Dr. Lynn (May 15

2008)• Office Visit Dr. Wilson (May 17

2008)• Office Visit Dr. Jones (Apr 12

2008)

Prescriptions• Cholesterol Panel (May 26 2008)• Prilosec – 500 mg (May 25 2008)• Accupril – 20 mg (Mar 28 2008)• Prilosec – 500mg (Mar 23, 2008)• Accupril – 20 mg (Feb 18 2008)• Paxil – 20mg (Feb 12 2008)• Lipitor 20 mg (Feb 10 2008)• Lipitor 20 mg (Jan 15 2008)• Accupril 20 mg (Jan 12 2008)• Paxil – 20mg (Jan 10 2008)

Lab Tests• Cholesterol Panel (May 26 2008)• Chest CT Scan (Feb 4 2008)• Complete Blood Count (Jan 15 2008)

Lab Test Results• Total Cholesterol 203 (Jan 15 2008)• LDL Cholesterol 152 (Jan 15 2008)• HDL Cholesterol 42 (Jan 15 2008)• Triglycerides 193 (Jan 15 2008)• Fasting Blood Sugar 123 (Jan 15 2008)

The more health information available, the more comprehensive the individual’s Personal Health Picture

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Evidence-Based Care• Has Condition Needs Drug• Has Condition Needs Test • Need Test Follow-up• Need Event Follow-up• Need Preventive Test-Age• Need Test to Optimize Drug Dose• Lab Result Need Doctor Follow-up• Lab Result Need Drug

Rx Adherence• Non-Compliance Drug Regimen• Discontinued Drug• Over-use of Drug

Rx Effectiveness• Need Test to Optimize Drug Dose• Test Result - Monitor Drug Dose• Started New Med - Need Doctor

Follow-up

Rx Cost Savings• Brand Switch to Generic• Brand Switch to Formulary Preferred• Formulary-Preferred Switch to Generic

Health Risk• Has Condition Needs Drug• Need Drug to Prevent Condition• Need Doctor Visit Follow-up ER• Need Preventive Info Condition• Need Info Warning Signs

MyHealth Advantage: The Personal Health Scan™

The Personal Health Scan compares the member’s data with medical best practices to find gaps in care and cost savings opportunities:

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MyHealth Advantage: MyHealth Note Examples

Examples of Gaps identified through MyHealth Advantage

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Eye catching symbols with bold headlines linked to messages inside

Member name, mailing date and notice of confidentiality

MyHealth Advantage: Member Communication

MyHealth Note: Sample Communication

Front Back

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MyHealth Note: Member Communication

Most recent medical, pharmacy, and lab claims

Member name

Harvard Medical School website reference

Targeted suggestions regarding care gaps or cost savings opportunities

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MyHealth Note: Medication Graphic Insert

New Medication Graphic provides an innovative, graphical representation of member medication compliance

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MyHealth Advantage: Member Analysis

We monitored members with MyHealth Advantage for twelve months to see what effect the MyHealth Note had on increasing medical compliance.

12 groups were monitored for a total of 12 months (159,959 lives total). 40,176 people, or 25.1% of the total population received at least one MyHealth Note due to an identified health opportunity.Of the 25% that received a MyHealth Note, 61.4% of people received more than one during the 12 month period. Over 12 months, 184,121 issues were addressed, excluding Daily Rx Safety Alert messages.

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Healthy employees = healthy businesses.1Based on internal review of current participants; Members acted within twelve months of receiving the initial MyHealth Note and may have been messaged more than once.

Results

The Member Analysis showed increases in complianceassociated with specific MyHealth Note messages: 46% showed increased compliance with clinical recommendations1

69% refilled a high blood pressure Rx when reminded1

60% went for annual lipid check when reminded it was overdue1

38% scheduled a mammogram when reminded it was overdue1

23% switched to a lower cost generic medication when told there was an alternative1

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MyHealth Note: Member Feedback

“I find the MyHealth Note very informative and helpful. It truly does help me manage my health issues. Keep up the excellent job.”

“I have found this service to be very helpful in continuing to manage my several health problems.”

“The MyHealth Note had me write down questions to ask my physician based on the meds I already take. It is very informational and a great benefit to me.”

“Better than any other insurance program I have had.”

Source: Quarterly MyHealth Advantage member surveys. 1,738 Member responses in 2009.

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MyHealth Advantage: Medical Guidelines

Evidence-based guidelines published by national medical associations and societies:

The American Heart Association The American Diabetes Association

Major studies and initiatives are used, including: The Global Initiative for Asthma (GINA)The United States Preventive Services Task Force (USPSTF) The National Cholesterol Education Program (NCEP)FDA information and drug package inserts from manufacturer

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Provider Care Alerts mailed monthly

Member non-adherence with tests,exams and screenings, medication therapy and drug safety issues

MyHealth Advantage: Provider Engagement

Member-specific messages sent to physicians increase compliance with practice guidelines by 15% (5% absolute increase).

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MyHealth Advantage: ROI

For every $1 invested in MyHealth Advantage, employers can save $1.63 in health care costs. This translates into an annualized savings of $1.63 per member.Based on a sample study of 34K members with clinical issues Actuarial validation, 2010.

$1Spent

$1.63Saved

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MyHealth Advantage: Part of the pathway to improved health

No matter which way it leads, we are here with personalized and proactive solutions to help our members feel better and live better—today and tomorrow.

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If you have questions about this presentation or your benefits, please contact your Anthem Blue Cross Blue Shieldrepresentative.

Anthem Blue Cross and Blue Shield is the trade name of: In Colorado and Nevada: Rocky Mountain Hospital and Medical Service, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans ofKentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. In Ohio: Community Insurance Company. In Virginia (excluding the City of Fairfax, theTown of Vienna and the area east of State Route 123.): Anthem Health Plans of Virginia, Inc. In Wisconsin: Blue Cross Blue Shield of Wisconsin ("BCBSWi"), which underwrites or administers the PPO and indemnity policies; Compcare Health Services Insurance Corporation ("Compcare"), which underwrites or administers the HMO policies; and Compcare and BCBSWi collectively, which underwrite or administer the POS policies. Independent licensees of the Blue Cross and Blue Shield Association. ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.

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Please join us for upcoming webinars

UPCOMING WEBINARS (All times 11:00 AM PST):

November 3: Complex Care /ConditionCareDecember 9: Anthem.com and the member experience

Register at http://group.anthem.com/360healthWest