TRAX^TM Summary

How TRAX Works | Disease Management Process

How TRAX Works

Matria's disease management programs are built on a sophisticated and advanced technology platform known as TRAX, which serves as the information hub for the patient's entire clinical picture. From initial risk assessment to outcomes reporting, TRAX builds a comprehensive record of the patient case.

As the industry's most advanced disease management technology, TRAX integrates information from multiple sources, including claims data, pharmacy prescriptions, lab results, emergency room visits and hospitalization information. From this information, a complete patient record is developed and accessed by clinicians as they interact with patients, allowing them to provide more informed medical counseling and guidance.

Because of this highly complex system, we can more effectively:

• Analyze data from claims, lab and prescription records
• Develop customized educational materials to eligible participants
• Perform multicondition risk assessments and risk stratifications to ensure patients receive the right level of care and information based on the severity of the disease
• Offer complete programs for co-morbidities
• Provide quantifiable, measurable outcomes

Most importantly, instant access to all relevant, timely and recent medical information allows Matria's healthcare professionals to make the best decisions regarding an individual's healthcare needs. By combining the human touch of experienced clinicians with the ability to access a patient's entire medical picture, Matria maximizes the potential for cost savings and improved outcomes.

Disease Management Process

Participant Identification - TRAX seamlessly integrates massive quantities of data from multiple disparate healthcare systems to identify and enroll at-risk individuals who can benefit from a disease management program. Information includes claims and utilization, laboratory and pharmacy data, as well as direct referrals from health plans and providers.

Assessment - Matria's specialized nurses conduct a multicondition risk assessment by phone and enter the data into TRAX. The system validates key conditions, identifies any undisclosed conditions or co-morbidities and performs a core assessment. Clinical performance indicators are analyzed to confirm and monitor the core assessment.

Risk Modeling & Stratification - The system stratifies the participant population into four levels of severity in order to provide the appropriate level of support to each participant:

• Level I      Patient Education for a Chronic Condition
• Level II     Intervention Management for a Chronic Condition
• Level III    Active Intervention for an Acute Condition
• Level IV    Case Management

Matria's technology solution includes state-of-the-art predictive modeling tools to determine the probability that a given patient has a chronic condition or is at risk of a significant health event that will result in substantial costs in the near or longer-term future.

Matria's predictive modeling tools turn raw claims data into approximately 100 clinically and statistically meaningful inputs. Information is analyzed in order to anticipate which patients might need early intervention to prevent future high-cost medical events.

Two important groups are identified:

1. Current high-cost participants whose chronic conditions are likely to generate additional high costs in the future
2. Current low-cost participants whose clinical indicators point to higher costs in the future.

Program & Patient Compliance - The TRAX system monitors and evaluates patient compliance on an ongoing basis. Patient compliance is measured against national clinical and quality standards for the specific condition. Interventions, education and follow-ups are triggered by assessment data. The entire workflow is managed by TRAX, including to-do lists, past-due alerts and participant reminders.

Patient Education - The TRAX system is integrated with Matria's On-Demand Publishing department to send educational materials to each patient. Risk-specific materials are customized to address the recipient's needs.

Intervention Management - TRAX develops a customized intervention management plan to help employees comply with their doctor's plan of care. Individualized plans reflect the medical issue, the employee's perception and willingness to change, specific goals, action items and scheduling, clinical referrals and ongoing notes. The entire workflow is managed by TRAX. The system also recognizes recent emergency room visits, hospitalizations and other indicators to initiate a patient contact from a Matria nurse.

Reporting - TRAX generates a broad range of reports for program management, clinical decision-making and strategic evaluation by employers or health plans. Clinical and administrative reports are available online 24/7 through a secure login. Reports include:

• Clinical Reporting
• Activity Reporting
• Outcomes Measurement
• Satisfaction Reporting
• Management Reporting
• HEDIS Reporting