Network Strength
NCPPO delivers regional access to contracted providers who have agreed to accept competitively discounted payments for health services. The NCPPO Mid-Atlantic service area includes Maryland, Virginia and the Washington DC metropolitan area. Additional markets of Arkansas, Illinois, southwest Indiana, Kentucky, central, southern, eastern (St. Louis) Missouri and Texas are available for access through HealthLink.

HealthLink, Inc. manages the NCPPO network. NCPPO is undergoing a transformation to revise contracts, fee schedules, and re-brand the name to HealthLink. Projected completion date is 2009. The HealthLink logo must be included on the member identification card for any new NCPPO groups.

Competitively Discounted Payments
HealthLink/NCPPO’s disciplined approach to fixed payment methodologies, precise modeling/forecasting of rate changes and actuarial calculations allows us to establish aggressive pricing targets by market and product.

Plan Performance Management
Sophisticated rate modeling techniques analyze and evaluate how current market trends, enrollee demographics and client objectives affect plan design. HealthLink/NCPPO makes this information available to help evaluate health benefit programs as well as the cost/ benefit value of changing and adding programs and services when the time is right.

Stability
HealthLink/NCPPO’s consistently high provider retention rate reflects the high level of satisfaction among contracted physicians, hospitals and other health care professionals.

Flexible Plan Options
HealthLink/NCPPO has the flexibility to work with a wide range of third party administrators, including most TPAs chosen by a contracted client. The PPO program can be integrated into company benefit plans to support any plan design. Clients may purchase the basic PPO program package, add components on a menu basis, or purchase a comprehensive PPO package of programs and specialty components at a special, discounted rate. Most pricing is PEPM. Please contact a sales representative for pricing information.

Basic PPO Program Package Includes:

• PPO network access
• IP/OP Medical Management
• Claims Repricing
• Client Management Reporting

Comprehensive PPO Program Package Includes:

• Basic PPO Program Package
• Case Management
• Condition Management Programs
• MaterniCall^™ Prenatal Program
• MedCall^® 24/7 Nurse Hotline

PPO Components Available on a Menu Basis:

• Case Management
• IP/OP Medical Management
• Condition Management Programs
• MaterniCall^™ Prenatal Program
• MedCall^® 24/7 Nurse Hotline
• Worksite Wellness
• Lifestyle Management
• Workers’ Compensation (MO & IL)
• Specialty Programs

Specialty Programs
Through the affiliation with WellPoint, HealthLink/NCPPO offers a broad portfolio of specialty programs, including: Reinsurance; Life and AD&D; Dental; Vision; and Employee Assistance Program.

Cost Management Program
The HealthLink/NCPPO Cost Management Program is an extensive suite of health promotion and wellness information, case management and care coordination services to help physicians help their patients achieve optimal health outcomes. The program consists of three components: Signature Services, Wellness Plus and Personal Care Resources.

Signature Services
HealthLink/NCPPO Signature Services include the following:

• Pre-Admission Certification of Planned Hospital Admission
• Notification of Emergency Hospital Admission
• Concurrent Hospital Stay Review
• Discharge Planning
• Pre-Certification of Selected Ambulatory/Outpatient Services
• Pre-Certification of Selected Ancillary Services

The Case Management program is a collaborative process among WellPoint and other health professionals who manage the resources necessary to support individuals with catastrophic or chronic medical conditions. Case Management enables the treating health care professional(s) to help the patient achieve optimal and timely medical outcomes.

Signature Services also include the following:

• Condition Management Programs – Individualized programs for members with Asthma, Chronic Obstructive Pulmonary Disorder, Coronary Artery Disease, Diabetes and Heart Failure.
• MaterniCall^™ – Maternity management program helps participants make informed decisions during pregnancy and after childbirth.
• MedCall^® – 24/7 nurse hotline and audio library of more than 300+ health topics.
• WellPoint NextRx – Aggressive pharmacy benefit manager targets costs and includes a national retail network, mail order and specialty prescription programs.

Wellness Plus
Wellness Plus includes the following programs, available on a fee-for-service basis. Please contact a sales account representative for pricing information.

• Worksite Wellness Programs – Health educators and registered dietitians visit your workplace to share knowledge on a variety of health and lifestyle topics.
• Lifestyle Management Programs – Online support and one-on-one telephonic coaching to help members make healthy behavior choices in five key areas: tobacco cessation, weight management, physical activity, diet/nutrition and stress management.

Personal Care Resources
The following value-added electronic member resources are available at no cost to clients and members:

• TLC^® (The Last Cigarette) – Smoking cessation program. Members request a TLC quit kit to assist in their efforts to be smoke-free.
• eHouseCall – Monthly wellness newsletter for members.
• Preventive Health Guidelines – As recommended by the U.S. Preventive Services Task Force and other health related agencies.
• Healthy Habits for Healthy Kids – Nutrition and activity guide from the American Dietetic Association.
• Enrollee Rights and Responsibilities – General guidelines for health care consumers.

Administrative Services
HealthLink/NCPPO is committed to supporting a health plan’s benefit administration through maximum use of technology throughout our organization. We offer fast, efficient electronic claim repricing, eligibility management, a state-of-the-art customer service response system, a provider portal and a fully interactive websites, www.ncppo.com and www.healthlink.com.

Account Management Services
Our account managers serve as liaisons between HealthLink/NCPPO and contracted clients. They are responsible for the timely resolution of day-to-day service issues. Account managers also make on-site service visits and compile/present management reports.

Management Reporting
Timely reporting tracks membership, health care services, claims accuracy, payments and utilization.