Molina Healthcare Update 11/30/2018 Presented by: Jorge

Molina Healthcare Update 11/30/2018 Presented by: Jorge Rivera, Director, Community Engagement

What we will cover About Molina What is happening in WA Medicaid Molina in Apple Health Molina in Dual Snip Medicare Contact Information 02/12/2024 2

Who do we help?. Molina Healthcare Focus Limited profit contracts This is the population we understand and have served in WA for 20 years, we feel proud to be able to help 3

Molina in Washington State Largest “Apple Largest Health” plan“Apple in the Health” plan state, 44% ofin the state, 44% of Washington’s 1.5M Washington’s 1.5M members served members served Longest standing Longest standing “Commendable” “Commendable” Quality Quality Accreditation from Accreditation from NCQA NCQA Chosen by about a Chosen by about a half (49.2%) half (49.2%) of all new members of all new members joining Medicaid joining Medicaid Longest standing Longest standing “Multicultural “Multicultural Healthcare” Healthcare” Distinction from Distinction NCQA from NCQA Largest Medicaid provider network including 101 of all Largest Medicaid and provider including 101 of 102 state hospitals, morenetwork than 25,000 providers ofall 102primary state hospitals, and more providers of and specialty care than in all 25,000 39 counties primary and specialty care in all 39 counties 4 NCQA National Committee for Quality Assurance

What is changing in Washington State Medicaid? The Path towards IMC – Integrated Managed Care In 2014 the state of Washington legislature decided to start integrating Medicaid services for physical health, behavioral health, and substance use disorder treatment under the service of Managed Care Organizations In April of 2016 the first region, SW WA, Early Adopter went live with over 80,000 members In 2017 the second region, NC WA, decided to move forward with IMC, went live this year with over 70,000 members This year the state completed scoring and assignments for selected MCOs in all remaining regions 5

State Scoring of MCOs for Integrated Managed Care 2019 2020 2019 2019 2018 2020 2019 2020 2019 2016 Molina Awarded 1st Place in each of 10 regions of the state, including Pierce County 02/12/2024 6

Integrated Financing Integrated Care 7

Integrated Managed Care What Does Better Look Like? Better medical care and outcomes for people living with chronic mental illness Better identification and treatment of behavioral health conditions in primary care Better integration of fragmented systems through care coordination – no falling through cracks Triple Aim Better inclusion of Social determinants of Health Better health outcomes Lower total cost of care Better Patient/ Provider experience 8

Leader in Integrated Managed Care Molina was one of the two MCOs selected for the first implementation, Early Adopter, of IMC in 2016 We are currently serving more than 130,000 members already converted to IMC, more than 80,000 of them for over 2 years Molina has signed agreements with all current providers of Behavioral Health and Substance Use Disorder treatment, previously contracted with the local BHO, in all current and upcoming regions The first official report from DSHS about health outcomes under Integrated Managed Care after the first year, showed overall improvement compared to regions not yet on IMC Of 19 metrics in the study 10 showed greater relative improvement, 8 stayed even and only 1 showed lower relative improvement than non IMC regions 9

Regional Membership Apple Health Medicaid in Pierce County Medicaid Enrollment by MCO 36413 18737– King County 19% 100856 53% 10% 16333 9% 18010 9% MCO 1 MCO 2 MCO 3 Molina MCO 4 Molina also has the highest percentage of new member choice in Pierce County with 48% of new enrollments when member makes the choice Choice represents 40% of all new enrollments in Washington State; Re-enrollments (28%), Family Connections, (18%), and Government Assignments (14%) make up the rest, Molina is highest in all enrollment categories Source: WA State Healthcare Authority July 2018 10

Benefits and Incentives for Medicaid 11

Virtual Urgent Care Member can talk or video chat with a provider 24/7 from their phone, tablet or computer. No appointment needed. Virtual care doctors and nurse practitioners can treat minor conditions like: Colds Rashes Ear pain Pink eye and more! Once member has been assisted via virtual visit, the member’s Primary Care Provider assigned receives a full report from the urgent care provider, to ensure continued care and allow for the member’s family clinic follow up. More than 3,000 Molina members have already and successfully used virtual urgent care services. “Very informative and personable, making the experience wonderful! I felt very comfortable, especially knowing what I can do to care for myself afterwards.” Molina Member

Free Cell Phone for Members Molina’s supports Safe Link Wireless Free Cell Phone service for its members, they can easily be connected to a free cell phone with 350 monthly minutes to access services and 1Gb Data to download. We are also connecting our systems so that calls to Molina Member Services line will not count towards members monthly minutes. My Health in Hand & My Molina Molina’s phone app and smart phone enabled information for members provides them with access and help to: Find a doctor or clinic near you Connect to our Virtual Urgent Care Clinic See member’s ID card Change your Primary Care provider Make payments (QHP) See health information anytime See you service history And more! 13

Healthinhand App - New Features* Push notifications Prenatal program Lab results added to MyHealth Simplified registration Marketplace paperless billing enrollment (effective 1/1/19) * Coming this fall 14

Health Incentives Health Programs Up to 200 per member per year in healthrelated gifts they can choose online for using preventive and chronic care services such as: Well-child exams Immunizations for children Breast cancer screenings Care during pregnancy and after baby is born Cervical cancer screening Breast Cancer screening Diabetes management Sports Physicals: Covered only if part of a full well-child visit, and according to age of the member; this way we ensure child is fully screened, which helps CHCs quality metrics goals, and not just completing a requisite for sports participation Weight Watchers Available to qualifying members 18 years and older. Motherhood Matters Pregnancy Program Learning how to have a healthy pregnancy and the services available. Text4baby Free text messages on baby care at text4baby.org Stop Smoking Program Kick the habit through one-on-one counseling and education. Women’s Health Get resources on ways to stay healthy like wellness exams, important screenings and maternity care. 15

Servicing LGBT Community in Washington Some community partners have expressed struggle to understand MCO services provided under Medicaid that are specifically related to gender transition. Molina covers, and is currently actively servicing with no need for prior authorization, the following services: – Hormonal Therapy – Psychosocial Therapy – In cases where the providers want to do extended psychological evaluation, those could require PA Molina also actively supports community based organizations providing services with focus in LGBT Community such Oasis Youth Center and across the state. 16

Molina and the Social Determinants of Health Molina partners with more that 1,200 Community Based Organizations across the state, more than 200 in Pierce County alone. Many of these provide supportive Housing (140 ) and Supportive employment (80 ) services We have also developed joint programs with Care Coordination Organizations for transitional housing, respite medical, and others Molina participated in the creation of the Foundational Community Supports since 2014, and currently participates in the work related to this benefit On the other hand, though, Molina support a larger set of initiatives for supportive housing, with different timelines and sustainability plans 17

Molina Support Dental Managed Care Molina chose not to directly bid for a Medicaid dental managed care service, and instead selected Delta Dental (Dentegra), a national and local leader in managed care dental services, as strategic oral health partner; Molina will also work with other managed care providers selected We believe this partnership will improve access to oral health and oral health outcomes for Molina members The Molina-Delta Dental partnership supports many of HCA’s stated objectives for the Managed Care Dental program including: – Reduced emergency room visits for dental services and treatment of oral health conditions by facilitating increased access to consistent dental care – Improved oral health outcomes for Medicaid clients – Retention of innovative programs such as Access to Baby and Child Dentistry (ABCD) program and the Oral Health Connections Pilot Project that improve access and care and develop new programs that improve access to care and dental outcomes – Providing timely access to dental services and coordination of dental and physical health services, as clinically indicated through care management 18

Another Benefit Call Center Operations and Outreach Member Services Live service in several languages M-F 8am-5pm Voice Mail Service level over 80% and less than 3% Abandoned rate New Enrollments Eligibility Questions Full application completion for Medicaid and QHP Leads and referrals processing Provider detailed search Renewals Calling 25,000 to 30,000 members a month Live assistance in recertification for Medicaid, no Robo-calls 3 Calls per member, close to 10,000 assisted per month Eligibility Phone Calls 800-294-8620 Marketplace Calls 855-540-1983 19

Molina and Medicare DNSP Jim Maguire, Medicare Sales Manager 20

What is Medicare? Medicare is the largest health insurance program offered by the U.S. government Medicare is divided into Parts A, B, C and D. Parts A and B are known as “Original Medicare” Medicare covers Americans 65 and older or those who qualify due to disability 21

Medicare Parts A, B, C & D Parts Who Offers What it is Medicare Part A Hospital insurance The Federal Government Part A helps cover you when you are admitted to a hospital or skilled nursing facility. It also helps cover hospice care and home healthcare. Medicare Part B Medical Insurance The Federal Government Part B helps cover your doctor’s visits and outpatient care. It also helps with services Part A doesn’t cover. Part B also covers some preventive care. You usually pay a monthly premium for Part B. Medicare Part C Medicare Advantage Health Insurance Companies Part C helps cover everything in Parts A & B, they can also cover additional benefits not covered by Original Medicare, like wellness programs. Medicare Part D Insurance Companies and other private companies Part D is optional prescription drug coverage for beneficiaries with Medicare. 22

Are you eligible for a Medicare Advantage Plan? Must permanently reside in the Medicare Advantage plan service area for Washington Counties: King Pierce Skagit Snohomish Spokane Stevens Whatcom Whitman 23

What is a Medicare Advantage Dual Special Needs Plan (D-SNP)? Must be entitled and enrolled in Medicare Part A and Medicare Part B and Medicaid Must live in the plan’s service area Must not have End Stage Renal Disease (ESRD). ESRD is permanent kidney failure and requires regular kidney dialysis or a transplant to stay alive Must use providers, pharmacy and services within the Plan Network Must coordinate all care with specialists through the Primary Care Physician 24

Why Molina Healthcare? It’s simple, really Additional benefits above what is currently covered under Original Medicare Access to providers! Part A, B and D, all with one card Additional Resources – Community Connectors, assigned case manager. All here to help you! 25

Model of Care 26

Questions? If you would like to learn more about Medicare DSNP or would like a presentation for your agency, please contact: Jim Maguire Molina Medicare Sales Manager-Washington Phone: 253-441-9182 Email: [email protected] 27

In Summary Molina is not only the largest Medicaid plan in the state, but also has the highest index of new member choice, and the longest standing “Commendable” quality accreditation and Multicultural Health distinction Our focus are the most vulnerable, we are a Medicaid organization serving people who need government assistance for their health We partner with the state on a contract limited to under 3% profit Molina scored first place in each and everyone of the 10 regions for the Integrated Managed Care transition Our benefits are focused in improving our people’s health, and in helping direct providers such as Community Health Centers engage more with members Our regional engagement team has local presence across the state, we know and understand our communities; contact us if you need any assistance! 02/12/2024 28

Molina’s Team Supports You! Sonia Morales – King County Sonia.Morales @molinahealthcare.com (425) 393-5501 Fluent in Spanish Anastasia Garcia – North Sound [email protected] (425) 773-2116 Fluent in Russian Donny Guerrero – North Central WA [email protected] (509) 264-5725 Fluent in Spanish Shannon Dayton – Better Health Together [email protected] (509) 951-9939 Carlos Mejia Rodriguez – Olympic Peninsula [email protected] (360) 489-7969 Fluent in Spanish Carlos Mejia Rodriguez – CPAA [email protected] (360) 489-7969 Fluent in Spanish Carrie Ching – Pierce County [email protected] (253) 973-5171 Fluent in American Sign Language Fenice Fregoso Greater Columbia [email protected] (509) 317-0910 Fluent in Spanish Aideet Pineda – Southwest WA [email protected] (360) 296-6481 Fluent in Spanish Office: 425-424-1100, Ext: 142931 Jeanne “JJ” McMinds – Statewide Tribal Relations [email protected] (369) 485-9991

Thanks! 30