1. Integration of Telehealth Into
Managed Care
Dr. William Alexander
Chief Medical Officer, Amerigroup Georgia
March 19, 2013

2. Who We Are: Amerigroup
• We have 17 years of experience providing
access to health care for 2.7 million
members in 13 states, focusing solely on
federal and state programs
• We’re one of the first companies to
integrate coordination of physical, behavioral and social needs while
emphasizing community-based care
• We offer real solutions to address the health care needs of the financially
vulnerable, seniors and people with disabilities
• Our Foundation has provided more than $16.7 million to community
organizations since 2001

3. Amerigroup-WellPoint State Activity
As a wholly owned subsidiary of WellPoint, together with its affiliated
health plans, the combined organizations serve 4.5 million members in
20 states, making us the largest provider of health care solutions to
public programs.

4. About Amerigroup Georgia
• We serve 288,000 members
— Medicaid
— Planning for Healthy Babies
— Children’s Health Insurance Program
— Medicare Advantage
• We have 193 employees, including 62
doctors, nurses and social workers
• We have 18,096 providers and 125 hospitals
• We have donated 4,655 in volunteer hours and $210,600
• National Committee Quality Assurance accreditation: Excellent
• Extra Benefits
— 24-hour HelpLine — Cellular phone service, health-
— Adult vision and dental care related text messages and extra
— Certain approved over-the-counter minutes for those who qualify
medications prescribed by a doctor through SafeLink
— Free Boys & Girls Club membership — Free transportation to doctor’s
appointments for PeachCare for Kids
1. Rural Assistance Center, Georgia, http://www.raconline.org/states/georgia.php. members

5. Why We Innovate
• Result of both the pressures of economic recession and recovery – and the
continuing high unemployment rate – but, also, the scope of health care
reform
• U.S. health system at 30,000 feet in 2019: majority of health spending will
be public (51.9 percent) versus private (48.1 percent)
• With total expenditures on health slated to hit $4.5 trillion by the end of
the decade, innovative solutions to lower costs and promote system
efficiency will be key
innovateto fill
the gap
Source: Congressional Budget Office, Mar. 2010; U.S. Census Bureau, Aug. 2008; Centers for
Medicare & Medicaid Services, Feb. 2010; MedPAC Data Book, June 2009.

6. Rural Georgia
• The poverty rate in rural Georgia is 23.5 percent, compared to 16.7 percent
in urban areas of the state — a 25 increase from the U.S. rate in rural
America (17.8 percent) and 11 percent increase from the rate in urban
America (14.8 percent), respectively1
• Georgia has 118 rural counties: Poverty rates for rural counties exceed
those in urban counties by 58 percent. The rural counties have
approximately half as many physicians and dramatic shortages of
nurses, therapists and nutritionists (per capita) as the metro counties2
1. Rural Assistance Center, Georgia, http://www.raconline.org/states/georgia.php; Rural Assistance Center, United States, http://www.raconline.org/states/unitedstates.php; 2. Georgia Health Equity
Initiative, Health Disparities Report 2008: A County-Level Look at Health Outcomes for Minorities in Georgia, http://health.state.ga.us/pdfs/ohip/Georgia%20Health%20Equity%20Initiative.pdf

7. Rural Georgia, cont’d.
• In Georgia, 24 percent of the rural population has not completed high
school, compared to 16.7 percent of urban populations — a 26.6 percent
increase from that of rural America (17.6 percent) and an 11.9 percent
increase from that of urban America (14.7 percent), respectively1
• 22 percent of Georgians are uninsured; a 27 percent increase over the
national average (16 percent)2
1. Rural Assistance Center, Georgia, http://www.raconline.org/states/georgia.php; Rural Assistance Center, United States, http://www.raconline.org/states/unitedstates.php; 2. Ibid.

8. Health Care Priorities in Rural Georgia
Amerigroup members in rural Georgia face three significant
challenges, which we are working to address:
• Inadequate access to care
• Reduced access to specialty care
• Timely access to behavioral health and specialty consultations

9. Georgia Telemedicine Program
Problem
• Inadequate access to specialty care in select rural and underserved
counties in Georgia
Solution
• First Care Management Organization (CMO) to become a
partner with GPT, the statewide telemedicine network leader
(140 specialists, 40 sites) in August 2011
• Population- and geographic-based targeting strategy for
future presentation site deployment (i.e., highest Medicaid
eligibles, greatest specialist deficiencies)
• Incorporation into internal case management rounds as a
resource to improve access for members with greatest needs
• Targeted provider and member marketing and external
communications in counties with existing sites
• Ongoing collaboration with GPT to address policy
hurdles, analytics and future innovation

10. Funding Our Telemedicine Initiative
Supporting GPT and the targeted
deployment of presentation sites to
improve access to underserved rural
populations:
2011 grant to add presentation
sites: $20,000
• Evans Memorial Hospital — Evans
County
• Meadows Regional — Toombs
County
2012 grant for school-based health clinic programs: $50,0001
• Jenkins County High School and Middle School
• Optim Medical Center Jenkins
• Optim Medical Center Tattnall2
• Optim Medical Center Screven2
1. Includes full presentation capabilities; available to students and community on a year-round basis.
2. Expected to come online within GPT’s network by Q2-2013.

11. Patient-Centered Medical Home Update
Problem
• Timely access to behavioral health consultations for select high-volume
Patient-Centered Medical Home (PCMH) and primary care groups
Solution
• In 2012, collaborated with a GPT partner to provide on-site
presentation capabilities for four PCMH groups
• Practices now have the ability to provide same-day, same-
week access to specialist behavioral health consultations
• Approximately 9,000 members have improved access to
address behavioral health issues
• 30–40 consultations per week across all groups
• Improved member and provider satisfaction, reduction in
time/cost away from work, lengthy gaps in appointment
times
• Enhances the ability of the primary care physician to
coordinate the patient’s care

12. Telehealth by the Numbers
Greater focus on building and communicating the benefits of
telemedicine has seen a rapid increase in the number of unique
members, providers and geographic areas accessing telemedicine
services.

13. Utilization Observations and Early Trends
• Greater than 90% of total utilization is encompassed by the top 10
procedure codes
• Of those top 10 procedure codes, behavioral health services are
currently the overall key driver in utilization
• The percentage of utilization occurring in the top 10 counties is
steadily decreasing, indicating greater access in a growing number
of counties
* All results are specific to a sample population of 501 members that: (a) utilized telemedicine services in 2012, (b) had at least 1 claim in 2011 and 2012.

14. Q-and-A
Dr. William Alexander
William.Alexander@amerigroup.com