Tuesday – November 3, 2015 – 9:15 AM - 10:30 AM

Improving Outcomes in a Value-Based World Through Stratified Data and Patient Nurturing

Topic

Level

Presenter(s):Bob Dichter - Senior Director, Product Management

Brian Sauers – Sr. Product Manager

Improving Outcomes in a Value-Based World Through Stratified Data and Patient Nurturing

300

CME/CNE

Safe Harbor Provisions/Legal Disclaimer

This presentation may contain forward-looking statements within the meaning of the federal securities laws, including statementsconcerning future prospects, events, developments, the Company’s future performance, management’s expectations, intentions, estimates, beliefs, projections and plans, business outlook and product availability. These forward-looking statements do not represent a commitment, promise or legal obligation to deliver any material, code or functionality. The development, release and timing of any features or functionality described for our products remains at our sole discretion. Future products developed beyond what is contemplated by existing maintenance agreements, will be priced separately. This roadmap does not constitute an offer to sell any product or technology. We believe that these forward-looking statements are reasonable and are based on reasonable assumptions and forecasts, however, undue reliance should not be placed on such statements that speak only as of the date hereof. Moreover, these forward-looking statements are subject to a number of risks and uncertainties, some of which are outlined below. As a result, actual results may vary materially from those anticipated by the forward-looking statements. Among the important factors that could cause actual results to differ materially from those indicated by such forward-looking statements are: the volume and timing of systems sales and installations; the possibility that products will not achieve or sustain market acceptance; the impact of incentive payments under The American Recovery and Reinvestment Act on sales and the ability of the Company to meet continued certification requirements; the development by competitors of new or superior technologies; the timing, cost and success or failure of new product and service introductions, development and productupgrade releases; undetected errors or bugs in software; changing economic, political or regulatory influences in the health-care industry or applicable to our business; changes in product-pricing policies; availability of third-party products and components; competitive pressures including product offerings, pricing and promotional activities; the Company's ability or inability to attract and retain qualified personnel; uncertainties concerning threatened, pending and new litigation against the Company; general economic conditions; and the risk factors detailed from time to time in the Company’s periodic reports and registration statements filed with the Securities and Exchange Commission.

Drivers of Health Market 2.0:

Rise of Value Based Care

Acceleration of Consumer Powered Health

Delivery System Restructuring

New Economic and Clinical Models

New Customer and Competitive Landscape

Fundamental Shifts Resulting Market Dynamics

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© Oliver Wyman Group

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3

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B

It’s all connected

• Multiple terms for value-based care• P4P (pay for performance) • Risk sharing• Incentivized payment• Capitation arrangements • Gain sharing • Value-based purchasing• Risk adjusted care• Population health

• Value-based payment models are associated with improving outcomes and reducing the cost of care delivery

• Effective Population Health Management impacts clinical and financial outcomes, and quality reporting

Population Health: a collaborative care foundation

• Chronic disease accounts for 75% of our total healthcare spending*• Identify at-risk patients starting with chronic conditions• At-risk patients utilize medical services the most• Highest costs associated with “at-risk” care• Payers are transferring risk to providers

* Centers for Disease Control and Prevention

Cost of chronic disease in U.S. – $1.5 Trillion

• Chronic diseases are increasing healthcare costs at an alarming annual rate*• Heart Disease and Stroke: $432 billion

• Diabetes: $174 billion

• Lung Disease: $154 billion

• Alzheimer’s Disease: $148 billion

* Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services

A diabetes care management team can consist of any or all of the following providers:• Primary care provider

• Endocrinologist

• Nurse diabetes educator

• Dietitian

• Dentist

• Ophthalmologist

• Pharmacist

• Mental health professional

• Cardiologist

• Exercise physiologist

• Nephrologist

• Neurologist

• Podiatrist

Leads to fragmented, uncoordinated & costly delivery of care…

PHM to Improve Collaborative Care

Comprehensive PHM involves:

1. Identifying patients at risk & with gaps in care

2. Managing risk thru chronic care mgmt.

3. Improving clinical outcomes & patient satisfaction

4. Engage patient for proactive care

5. Reducing cost

Goal: Improving Long-term Patient Health

• The goal is to improve the health of your patients and the community

• The onus for managing, improving, and reporting your patients’ health status/outcomes is shifting to providers, particularly primary care physicians

• Reporting outcomes will impact how much you get paid, whether or not your patients comply with treatment

All these things…increased demands, requirements and pressure on you…

Introducing NextGen Care

NextGen Care – Everything you need in one place

Providers need a solution that enables collaborative care

• Onslaught of changes

• Regulatory mandates

• Ever-increasing level of quality reporting

• Increasing Practice/Staff Efficiencies

NextGen Care - integrated across our entire ambulatory care suite

• Provides holistic patient data to the entire care team

• Makes it easier to access vital information and coordinate care

• Helps improve care quality and medical outcomes

Your gateway to collaborative, coordinated care

A one-stop shop to manage your patient population

IntegratedNextGen Care is within the NextGen Healthcare enterprise. No third-party

interfaces, “bolted” solutions

ConfigurableConfigurable automation options

ScalableHosted and server options that

grow with you as you grow

Facilitate multisource data flow with expertise of Mirth products

Interoperable

What makes us different?

RiskMilliman*

Patient Portal*

Population Management

Hub

NextGen Share*

NextGen Care Management Suite…

* Optional Modules

Profiler/OutreachEngine

NextGenEHR

Six essential functions for collaborative care

All you need to collaborate in one integrated platform

• View care gaps and risk score for a specific patient

• Produce a list of patients using EHR reports

• Take multiple actions for multiple patients (or individual patients) with very few clicks

• Goal = to identify the most at-risk patients, make the best clinical decisions, and take appropriate actions to enable collaborative care

One screen, few clicks, multiple functions

• View care gaps and risk score for a specific patient

• Produce a list of patients using EHR reports

• Take multiple actions for multiple patients (or individual patients) with very few clicks

• Goal = to identify the most at-risk patients, make the best clinical decisions, and take appropriate actions to enable collaborative care

One screen, few clicks, multiple functions

Population Management Hub…

• Chart - EPM/EHR/Dashboard

• Recall – Create an EPM recall

• Message – Send message to Patient Portal or Population Health

• Task – Create an EPM or EHR Task

• Referral – Create Referral (NextGen Share)

• Document – Product an EHR Document

• Export – Export Excel, PDF, HTML, XML, CVS or My List

Population Management Hub…

Target Patients: Follow-up / Preventive Care

Example:• Hypertensive patients for

blood pressure control

• Diabetic patients with A1C levels greater than seven

• Women age 55, who require pap smears and mammograms in May

• Men age 60, who require prostate exams in September

Predict, prioritize, prevent

• Do you really know who your patients are? Before a practice can deliver appropriate care to the patients who need it most, it must first identify those individuals.

• Today’s diabetes patient may have been pre-diabetic last year. Not only is the patient sicker today, but he or she probably generates higher costs than a year ago.

Risk Stratification • NextGen Healthcare has

partnered with Milliman for risk analysis and predictive modeling for population health and collaborative care

• Group patients by chronic conditions, severity of illness, and demographics; and identify risk

• Take the appropriate action based on patients’ risk levels to address gaps in care

Risk Scores Data Flow

• User uploads CCLF, Member, Provider & Location files to Milliman

• Milliman processes the files

• Client pulls down file containing risk scores

• Risks are imported into NextGen

Risk Score Available to Care Managers…

EHR Reporting Tool…

Population Out Reach…

• Track your outreach efforts, results, and outcomes to meet stringent reporting requirements.

• Provide that data to external stakeholders. • Export and send information to payers and ACO

leadership to show you are providing better, proactive care.

• NextGen Care incorporates the NextGen® Share platform, enabling other connected providers to compose and exchange data.

No collaboration if you’re not connected

Access NextGen Share from the Pop Management Hub home screen. This is our integrated HISP that automates electronic referrals both inside and outside the NextGen® network.

The Hub makes it easy to create a referral and…

• Find an external provider• Attach documents• Transmit referral package

Referral Management

Generate referrals with NextGen Share

MU2Send Referral

Compose Referral

Find a Provider

• Search and discover external providers

• Connect to multiple networks and federated HISPs

• Built into the KBM referral template

• Supports multiple attachments

• Uses Direct

• SupportsMU2 core measure #15

• Automates MU2 Calculations

NextGen Care – What is it?

• The NextGen Care solution proactively reaches out to those patients with gaps in care based on selected protocols and evidence-based clinical quality measures

• Patients are alerted using automated communication methods to take action

• NextGen provides outreach tools that are highly configurable allowing each practice to determine the best solutions for their patient populations.

Patient Outreach

Types of Alerts / Communications: Patient Portal Secure Message Email Text Messaging Interactive Voice Response (IVR) Worklog Recall Plan

Communication limits can be determined per practice for each message type

Patient Engagement / Outreach

• Process is fully automated and integrated with NextGen Ambulatory EHR, Practice Management, Patient Portal and Dashboard (no third-party interfaces required)

• Pulls your data directly from the EHR/PM/HQM systems

• No additional FTEs, time, or resources needed

Patient Portal EHR EPM Dashboard

Analytics

• Critical role in population health management

• Select, filter, and save different groupings of patients

• You’ve identified high-risk patients, now what?- Slice and dice information based on what you want to know

- With true analytics, identify problem areas and utilize proven clinical decision support tools

- Monitor your out reach campaigns

- Ultimately, drive down the cost of care!

Population Health Administration –Reports

Outreach Reports - Example Outreach Report

Outreach Reports• Outreach Queue & History By Measure

• Outreach Queue by Measure

• Task Queue by PCP/Rendering

• IVR Outreach Communication by Patient

• Outreach Communication by Patient/PCP/Rendering

• Outreach Exception by Contact Method/Patient/PCP/Rendering

• Patient Not Contacted

• Patient Skipped (DNC)

• Outreach Performance by Contact Method/Patient/PCP/Rendering

Population Health Administration – Reports

Return on Investment Reports (ROI) - Selecting

the ROI folder displays various reports.

Return on Investment Reports (ROI)• Expected Revenue by Appointment Type

• Booked Appointment by Measure

• Measure Return Analysis

• Outreach Analysis

• Patient Response Time Details

• Monthly Comparison of Procedure Counts

• Procedure Charges by Measure

• Revenue by Practice

Recap: Integrated Care Management Workflow

• Embedded in NextGen Ambulatory EHR• Non-disruptive workflow for providers / care managers• Automated outreach (e-mail/text/IVR/Portal…)• Generate, save, and track patient list to review gaps in care• Take actions from single screen, minimum clicks

• Access Patient Chart• Access Patient Dashboard• Add to Recall Plan• Send message using Patient Portal & Population Health• Create tasks• Refer patient• Generate documents

The future:

5.8 UD3 & KBM 8.3.11Spring 2016

NextGen Care Phase 2Provide the ability to add Alerts to selected patients for the Hub

Ability to add a patient to a my list while charting on them

Ability to import lists into a my list

Ability to send patient education material to a patient

Ability to print Care Opportunities

• Single Patient

• All Patients

Ability to see what Cohort list created the Outreach

Alerts

Alerts

Add to My List

Patient Education

Patient Education

Patient Education

Print Care Opportunities

Additional Information

Additional Information

Visit with one our application specialist located at the -Sales Booth

Check out our web site:https://www.nextgen.com/Products-and-Services/Population-Health

• Client Success Stories• White Papers• ACO eBook

Knowledge Exchange

Installation Guide for NextGen Population Health, Version 1.4 UD1

Overview for NextGen Population Health, Version 1.4 UD1

Administrator Guide for NextGen Population Health, Version 1.4 UD1

Operation Staff Training Guide for NextGen Population Health, Version 1.4 UD1

Profiler User Guide for NextGen Population Health, Version 1.4 UD1

Population Management Hub User Guide for NextGen Ambulatory Products, Version 5.8 UD2

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