Well Care Health Plans, Inc. Presentation to Georgia House Children's Mental Health Study Committee October 20, 2015 Dauda Griffin, MD Behavioral Health Medical Director Remedios Roderiguez, Senior Director Behavioral Health Operations

1. WellCare Health Plans, Inc.
Agenda
I. Who is WellCare
II. Healthcare Quality and Access
III. Integrated Health Services
IV. Quality
V. Innovation
VI. Questions
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2. 11/2/2015
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WellCare Health
Plans, Inc.
House Study Committee on Children’s Mental Health
By Dauda Griffin, MD, Behavioral Health Medical Director
Remedios Rodriguez, Senior Director, Behavioral Health Operations
October, 20, 2015

3. WellCare Health Plans, Inc.
Agenda
I. Who is WellCare
II. Healthcare Quality and Access
III. Integrated Health Services
IV. Quality
V. Innovation
VI. Questions
3

4. WellCare Health Plans, Inc.
Vision
To be a leader in government-sponsored health care programs in partnership
with the members, providers, governments and communities we serve.
Mission
• Enhance our members' health and quality of life
• Partner with providers and governments to provide quality, cost-effective
health care solutions
• Create a rewarding and enriching environment for our associates
Core Values
• Partnership
• Integrity
• Accountability
• One Team
4
Data is per the last reported quarter, ending June 30, 2015
All numbers are approximated.
Updated: September 18, 2015

5. Serving Georgia
WellCare’s direct economic impact* on the state of Georgia is $26 million annually.
In Georgia, WellCare:
• Serves 653,000 members across the state†
• Has a local presence with five office locations
• Employs 305 people
Counties with WellCare offices
Echols
Lowndes
Charlton
Thomas
BrooksGradyDecatur
Camden
Lanier
Clinch
Miller Colquitt
Cook
Brantley
Atkinson
Mitchell
Baker
Glynn
Ware
Berrien
Early Pierce
TiftCalhoun Dougherty
McIntosh
Bacon
Irwin
Coffee Wayne
Worth
Ben Hill
Turner
LeeRandolph
ApplingTerrell Long
Crisp
Liberty
Wilcox Telfair
SumterStewart Chatham
Bryan
EvansDooly
Tattnall
Toombs
Pulaski
Dodge
Treutlen
Macon
CandlerMarion
Effingham
Muscogee
Bulloch
Houston
Laurens
Taylor
Johnson
Emanuel
CrawfordHarris
Talbot
Twiggs
Bibb Jenkins
Upson
Wilkinson
Screven
Jones
Baldwin
Monroe
Pike
Troup
Washington
BurkeJefferson
SpaldingHeard Butts Hancock
Putnam
Coweta
Jasper RichmondWarren
Henry
ColumbiaNewton Greene
Douglas
Carroll Morgan
Haralson
WaltonDekalb LincolnWilkes
Clarke
OglethorpePaulding
CobbPolk Barrow
Gwinnett
Madison
ElbertJackson
ForsythCherokee
Bartow
Banks Hart
Hall
Franklin
Pickens
Floyd
Chattooga Gordon
StephensLumpkin
White
GilmerWalker
Dade
Union
Catoosa Fannin
Murray
Towns
Rabun
5
Data is per the last reported quarter, ending June 30, 2015
All numbers are approximated.
Updated: September 18, 2015

6. Overview of BH Population
6
Data is per the last reported quarter, ending June 30, 2015
All numbers are approximated.
Updated: September 18, 2015
% of Child Members with a Behavioral Health Diagnosis
Estimated % of Child Members with a BH
Diagnosis
0.00% - 0.19% Members
0.20% - 0.99% Members
1.00% - 2.99% Members
3%+ Members
Estimated % of Child Members with a BH
Diagnosis
American Indian: 40 .09%
Asian: 212 .38%
Black: 20,2303 36%
Black (non-Hispanic): 1223 2%
Caucasian: 31,606 57%
Other: 1,926 3.5%

7. Health Care Quality and Access
Access*
Provider Access:
• 5,200 primary care providers.
• 21,700 specialists.
• 1,900 behavioral health and substance abuse
providers.
Facilities Access:
• 150 hospitals
• 26 community mental health centers
• 160 federally qualified health centers
• 115 CORE providers
• 68 Intensive Family Intervention providers
Geographic Access:
• One primary care provider within 30 minutes for
urban counties and 45 minutes for rural counties.
• One hospital within 30 minutes for urban counties
and 45 minutes for rural counties.
School Based/Telemedicine
• School Based Health Center Partners: Emory University,
Clayton County Public Schools and Family Health Centers of
Georgia
• The school based health center is located at North
Clayton High School. The clinic provides on-site BH
support groups and individual counseling. The goal is to
evaluate 9th graders over the next four years as they
matriculate through high school (academics, social needs,
class behaviors). In addition, there is a student committee
that works closely with the SHBC team.
• Telemedicine : Crisp County and Appling County (school
based)
• Currently, there is limited to no access to therapist
and/or psychiatrist in the community. The setup for the
telemedicine would be in a convenient location to the
school as well as in an area that adults and/or seniors
could access it as well.
• CORE and CSB
• Tanner Medical Center partnership with Haralson
County School Systems
• APEX Project – school-based counseling by CSB’s
WellCare is committed to continually improving the quality of care and service that we
provide to our members.
7Data is per the last reported quarter, ending June 30, 2015
All numbers are approximated.
Updated: September 18, 2015

8. 8
Integrated Health Services
Member
Care
Coordination
& Provider
Engagement
Community
& Social
Safety Net
Resources
Primary
Care, EPSDT
& Wellness
Services
Medical &
Behavioral
Health
Services
MedicalManagement
Services
Community-Based
Services
BENEFIT
COORDINATION
• Comprehensive Needs Assessment
• Multidisciplinary Care Plan
Development
• Covered Benefits
• Enhanced Benefits
BUSINESS & QUALITY
MANAGEMENT
• Education & training
• Continuous Improvement Plans
• HEDIS Care gap closures
• PIPS - data review and trending
• Expanded Benefits & Quality Incentives
CLINICAL CARE
MANAGEMENT
• Disease Management
• Complex Medical Management
• Transitions in Levels of Care
• Medication Management
• Medical Service Authorizations
COMMUNITY CARE
MANAGEMENT
• Social , Functional & Behavioral
Interventions
• Social Determinants of Health
• Community Advocacy
• Community Resource Mapping

9. Integrated Case Management
Regional Pod Assignments
7 Regional pods
 Metro Atlanta – North
 Metro Atlanta – South
 Non-Metro Atlanta
 Central
 Southeast
 East
 Southwest
Pod configuration
 3 Field Service Coordinators
(RN – Medical, OB & Pediatrics)
 1 Social Worker
 1 Clinical BH Social Worker
 1 OB Social Worker
 1 Community Health Worker
 1 Care Coordinator
 1 Utilization Management nurse

10. Integrated Health Services
Focus on Quality – Behavioral Health HEDIS® Measures
 Follow-up care for children prescribed ADHD medication – One follow-up visit within 30 days of medication
initiation. At least two more follow-up visits between 4 and 9 weeks if on medication at least 210 days.
 Follow-up after hospital discharge: One follow-up visit with a mental health provider within 7 and 30 days of
discharge.
 Use of multiple concurrent antipsychotics in children and adolescents
Focus on Care Coordination
 Bilateral communication between PCPs and Behavioral Health providers, with member consent, upon care initiation
and quarterly thereafter via summary reports that include treatment plan, health status changes and medications.
 Psychiatric Hospital communication with PCP and outpatient behavioral health providers upon admission and
discharge plan.

11. On Site Utilization Management /
Discharge Planner
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 Embedded Care Manger in high
volume hospital
 Partnership with hospital to
provide efficient and high quality
care
 Assist inpatient team with
members who have barriers to
discharge
 Provide access to outpatient
and transition services
 Transportation
 Referral to field-base case
management
 Call member to ensure they
have everything needed to
attend follow-up appointment
within 7 days

12. COBALT
Web-based confidential care
When it comes to your patients’ emotional
health, we have a program that makes it
easy for them to get the support they
need. Access self-guided, self-paced,
online programs to support them anytime
and anywhere.
Programs are:
• Clinically proven
• Medication free
• Easy to use
• Long-lasting improvement
This is short-term, goal-oriented,
computerized cognitive behavioral
therapy (CCBT) that focuses on problem-
solving and skill building to help identify
thoughts, modify beliefs and change
behaviors.
You can refer your patients now to these
programs:
RESTORE (Insomnia) — for difficulty
sleeping, 7 online sessions
SHADE — for alcohol or substance use,
10 online sessions
FEARFIGHTER—for anxiety, panic and
phobia, 9 online sessions
MOODCALMER—for mild to moderate
depression, 4 online sessions
Enroll patients now by going to:
wellcare.cobaltcbt.com and select
"Create Account Now"
Questions?
Please call Bridget Cepalia at 860-507-1844

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Questions???