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HealthCore - MDEpiNet.org
HealthCore Overview Real-world research to support evidence-based medicine March 2016 Who We Are COMPANY CONFIDENTIAL | FOR INTERNAL USE ONLY | DO NOT COPY 2 Company History 1996 • Originated as the clinical research and health outcomes arm of Blue Cross Blue Shield of Delaware (now Highmark BCBS of Delaware), becoming an independent research firm 2003 • Acquired by WellPoint Health Networks, Inc. as a wholly‐owned, for‐profit subsidiary for clinical outcomes research 2004 • WellPoint Health Networks and Anthem, Inc. merge to become WellPoint, Inc. , the largest health benefits companies in the United States and largest independent licensee of the Blue Cross & Blue Shield Corporation 2014 • WellPoint, a Fortune 50 company, changes its name to Anthem. COMPANY CONFIDENTIAL | FOR INTERNAL USE ONLY | DO NOT COPY 3 Anthem: A Health Benefits Leader ~71M individuals served 1 in 9 Americans 38.5 million $213 billion total medical members in affiliated health plans benefits paid ` 40% 19% 14% BC or BCBS licensed plans (6) BC or BCBS licensed plans + Medicaid presence (8) Medicaid presence (11) Local Group National Accounts BlueCard® 14% Medicaid 5% 4% 4% Individual FEP Medicare 4 Research areas PPR Payer and Provider Research GAR LSR Government and Academic Research Life Sciences Research COMPANY CONFIDENTIAL | DO NOT COPY 5 HealthCore’s Research Environment COMPANY CONFIDENTIAL | FOR INTERNAL USE ONLY | DO NOT COPY HealthCore Integrated Research Environment - HIRE HIRD Anthem Health Plans & Affiliated Businesses Anthem, BCBS, Empire, Other Blues Member/Patient Community Surveys Focus Groups Medical Charts Registries Provider Community Clinical and Scientific Expertise Physician Practices Hospitals Integrated Delivery Systems Pharmacies Ancillary Services Actionable Information Physicians, Industry, Health Plans, Employers, Regulatory, Patients COMPANY CONFIDENTIAL | DO NOT COPY 7 HealthCore Integrated Research Database COMPANY CONFIDENTIAL | DO NOT COPY 8 HealthCore Integrated Research Database: Nearly 60 million lives with medical eligibility ME WA ND MT VT MI New Hampshire MN OR NY WI ID SD MA Rhode Island MI WY NE OH CA NV NJ MD Delaware IN IL WV UT MO Washington, DC VA CO KS Connecticut PA IA KY NC Virginia TN OK AZ SC AR NM MS TX WellPoint states* >1,000,000 500,000 – 1,000,000 250,000 – 500,000 100,000 – 250,000 <100,000 AL GA LA FL *California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia, Wisconsin COMPANY CONFIDENTIAL | DO NOT COPY 9 HIRD vs US Census - Demographic comparison Age group distribution 10.0% 8.0% 6.0% 4.0% 2.0% HIRD Total HIRD Male HIRD Female US Census Total US Census Male US Census Female 0.0% COMPANY CONFIDENTIAL | DO NOT COPY 10 Research Study Enhancements Value is unlocked with integration The greater the overlap the deeper the insight Health Plan Claims Health Plan Claims provides a broad view, insight into cost of care & information such as actual fill (Rx) history (4‐6 months) Patient/ Provider Surveys Medical Record Information (6‐9 months) (6‐9 months) Prospective/Site Based Data Collection (2 years+) Each Data Source Contributes Unique Information Medical Record Information provides rich clinical information such as prescribed medications, lab and test results, OTC advice and reported use, family history, procedures, conditions treated Patient/Provider Surveys identify decision drivers for seeking care, prescriber preferences, patients’ attitudes and behavior regarding disease/therapies, perceived effectiveness and tolerability of treatments, use of OTC therapies, disease severity, quality of life, patient satisfaction Site-Based Data: Prospectively capture clinical data COMPANY CONFIDENTIAL | FOR INTERNAL USE ONLY | DO NOT COPY 11 California Integrated Data Exchange – Cal INDEX The California Integrated Data Exchange is an independent, not-for-profit organization developing a statewide, next-generation health information exchange (HIE) This comprehensive collection of electronic patient records will include clinical data from healthcare providers and health insurers Cal INDEX will allow physicians, nurses and hospitals throughout the state to share patients’ health information and will provide them with the tools to help them give their patients the safest, highest-quality care possible 12
