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2008 HIGHLIGHTS: STEADY GROWTH, MEASURABLE RESULTS, LASTING CONTRIBUTIONS

For nearly a decade CAQH® has consistently demonstrated that industry ingenuity can contribute meaningful solutions to improve the U.S. healthcare system. We started with highly regarded national education programs that communicated the appropriate use of antibiotics and the critical role that beta-blockers play in preventing future heart attacks. We developed and implemented a centralized approach to data collection that has now forever changed provider credentialing. We introduced an innovative e-prescribing initiative. Most recently, we launched a multi-stakeholder collaboration that is advancing system interoperability and driving consistent information exchange between health plans and providers. Through each, CAQH has created lasting impact. Our work in 2008 further positioned CAQH as a nonprofi t alliance that achieves what it sets out to accomplish. Both the Committee on Operating Rules for Information Exchange® (CORE) and the Universal Provider Datasource® (UPD) reached important milestones last year. CAQH solutions generated heightened interest and support from stakeholders throughout the industry. As a result, we were able to increase momentum toward realizing our vision of a healthcare system in which administrative processes are effi cient and easily understood by patients, caregivers and providers.

CORE CORE effectively moved beyond the proof-of-concept stage when it fi nalized the Phase II rules in September. In addition to offering connectivity and other data-exchange infrastructure standards, the Phase II rules address information critical to the healthcare revenue cycle. These data elements include more robust patient eligibility and benefi ts information, and year-to-date patient fi nancial liability. Over 25 organizations committed to complete Phase II certifi cation by the end of 2009 or Q1 2010. Another 20 organizations committed to endorsing the rules. The American Medical Association and the American Academy of Family Physicians endorsed the Phase II rules by year end. Initiative momentum also spurred signifi cant state and national interest in CORE last year, a testament to the real need for uniform electronic communication protocols. In 2008, state-sponsored, multi-stakeholder committees in Ohio and recommended their respective legislatures consider adopting the CORE Phase I rules for exchanging electronic eligibility information between providers and payers. By the end of the year, CORE rules were being considered for use in national interoperability standards. The entire set of CORE Phase I rules, as well as three Phase II rules specifi c to eligibility, for example, were incorporated into the Healthcare Information Technology Standards Panel (HITSP) Patient Generic Health Plan Eligibility Verifi cation Transaction. In addition, the joint WEDI/X12 Real-time Adjudication Communications Workgroup acknowledged the CORE Phase II connectivity rule as a potential national standard. CORE experienced growth in both Phase I rules certifi cation and endorsement in 2008. Of particular note, RxHub, now Surescripts, was the fi rst e-prescribing entity to complete CORE certifi cation. This achievement represents a necessary step toward synchronizing interoperability efforts throughout the healthcare marketplace. CORE rules certifi cation last year also enabled a select number of electronic medical record (EMR) vendors to ensure that consistent patient administrative data can be integrated with clinical information into electronic records. That integration creates a more complete, robust picture of the patient for physicians and other healthcare professionals at the point of care. We believe that the CORE rules have only begun to demonstrate their potential as a component of a successful national HIT strategy. The current healthcare reform efforts view information technology solutions as essential to achieving a more effi cient industry. Within that framework and with the introduction of the Phase III rules in 2009, we anticipate industry adoption of CORE to accelerate at an even faster pace.

UPD An additional 90 health plans, hospitals and other healthcare organizations signed on to streamline provider data collection through the UPD service in 2008—a 26 percent increase over 2007. On the provider side, more than 688,000 physicians and allied health professionals were using UPD to securely maintain their data and cut costs—107,000 more than the previous year. CAQH estimates that the online service was saving more than $76.5 million annually and had eliminated nearly 2 million legacy paper applications to date by the end of 2008. We broadened that base of participation through a fi rst-in-the-nation agreement between CAQH and a state hospital association. The Vermont Association of Hospitals and Health Systems (VAHHS) agreement makes it easier for its member hospitals to participate in the service and, therefore, more effi ciently obtain provider information. CAQH is promoting the arrangement as a model approach to other hospital associations. Two additional states, and Ohio, simplifi ed the provider data-collection process by moving from their state form to the CAQH Standard Provider Credentialing Application as their required form. Those moves extended a trend in state adoption, increasing the total number of states mandating or designating the form for use by managed care organizations to 11. In 2008 CAQH witnessed a jump in SanctionsTrack participation. A signifi cant number of health plans signed on to the service that centralizes access to continuously monitored provider sanctions information from more than 400 national and state primary sources. CAQH will drive further adoption of the service in 2009 through a focused outreach effort promoting SanctionsTrack as a comprehensive tool for easily identifying sanctioned providers. CAQH ensured that UPD growth in the future will be effectively supported when we transitioned management of the initiative to Affi liated Computer Services, Inc. (ACS) last summer. The respected Fortune 500 technology company is now providing all business processes, information technology, and customer care activities related to UPD. CAQH will work with ACS to modernize and enhance the service in 2009. In addition, we will introduce system functionality that enables providers to opt-in to participate in volunteer emergency response efforts, receive liability insurance quotes and access other programs to streamline practice management. CAQH also took steps in 2008 to evaluate the quality of data entered into the UPD. We convened the Data Quality Task Force group to specifi cally assess the integrity, timeliness and accuracy of the information obtained through the service. CAQH will use the anticipated results to generate broader understanding about how UPD can reduce administrative costs related to provider directories, claims administration, network management and more.

LOOKING FORWARD The national dialogue about a more effi cient healthcare system has focused increased interest in simplifying healthcare administration. Leading industry organizations have issued thoughtful recommendations for reducing costs and improving productivity during the past several months. When examined closely, those recommendations point to approaches consistent with our mission and specifi c improvements that CAQH is already addressing—confi rming that we have been on the right track for some time. CORE and UPD are targeting real business issues. They are producing real results in the marketplace today—results that can be tracked across a wide range of stakeholders. They have helped provider practices operate more effi ciently and spend more time treating patients. Most importantly, our initiatives have demonstrated that cross-industry, public-private collaboration can contribute positive, lasting change. We will take every opportunity to extend their impact in 2009. CAQH will continue to work closely with federal and state agencies, provider organizations, standards-setting bodies, and other leading healthcare entities to more broadly implement meaningful solutions that leverage the success of our initiatives. Your leadership has been critical to the success that CAQH has achieved in moving the industry toward a signifi cant reduction in the cost and frustration associated with healthcare administration. Given the current national discussion on healthcare reform, your leadership has never been more important. We look forward to working together to further position the CAQH initiatives as important solutions for achieving reform goals.

Robin J. Thomashauer

Executive Director CAQH MEMBERS AND PARTICIPATING ORGANIZATIONS*

A CareFirst BlueCross BlueShield G K NextGen Healthcare Information Southern California Childrens Absolute Total Care Care Improvement Plus Gateway EDI Kaiser Foundation Health Plan of the Systems, Inc. Health Network Accenture CareMedic Systems, Inc. GE Healthcare Mid-Atlantic States NJ Shore (WEDI/SNIP NY Affiliate) Southwestern Vermont Medical Center ACS EDI Gateway, Inc. CareSource Geisinger Health Plan Kaiser Health Foundation of NoMoreClipboard.com Space Center IPA ActivHealthCare CareSource Ohio General Vision Services (GVS) Kent County Health Services North Country Health System Spectrum Laboratory Network Advantage Health Plan Care to Care George University Medical Kentucky Division of Medicaid Services North Shore Long Island Jewish Springfield Hospital Vermont Advantica Eyecare Carolina Care Plan Faculty Associates Kentucky Medical Services Health System St. Francis Health Network Adventist HealthCare, Inc. Carolina Crescent Health Plan Georgetown University Hospital Foundation, Inc. North Shores Hospital St. Francis PHO Adventist Health System, Catholic Healthcare West Gifford Medical Center Kentucky Orthopedic Physical Therapy North Texas Specialty Physicians St. Francis PHO of Network Aetna, Inc. Cedars-Sinai Health System Gordon PHO NorthWest Georgia Physicians St. John Macomb Oakland Hospital Kentucky Orthopedic Rehab Team, LLC Association Affiliated Healthcare, Inc. (AHI) Cenpatico Behavioral Health, LLC Goshen General Hospital / Indiana St. John’s Health Keystone Mercy Health Plan Northwestern Medical Center Affinity Health Plan Centene Corporation Lakes MCO St. Louis University Hospital L O AGMCA (Akron General PHO) Center Care Health Benefit Programs Grace Cottage Hospital Stark Regional PHO LaSalle Medical Associates Ohio State University Hospital Alliance Health Partners Center for Health Transformation Grady Memorial Hospital Suburban Health Organization Lewis – Gale Clinic, LLC. Ohio State University Hospital East Alpha Care Medical Group Centers for Medicare and Medicaid Grant Medical Center SummaCare Services (CMS) Greater Hospital Association Lifespan / New England Physician OhioHealth Group, Ltd. Summit Medical Group Always Care Benefits Network CentMass (GNYHA) Omega Technology Solutions Sunshine State Health Plan America’s Health Insurance Plans LINXUS (initiative of GNYHA) (AHIP) Central Vermont PHO Greater Rochester IPA (GRIPA) OptiCare Eye Health Network Surescripts Louisiana Medicaid – Unisys American Academy of Family Physicians Childrens Hospital Medical Center Great Lakes Health Plan OptumHealth Care Solutions – Sutter Medical Foundation Lovelace Health Plan Physical Health (AAFP) (Cincinnati) Great-West Healthcare Synergy Health Network, Inc. M Oregon Department of Human American Association of Preferred Childrens Mercy Family Health Partners Group Health, Inc. T Magellan Health Care, Inc. Resources Provider Organizations (AAPPO) Childrens National Medical Center Group Health Insurance of New York Target Clinics (GHI) MagnaCare Health Plan Otis Health Care Center / Grace American College of Physicians (ACP) CIGNA Behavioral Health Texas Professional Healthcare Alliance H Maine Network for Health Cottage American Health Information CIGNA HealthCare The Chiropractic Association of Management Association Hardin Memorial Hospital MAMSI Health Plans Owensboro Community Health Citrus Healthcare Network the Midwest American Health Network of Indiana Harding Hospital Managed Health Network Claredi (an Ingenix Division) Oxford Health Plans, Inc. The First Health Network / American Medical Association (AMA) Harvard Pilgrim HealthCare Managed Health Service Clarian Ambulatory Care Management P CCN Network AmeriChoice Health Alliance of the South Marion General Hospital / MMG Palladian Muscular Skeletal Health The Physicians Assurance Company Amerigroup Corporation Health Alliance Plan Martin’s Point Health Care Clinical Practice Organization Parkview Health Plan Services The SSI Group, Inc. AmeriHealth Mercy Health Care Service Corporation Mayo Clinic Colonial Cooperative Care PartnerCare Health Plan, Inc. The TriZetto Group, Inc. AmeriHealth New Jersey Health Level 7 (HL7) MDI Colorado Access Passport Health Communications TRIAD Healthcare, Inc. Angeles IPA Health Net, Inc. MD On-Line, Inc. Commonwealth Family Health Plan Passport Health Plan TRICARE Anthem Blue Cross and Blue Shield Health Net Federal Services, LLC MDWise Select Health Community Care Physicians Payerpath, a Misys Company Tufts Health Plan Arcadian Health Plans Health One Alliance / Alliant Health MedData Community Choice Peach State Health Plan U Arnett Clinic, LLC Health Options, Inc. Medical Group Management Association Community Family Care Medical Group Pediatrix UniCare ASC X12 Health Plus PHSP (MGMA) Community Health Care Network People’s Health Unified Physician Network athenahealth, Inc. Health New England Medical Informatics Engineering, Inc. Comprehensive Care Management Physician Associates of Middle Georgia Unison Health Plan Atlantis Health Plan Healthcare Administration Medical Mutual of Ohio Continuum Health Partners, Inc. Physician Healthcare Network, PC United Behavioral Health AultCare Technologies, Inc. Mercy Care Plan Copley Hospital Physician Organized Healthcare System United Physicians Availity LLC Healthcare Association of New Mercy Health Plans Cornerstone Alliance, Inc. (A PHO) Physicians Health Plan of Mid Michigan United States Army National Guard Avalon Healthcare York State Mercy Health System PHO Coventry Health Care Physicians Health Plan of Northern United States Department of Averde Health Healthcare Billing and Management Meriden – Wallingford IPA Veterans Affairs Creoks Behavioral Health Services, Inc. Association Indiana, Inc. AvMed Health Plans Meridian Health Plan UnitedHealth Group CSC Healthcare Financial Management Physicians of Coastal Georgia B Culpeper PHO Michigan Department of Community Unity Healthcare Association (HFMA) Health Physicians United Plan, Inc. Beacon Health Network D Univera Healthcare Information and Michigan Public Health Institute Pillsbury Winthrop Shaw Pittman LLP BlueCare Network Davis Vision Management Systems Society Universal American Microsoft Corporation Porter Hospital Blue Cross and Blue Shield DaVita Village Health (HIMSS) Universal Health Care MidCounty IPA Planned Parenthood of Metropolitan Association (BCBSA) DC Chartered Health Plan, Inc. Healthcare Partners Medical Group Washington DC, Inc. University Healthcare Associates, Inc. Blue Cross and Blue Shield of HealthFusion, Inc. Minnesota Department of Human University Health Plans Inc. Deaconess Health Plans Services PNC Bank Blue Cross and Blue Shield of HealthLink, Inc. University Physicians Associates Delta Dental Plans Association Mobility Medical, Inc. Post-N-Track Blue Cross and Blue Shield of Georgia HealthNow New York, Inc. Louisville Dental Partners of Georgia, LLC Molina Healthcare of California Preferred Care Partners (Florida) Blue Cross and Blue Shield of Kansas HealthPlan of Michigan University Physicians, Inc. (University Devon Healthcare Molina Healthcare of Florida Preferred Health Professionals Blue Cross and Blue Shield of HealthPlus of Michigan of Maryland) Doctors Hospital Molina Healthcare of New Mexico PricewaterhouseCoopers LLP Kansas City HealthRight UNMC Physicians Doctors Hospital Nelsonville Molina Healthcare of Ohio Principal Financial Group Blue Cross and Blue Shield of HealthSmart Preferred Care US Family Healthplan / St. Vincent Massachusetts Dublin Methodist Hospital Molina Healthcare of Utah Priority Health Catholic Medical Centers DuPage Valley Physicians (The Parker Group) Prism Health Blue Cross Blue Shield of Highmark Blue Cross Blue Shield Molina Healthcare of Washington Utah Health Information Network (UHIN) Michigan E Private Sector Technology Group HIP Health Plan of New York Montefiore Medical Center of New York Utilization Review Accreditation Blue Cross and Blue Shield of East Georgia Physician Group Providence Hospital Commission (URAC) HMS mPay Gateway Blue Cross and Blue Shield of Edifecs, Inc. Providence Park Hospital V Hollywood Presbyterian Medical Group Mt. Ascutney Hospital North Carolina eHealth Initiative Multicultural Primary Care Q Valley Health Blue Cross and Blue Shield of Rhode Electronic Data Systems (EDS) Horizon Blue Cross Blue Shield of QS/1 Data Systems New Jersey Medical Group Valley Health Network Island Electronic Healthcare Network R Hospital for Sick Children MultiPlan, Inc. Virginia Health Exchange Network BlueCross BlueShield of Accreditation Commission (EHNAC) RealMed Corporation HSC Health Plan MVP Health Plan, Inc. Virginia Premier Electronic Network Systems, Inc. (ENS) Recondo Technology, Inc. Hudson Health Plan, Inc. N VisionShare, Inc. Blue Cross and Blue Shield of Vermont (an Ingenix Division) RelayHealth Humana Inc. / ChoiceCare Network NACHA – The Electronic Payments Visiting Nurse Service of New York / Blue Cross and Blue Shield of Western Emdeon Business Services Association Richard M. Ross Heart Hospital VNS Choice New York Humana Vision Emerging Health National Account Service Company River District Hospital W Blue Cross and Blue Shield of Huron Valley Healthcare Empire HealthChoice (NASCO) River Valley Health Alliance Wake Forest University Health Sciences I Employee Health Systems National Capital Preferred Provider Riverside Methodist Hospital WellCare Blue Cross of California Independence Blue Cross Enclarity, Inc. Organization (NCPPO) Rochester Community IPA, Inc. WellChoice Bluegrass Family Health Independent Health Excellus Health Plans National Committee for Quality Rocky Mountain Health Plans WellPoint Behavioral Health Boston Medical Center HealthNet Plan Independent Practice Association of Assurance (NCQA) EyeMed Vision Care Rutland Regional Medical Center WellPoint, Inc. Brattleboro Memorial Hospital F Georgia, Inc. National Council for Prescription Brattleboro Retreat Indiana Pro Health Network Drug Programs (NCPDP) S Windsor Health Plan Fairpay Select Health Saint Barnabas – Metrowest IPA Wise Provider Networks Bravo Health Fallon Community Health Plan Indiana University / University Health National eHealth Collaborative Care Associates Schaller Anderson Women and Infants PHO of Rhode Island Bridgeway of Arizona FEI Behavioral Health NaviNet Industry Buying Group Secure EDI Health Group, LLC Work Group for Electronic Data Brighton Hospital Fidelis Secure Care Neighborhood Health Plan Inland IPA Select Health Interchange (WEDI) Buckeye Community Health Plan, Inc. First Choice PHO Netwerkes InstaMed Senior Whole Health, LLC Workers Compensation Trust C First Data Corp. – Healthcare Network Health Plan Interplan Health (The Parker Group) Sentara Healthcare CalRHIO 1st Medical Network New Avenues, Inc. J Siemens / HDX * CAQH member organizations Capario Fletcher Allen Healthcare New Directions Behavioral Health in bold James Cancer Hospital and Solove SIHO Insurance Services Capital District Physicians’ Health Plan Foresight Corporation New York-Presbyterian Hospital (CDPHP) Research Institute Smart Card Alliance Council Freedom Healthcare New York Presbyterian System Care1st of Arizona Select Health South Georgia Physicians Association, FrontPath Health Coalition LLC

601 Avenue, NW · South Building · Suite 500 · Washington, DC 20004 · www.caqh.org 2008 Highlights