The healthcare system in the U.S., when compared to similar nations, is one of the costliest in the world with higher levels of healthcare spending, costlier hospital stays and higher prices of prescription drugs. A major reason for the steady rise in healthcare expenditure over the years has been the episodic treatment approach that has been prevalent in the U.S. These inefficiencies are further exacerbated when factoring the impact of chronic conditions which contributes to roughly 84% of the total healthcare cost. HCL realizes that innovative approaches to population health management – like offering personalized intervention plans to participants of a chronic disease management program – is key for a payer to maintain their customer centric approach and differentiate their services from a traditional care management program. Gain health and wellness of member population through HCL’s personalized, scalable, multi-channel, multi-lingual, cost-effective Member Engagement Program. To know how, please click here: http://microsite.hcltech.com/gainwithchange/care-management.asp

1. Copyright © 2014 HCL Technologies Limited | www.hcltech.com
HCL – Healthcare Payer
Solutions
Patient Engagement Platform

2. 2 Copyright © 2014 HCL Technologies Limited | www.hcltech.com
Healthcare Challenges…
Payer
PharmaProvider
 $300 Billion in redundant or ineffective healthcare
 Effective Care Management and Reduced cost of care
 Regulatory Compliance and Reporting
 Consumer Engagement Explosion
 Administrative overheads
 $290 billion annual in prescription
non-adherence
 Proactively managing quality and
outcomes
 Improving efficiency of care delivery
 Managing Financial Risk and Incentives
 Regulatory Compliance
 One in four seniors take between
10 and 19 pills a day
 1.5 million annual avoidable adverse
drug events
 Pharma companies are not pushing
Pills alone anymore, but looking at
total solutions
 Drug Cost vs. effectiveness;
 Regulatory Compliance and
Transparency

3. 3 Copyright © 2014 HCL Technologies Limited | www.hcltech.com
HEALTHONE
 Make better and informed
decisions
 Have greater
responsiveness to Care
 Be more discriminating,
efficient and effective
users of healthcare
resources
 Have a greater
adherence to health,
wellness and quality
guidelines
 Follow best practices
Payer -
Member Care
Management
Provider -
Patient
Engagement

4. 4 Copyright © 2014 HCL Technologies Limited | www.hcltech.com
Patient Engagement Life-cycle
Member Stratification
 Burden of Illness +
Utilization based score
 Member Demographic
Member to Provider Attribution
 Member attribution to PCP
 Analyzing Claim data for Member
attribution
Set care delivery goals and
incentives
 Track Current Costs
 Set benchmarks and targets for
incentives
Care Delivery to Member – Execute Care Plan
 Care Plan for members with chronic or severe
disease condition
 Define Key patient problem and provide
guidelines
 Referral Management
Enable Follow up care through Patient
Engagement
 Call Scheduling
 Multi-channel patient outreach
 Alerts and Adherence Monitoring
Enable Self Managed Care –
Member Tool kits
 Patient Education
 Self-Managed member tool
kits to measure and track
health parameters
Measure Care Outcomes
 Measure Outcomes based on
the set benchmarks
 Degree of appropriate use of
services

5. 5 Copyright © 2014 HCL Technologies Limited | www.hcltech.com
Member Stratification & Attribution
MEMBER
SEGMENTATION
ANALYTICS
ENGINE
PCP
ATTRIBUTION
DATA
SOURCES
 Member Stratification and Segmentation based on Burden of Illness score
 Member Attribution to PCP based on Member visits based on frequency and recent visits to a PCP

6. 6 Copyright © 2014 HCL Technologies Limited | www.hcltech.com
Care Delivery through Patient Engagement
Nursing Coordinator
SMS/ E-Mail
Snail Mail
Online Resources
PCP
DISEASE BASED
CARE PLAN
PATIENT
ENGAGEMENT
PATIENTS
 PCP assigns a Patient to a pre-defined Disease Protocol based on the Patients Disease condition, stage and need for a
Care Plan
 Patient is supported by a Care Plan administered through multiple Channels and is provided online resources/ toolkits
for self-managed care

7. 7 Copyright © 2014 HCL Technologies Limited | www.hcltech.com
Setting Care Delivery Goals and
Measuring Outcomes
 Track Current Costs and set benchmarks
 Measure Outcomes based on the set benchmarks and identify outliers
 Measure degree of appropriate use of services

8. 8 Copyright © 2014 HCL Technologies Limited | www.hcltech.com
Patient Engagement Platform
Counselor
Pool
PEP PLATFORM
Nurses Pharmacologist Life Science Graduate
 Enrollment through
physicians
 Direct enrollment thru
marketing channels
PATIENT PROFILING &
SEGMENTATION
 Program benefits to
patients
 Biological behavior
mapping with disease
symptoms and patient
support program
correlation
PATIENT ENROLLMENT ONGOING CAREPATIENT COUNSELING
Dietician
Therapeutic
Area
Diabetes, Asthma, Rheumatoid Arthritis, Osteoarthritis, COPD
Channel O/ B Calls SMS E-Mail/ Snail-Mail Online Resources
 Reminder calls
scheduling
 Education on ongoing
treatment
 Gather adherence
data points
 How much
knowledge –
disease &
treatment
 How concerned
about the disease
 Perceived control
of their health

9. 9 Copyright © 2014 HCL Technologies Limited | www.hcltech.com
For Questions,
Please Contact: contact.lsh@hcl.com

10. 10 Copyright © 2014 HCL Technologies Limited | www.hcltech.com