INLAND EMPIRE HEALTH PLAN

STANDARD MONTHLY REPORTS

Supplemental to:

Board Report #288

March 11, 2019

Inland Empire Health Plan Supplemental to Board Report #288 March 11, 2019

ADMINISTRATION (Bradley P. Gilbert, M.D.)

1. Standard IEHP Monthly Reports a. IEHP Finance Reports 1) Income Statements 2) Capitation Income and Expense b. IEHP Operations Reports 1) Claims Summary Report 3) Claims Processing Turnaround Time 3) PCP Member Allocation Report 4) Member Services Telephone Activity Report 5) Provider Automated Eligibility Contact Report 6) Member Eligibility Verification Report c. IEHP Provider Reports 1) IPA Consolidated Membership Report 2) Hospital Consolidated Membership Report 3) New Enrollment Trend Report by Consolidated IPA d. IEHP Marketing Reports 1) All Medi-Cal Aid Codes Enrollment Report 2) Medi-Cal Mandatory – Families Aid Codes Enrollment Report 3) Medi-Cal Mandatory – Seniors & Persons with Disabilities (SPD) Aid Codes Enrollment Report 4) IEHP’s Medi-Cal Non-Mandatory Aid Codes Enrollment Report 5) IEHP’s Medi-Cal Expansion Aid Codes Enrollment Report 6) IEHP Medicare Enrollment Report

2 Inland Empire Health Plan Supplemental to Board Report #288 March 11, 2019

ADMINISTRATION (Dr. Gilbert) 1. Review of the Financial Monthly Reports a. Finance Reports 1) Income Statement for the Month Ended January 31, 2018 (in thousands)

Organizational Medi-Cal Medicare Expenditures Grand Total Actual Budget Variance $ Actual Budget Variance $

Premium Revenue 328,642 319,162 9,481 36,240 34,486 1,753 - 364,882 Supplemental 35,487 26,276 9,210 - - - - 35,487 Other Revenue - - - 2,086 1,338 748 - 2,086 Net Revenue 364,129 345,438 18,691 38,325 35,824 2,501 - 402,454

Facility Claims 126,683 129,243 (2,560) 14,290 12,885 1,405 - 140,974 Capitation Expense 64,678 67,702 (3,025) 12,876 12,530 345 - 77,553 Professional 40,822 34,415 6,407 4,537 4,004 533 - 45,359 Pharmacy 60,440 62,580 (2,140) 4,691 5,776 (1,086) - 65,131 Incentives 5,102 5,435 (333) 171 349 (178) - 5,274 All Other Medical 25,877 21,607 4,270 3,185 2,204 981 - 29,062 Other Expenses 16,715 6,778 9,937 62 - 62 - 16,777 G & A Expenses - Medical ------9,961 9,961 Medical Cost Allocations 7,770 8,933 (1,163) 2,191 2,265 (73) (9,961) - Total Medical Costs 348,088 336,695 11,394 42,003 40,014 1,990 - 390,092

Gross Margin 16,040 8,743 7,297 (3,678) (4,189) 512 - 12,363

3 Inland Empire Health Plan Supplemental to Board Report #288 March 11, 2019

ADMINISTRATION (Dr. Gilbert) 1. Review of the Financial Monthly Reports a. Finance Reports 1) Income Statement for the Month Ended January 31, 2018 (in thousands) (continued)

Organizational Medi-Cal Medicare Expenditures Grand Total

Actual Budget Variance $ Actual Budget Variance $ Operating Expenses Administration 1,773 1,954 (181) 138 156 (18) - 1,911 Finance 797 930 (132) 134 162 (27) - 931 Information Technology (IT) 5,634 4,633 1,001 133 113 20 - 5,767 Marketing 1,056 1,046 11 307 302 5 - 1,364 Health Services 2,011 1,836 175 553 507 46 - 2,564 Network Development 53 55 (2) 178 183 (5) - 231 Operations 4,949 5,084 (134) 869 836 33 - 5,818 Total Operating Expenses 16,273 15,537 737 2,313 2,259 54 - 18,586

Operating Surplus (Deficit) (233) (6,794) 6,561 (5,991) (6,449) 458 - (6,223)

Total AB85 2,051 2,048 3 - - - - 2,051 Total IHSS (2,200) - (2,200) - - - - (2,200) Total Sales Tax (77) - (77) - - - - (77) Other Income (Expense) ------936 936 Property Management Income (Expense) ------82 82

Total Non Operating Income (Expense) (226) 2,048 (2,274) - - - 1,018 793 Net Surplus (Deficit) (459) (4,746) 4,287 (5,991) (6,449) 458 1,018 (5,431)

4 Inland Empire Health Plan Supplemental to Board Report #288 March 11, 2019

ADMINISTRATION (Dr. Gilbert) 1. Review of the Financial Monthly Reports a. Finance Reports 1) Year-To-Date Income Statement for the One Month Ended January 31, 2018 (in thousands)

Organizational Medi-Cal Medicare Expenditures Grand Total Actual Budget Variance $ Actual Budget Variance $

Premium Revenue 2,304,215 2,226,600 77,615 244,967 236,265 8,702 - 2,549,181 Supplemental 242,482 175,815 66,666 - - - - 242,482 Other Revenue 0 - 0 4,929 7,540 (2,612) - 4,929 Net Revenue 2,546,696 2,402,415 144,281 249,896 243,805 6,091 - 2,796,592

Facility Claims 901,182 866,740 34,442 95,829 86,118 9,711 - 997,011 Capitation Expense 461,983 478,039 (16,056) 91,311 85,237 6,075 - 553,295 Professional 266,397 229,889 36,508 33,063 26,748 6,315 - 299,460 Pharmacy 402,486 396,501 5,985 19,864 25,863 (5,999) - 422,350 Incentives 26,877 38,045 (11,169) 1,749 1,004 745 - 28,626 All Other Medical 163,471 144,751 18,720 18,110 14,719 3,391 - 181,581 Other Expenses 113,611 50,394 63,217 (118) - (118) - 113,493 G & A Expenses - Medical ------62,273 62,273 Medical Cost Allocations 48,823 59,274 (10,451) 13,450 15,225 (1,775) (62,273) - Total Medical Costs 2,384,831 2,263,633 121,198 273,258 254,914 18,344 - 2,658,089

Gross Margin 161,866 138,782 23,083 (23,362) (11,110) (12,253) - 138,503

5 Inland Empire Health Plan Supplemental to Board Report #288 March 11, 2018

ADMINISTRATION (Dr. Gilbert) 1. Review of the Financial Monthly Reports a. Finance Reports 1) Year-To-Date Income Statement for the One Month Ended January 31, 2018 (in thousands) (Continued)

Organizational Medi-Cal Medicare Expenditures Grand Total Actual Budget Variance $ Actual Budget Variance $ Operating Expenses Administration 12,760 13,936 (1,176) 1,054 1,058 (4) - 13,814 Finance 5,108 5,828 (720) 847 970 (124) - 5,955 Information Technology (IT) 38,533 32,237 6,296 898 764 134 - 39,431 Marketing 6,149 7,696 (1,547) 2,061 2,146 (85) - 8,209 Health Services 11,188 12,847 (1,658) 3,024 3,577 (552) - 14,213 Network Development 500 361 139 1,187 1,207 (20) - 1,687 Operations 33,007 34,727 (1,720) 5,861 5,806 55 - 38,868 Total Operating Expenses 107,245 107,632 (387) 14,931 15,529 (598) - 122,177

Operating Surplus (Deficit) 54,621 31,151 23,470 (38,294) (26,639) (11,655) - 16,327

Total AB85 14,354 14,334 20 - - - - 14,354 Total ACA 0 - 0 - - - - 0 Total IHSS (16,648) - (16,648) - - - - (16,648) Total Sales Tax 331 - 331 - - - - 331 Other Income (Expense) ------2,570 2,570 Property Management Income (Expense) ------853 853

Total Non Operating Income (Expense) (1,962) 14,334 (16,296) - - - 3,423 1,461

Net Surplus (Deficit) 52,659 45,485 7,174 (38,294) (26,639) (11,655) 3,423 17,788

6 Inland Empire Health Plan Supplemental to Board Report #288 March 11, 2018

ADMINISTRATION (Dr. Gilbert) 1. Review of the Standard IEHP Monthly Reports a. Finance Reports 2) Capitation Income and Expense for the Period Ended January 31, 2018

January Year-to-Date Riverside SB Total Riverside SB Total Membership: Medi-Cal 607,439 607,260 1,214,699 4,253,864 4,282,774 8,536,638 CMC 13,653 13,220 26,873 95,105 92,165 187,270 Total Members: 621,092 620,480 1,241,572 4,348,969 4,374,939 8,723,908

Revenue: Medi-Cal 179,186,222 179,273,290 358,459,512 1,250,755,057 1,258,738,080 2,509,493,137 CMC 22,714,867 21,279,950 43,994,816 146,071,139 141,027,763 287,098,902 Net Revenue: $201,901,089 $200,553,240 $402,454,329 $1,396,826,196 $1,399,765,843 $2,796,592,039

Medical Costs: Medi-Cal 167,860,556 178,111,773 345,972,329 1,255,643,844 1,113,364,736 2,369,008,579 CMC 20,951,095 23,168,216 44,119,311 152,674,084 136,405,967 289,080,051

Total Medical Costs: $188,811,652 $201,279,989 $390,091,641 $1,408,317,928 $1,249,770,702 $2,658,088,631

Gross Margin: $13,089,437 $(726,750) $12,362,688 $(11,491,732) $149,995,141 $138,503,408

7 Inland Empire Health Plan Supplemental to Board Report #288 March 11, 2019

ADMINISTRATION 1. Review of The Standard IEHP Monthly Reports b. Operations Reports 1) Claims Summary Report

Claims Inventory Report Month End January 2019

Claims Beginning Claims Claims Claims Claims Ending Category Inventory Received Paid Denied Capitated Inventory

Professional IEHP Responsible 3,276 129,897 92,181 31,663 1,845 7,484 IEHP Direct 27,739 397,466 299,239 27,805 37,583 60,578 Per Diem Hospital Contract 37,616 101,052 101,275 11,252 1,052 25,089 Vision 3,372 20,120 18,584 984 2 3,922 Pay For Performance (P4P) 695 2,513 1,681 119 - 1,408 Mental Health 6,662 10,030 8,038 706 13 7,935 Member Reimbursement 6 - - - 6 Redirected 780 35,132 48 34,545 316 1,003 Decaps ------No Category ------Professional Subtotal 80,146 696,210 521,046 107,074 40,811 107,425

Institutional IEHP Responsible 16,354 54,087 41,515 9,893 564 1 IEHP Direct 19,820 66,076 55,048 3,193 3,956 23,699 Per Diem Hospital Contract 2,477 23,858 20,780 2,129 2,176 1,250 Vision 1 - - - - 1 Pay For Performance (P4P) ------Mental Health 336 183 180 24 15 300 Member Reimbursement ------Redirected 5,465 3,893 246 3,728 - 5,384 Decaps ------No Category ------44,453 148,097 117,769 18,967 6,711 49,103

Total Claims in Diamond 124,599 844,307 638,815 126,041 47,522 156,528

November Production Days 21 Delayed Receipts (included in Claims Received Column) 0 Paid, Denied and Capitated Claims 812,378 Claims aw aiting Check Write 145,541 Claims aw aiting adjudication 10,987 Auto-Adjudicated Claims 663,607 Auto-Adjudication Rate 82% Average Claims Worked per Day 38,685 Average # of Days Claims are in Inventory 1

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ADMINISTRATION 1. Review of the Standard IEHP Monthly Reports b. Operations Reports 2) Claims Processing Turnaround Time

INLAND EMPIRE HEALTH PLAN January-19 Claim Processing Turnaround Time

1-30 Days 31-45 Days 46-90 Days Over 90 Days Total Professional IEHP Responsible 125,341 284 31 33 125,689 IEHP Direct 364,193 369 35 30 364,627 Per Diem Hospital Contract 113,535 29 10 5 113,579 Vision 19,390 10 165 5 19,570 Pay For Performance (P4P) 1,800 - - - 1,800 Mental Health 8,735 16 5 1 8,757 Member Reimbursement - - - - - Redirected 34,765 119 24 1 34,909 Decaps - - - - - No Category - - - - - Professional Subtotal 667,759 827 270 75 668,931 % of Total 99.82% 0.12% 0.04% 0.01% Institutional IEHP Responsible 51,784 171 9 8 51,972 IEHP Direct 61,313 869 8 7 62,197 Per Diem Hospital Contract 24,697 380 5 3 25,085 Vision - - - - - Pay For Performance (P4P) - - - - - Mental Health 184 35 - - 219 Member Reimbursement - - - - - Redirected 3,862 106 5 1 3,974 Decaps - - - - - No Category - - - - - Institutional Subtotal 141,840 1,561 27 19 143,447 % of Total 98.88% 1.09% 0.02% 0.01%

Grand Total 809,599 2,388 297 94 812,378 % of Total 99.66% 0.29% 0.04% 0.01%

Month Reporting: 01/201912/18 Submitted: 02/19

9 Inland Empire Health Plan Supplemental to Board Report #288 March 11, 2019

ADMINISTRATION 1. Review of The Standard IEHP Monthly Reports b. Operations Reports 3) PCP Member Allocation Report

10 Inland Empire Health Plan Supplemental to Board Report #288 March 11, 2019

ADMINISTRATION 1. Review of The Standard IEHP Monthly Reports b. Operations Reports 4) Member Services Telephone Activity Report

Response Actual Time in Call Length Abandonment Outbound Month Inbound Calls % of Inbound Calls Membership Seconds in Minutes Rate Calls Total Calls Provider Provider Actual Forecast Variance Member Eligibility General February '18 1,240,043 100,157 102,176 -2,019 0:27 8:58 1.36% 99.5% 0.2% 0.3% 16,954 117,111 March '18 1,239,499 109,194 109,581 -387 0:30 8:57 1.72% 99.3% 0.4% 0.3% 21,295 130,489 April '18 1,239,450 132,463 119,041 13,422 4:51 11:24 18.85% 97.7% (a) 1.4% 0.9% 13,131 145,594 May '18 1,243,357 113,132 116,922 -3,790 1:29 10:12 5.25% 98.4% 0.6% 1.0% 15,456 128,588 June '18 1,241,106 108,889 104,952 3,937 1:29 9:26 5.51% 98.6% 0.6% 0.8% 17,761 126,650 July '18 1,237,765 111,587 106,936 4,651 2:05 9:42 7.54% 98.8% 0.5% 0.7% 15,953 127,540 August '18 1,238,060 130,590 134,536 -3,946 2:46 10:00 11.22% 98.9% 0.5% 0.6% 19,906 150,496 September '18 1,239,687 104,159 111,946 -7,787 1:12 9:55 4.04% 99.0% 0.4% 0.6% 16,656 120,815 October '18 1,238,556 121,273 122,682 -1,409 0:21 9:38 1.32% 98.9% 0.5% 0.6% 26,515 147,788 November'18 1,244,093 111,304 106,327 4,977 1:49 9:48 6.85% 99.0% 0.4% 0.6% 26,888 138,192 December'18 1,239,523 86,308 93,073 -6,765 2:00 10:23 7.15% 98.9% 0.5% 0.6% 22,086 108,394 January '19 1,234,773 118,651 121,245 -2,594 1:31 10:45 5.41% 98.9% 0.5% 0.6% 27,601 146,252

(a) CORE System Implementation

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ADMINISTRATION 1. Review of The Standard IEHP Monthly Reports b. Operations Reports 5) Provider Automated Eligibility Contact Report

Total Actual IVR WEB Page Spot Check Automated Month Membership Contacts Contacts Contacts Contacts February '18 1,240,043 17,834 1,266,184 694,767 1,978,785 March '18 1,239,499 20,502 1,520,728 737,468 2,278,698 April '18 1,239,450 (a) 4,566,011 (b) 985,538 5,551,549 May '18 1,243,357 (a) 4,416,731 (c) 1,019,873 5,436,604 June '18 1,241,106 (a) 2,707,381 863,053 3,570,434 July '18 1,237,765 (a) 3,847,573 934,200 4,781,773 August '18 1,238,060 (a) 4,519,748 975,279 5,495,027 September '18 1,239,687 (a) 4,173,070 1,258,233 5,431,303 October '18 1,238,556 (a) 4,738,683 1,007,691 5,746,374 November'18 1,244,093 (a) 7,101,131 (d) 1,400,706 8,501,837 December'18 1,239,523 (a) 6,505,058 1,435,747 7,940,805 January '19 1,234,773 (a) 6,746,018 2,043,252 8,789,270

(a) IVR lines are no longer in use, instead all transactions are handled by the Provider Web Portal. (b) Internal Eligibility went up exponentially, because it is now being captured and used within HSP, MedHOK and Internal Tool. (c) Revised total.

(d) The increase was due to an external partner running their entire membership through eligibility. This has stopped.

12 Inland Empire Health Plan Supplemental to Board Report #288 March 11, 2019

ADMINISTRATION 1. Review of The Standard IEHP Monthly Reports b. Operations Reports 6) Member Eligibility Verification Report (January 2019 – Total: 8,789,270)

13 Inland Empire Health Plan Supplemental to Board Report #288 March 11, 2019

ADMINISTRATION 1. Review of the Standard IEHP Monthly Reports c. Provider Reports 1) IPA Consolidated Membership Report (January 2019)

Number of

Service PCPs Enrollment IPA NAME Areas 02/01/19 * 02/01/19ŧ Inland Empire Health Plan Direct All Areas 1,758 495,576 Inland Faculty Medical Group R1/R4/S1/S2/S3 254 184,200 Alpha Care Medical Group Inc R1/R3/R6/S1/S2 301 169,457 LaSalle Medical Associates R1/R2/R4/S1/S2/S3 107 119,128 Kaiser Foundation Health Plan Inc R1/S1 N/A 100,440 Physicians Health Network S1 50 35,945 Regal Medical Group R1/R2/R3/R4/R5/S1/S2/S3 147 18,271 Horizon Valley Medical Group E7/S3 23 18,202 Dignity Health Medical Group - Inland S1 20 12,914 Empire Allied Pacific IPA S2 8 3,191 Pomona Valley Medical Group S2 64 1,350 Desert Oasis E2/R6 42 986 Beaver Medical Group S1 43 831 PrimeCare of San Bernardino S1/S2 21 634 Riverside Medical Clinic R1/R4 26 544 Pinnacle Medical Group S1 15 531 San Bernardino Medical Group S1 14 523 PrimeCare Medical of Chino Valley S2 36 495 CPN-Horizon Valley Medical Group E7/S3 19 486 PrimeCare of Inland Valley S2 41 483 PrimeCare of Moreno Valley R1/R2 13 459 Dignity Health Physician Network - IE 7 399 PrimeCare of Hemet Valley R3 10 319 PrimeCare of Riverside R1/R4 12 272 PrimeCare of Temecula R5 17 268 Heritage Victor Valley E7/S3 14 263 PrimeCare of Citrus Valley R4 11 244 PrimeCare of Corona R1/R4 18 215

14 Inland Empire Health Plan Supplemental to Board Report #288 March 11, 2019

PrimeCare of Sun City R5 10 183 Valley Physicians Network R5 9 170 Redlands Yucaipa Medical group S1 11 157 Alliance Desert Physicians S3 4 90 PrimeCare of Redlands S1 6 72 Tri Valley Medical Group R5 8 64 Fenix Medical Group S2 7 38 Chaffey Medical Group S2 5 7 Totals: 3,151 1,167,407

Due to timing issues, these figures may not exactly reflect figures used for capitation

* = Total number of non-terminated unique PCPs per IPA ŧ = Excludes Medi-Medi and Open Access Enrollment.

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IPA GEOGRAPHIC SERVICE AREAS

R1 Riverside Proper Mira Loma, Riverside, Nuevo, Perris, Moreno Valley R2 The Pass Banning, Beaumont, Cabazon, Calimesa R3 Hemet Region Idyllwild, Hemet, Homeland, Mountain Center, San Jacinto, Winchester R4 Corona Region Corona, Norco R5 Temecula Region Aguaga, Anza, Canyon Lake, Lake Elsinore, Menifee, Murrieta, Sun City, Temecula, Wildomar R6 Low Desert Cathedral City, Coachella, Desert Hot Springs, Indian Wells, Indio, La Quinta, Mecca, North Palm Springs, Palm Desert, Palm Springs, Rancho Mirage, Thermal, Thousand Palms, Whitewater S1 San Bernardino Proper Bloomington, Colton, Fontana, Grand Terrace, Highland, Patton, Rialto, San Bernardino, Bryn Mawr, Crafton, Loma Linda, Mentone, Redlands, Yucaipa S2 West End San Bernardino Alta Loma, Chino, Chino Hills, Etiwanda, Guasti, Montclair, Ontario, Pomona, Rancho Cucamonga, Upland S3 High Desert Adelanto, Apple Valley, Hesperia, Lucerne Valley, Oro Grande, Phelan, Pinon Hills, Victorville

16 Inland Empire Health Plan Supplemental to Board Report #288 March 11, 2019

IPA GEOGRAPHIC SERVICE AREAS (Excluded Areas)

E1 Blythe Blythe, Ripley, Desert Center, Mesa Verde, Ehrenberg, Eagle Mountain E2* Yucca\Morongo Valley Amboy, Cadiz, Landers, Joshua Tree, Moronga Valley, Marine Corp Base, Pioneer Town, Twenty-nine Palms, Yucca Valley, Wonder Valley, Rimrock E3* Mountains Angelus Oak, Big Bear City, Big Bear Lake, Blue Jay, Cedar Glen, Cedarpines Park, Crestline, Crest Park, Phelan, Fawnskin, Forest Falls, Green Valley Lake, Lake Arrowhead, Rimforest, Running Springs, Sky Forest, Sugar Loaf, Twin Peaks E4 Needles\Laughlin Cima, Essex, Kelso, Needles, Nipton, Mountain Pass E5 Ridgecrest Johannesberg, Randsburg, Ridgecrest, Red Mountain, Trona E6 Colorado River Big River, Parker Dam E7* Barstow Baker, Barstow, Daggett, Fort Irwin, Hinkley, Ludlow, Yermo, Newberry Springs, Desert Center, Lenwood, Helendale

* Active Membership in these areas

17 Inland Empire Health Plan Supplemental to Board Report #288 March 11, 2019

ADMINISTRATION 1. Review of the Standard IEHP Monthly Reports c. Provider Reports 2) Hospital Consolidated Membership Report (February 2019)

Number of PCPs Enrollment HOSPITAL NAME 02/01/19 02/01/19 ŧ Dignity Health Community Hospital of San Bernardino 214 95,065 St. Bernardine Medical Center 158 66,335 Subtotal: 372 161,400 Physicians For Healthy Hospitals Hemet Valley Medical Center 82 49,342 Subtotal: 82 49,342 Prime Healthcare Services Montclair Hospital Medical Center 78 31,741 Subtotal: 78 31,741 Tenet HealthCare Corporation John F. Kennedy Memorial Hospital 93 57,476 Desert Regional Medical Center 91 43,726 Subtotal: 184 101,202 Universal Health Systems, Inc Rancho Springs Medical Center 104 61,348 Corona Regional Medical Center 107 43,358 Inland Valley Regional Medical Center 41 9,945 Subtotal: 252 114,651 Victor Valley Global Medical Center 181 108,446 Kaiser Fontana/Riverside N/A 100,440 Pomona Valley Hospital Medical Center 341 87,053 Arrowhead Regional Medical Center 103 79,640 Riverside Community Hospital 162 76,262 Riverside County Regional Medical Center 114 73,183

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ADMINISTRATION 2. Review of The Standard IEHP Monthly Reports c. Provider Reports 2) Hospital Consolidated Membership Report (February 2019 continued…..)

Number of PCPs Enrollment HOSPITAL NAME 02/01/19 02/01/19 ŧ Parkview Community Hospital Medical Center 121 54,829 Eisenhower Medical Center 65 28,320 Loma Linda Children Hospital 25 16,430 St. Mary Medical Center 13 15,140 San Gorgonio Memorial Hospital 30 14,156 Redlands Community Hospital 79 14,154 Barstow Community Hospital 9 7,296 Mountains Community Hospital 9 1,773 Subtotal: 1252 677,122 Total: 2,220 1,135,458

Due to timing issues, these figures may not exactly reflect figures used for capitation PCP totals deviate from IPA report totals due to multiple hospital affiliations ŧ = Excludes Medi-Medi, Medicare and Open Access Members

19 Inland Empire Health Plan Supplemental to Board Report #288 March 11, 2019

ADMINISTRATION 1. Review of The Standard IEHP Monthly Reports c. Provider Reports 3) New Enrollment Trend Report by Consolidated IPA ( February 2019)

Data not available at time of printing

20 Inland Empire Health Plan Supplemental to Board Report #288 March 11, 2019

Data not available at time of printing

21 Inland Empire Health Plan Supplemental to Board Report #288 March 11, 2019

ADMINISTRATION 1. Review of The Standard IEHP Monthly Reports d. Marketing Reports 1) All Medi-Cal Aid Codes Enrollment Report (February 2019)

Month IEHP* Percent of IEHP Molina* Percent of Molina Total Enrolled July 2018 1,230,617 72.1% 156,429 9.2% Recipients**1,707,000 August 2018 1,226,247 71.8% 154,854 9.1% 1,707,000 September 2018 1,218,637 71.4% 153,173 9.0% 1,707,000 October 2018 1,218,133 71.4% 152,239 8.9% 1,707,000 November 2018 1,221,986 71.6% 151,757 8.9% 1,707,000 December 2018 1,219,492 71.4% 149,363 8.8% 1,707,000 January 2019 1,215,668 71.2% 149,205 8.7% 1,707,000

Sources: * http://www.dhcs.ca.gov - Med-cal Managed Care Enrollment Reports ** http://www.dhcs.ca.gov - Medi-Cal Beneficiary Counts Pivot Table, County, Mar 2018

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ADMINISTRATION 1. Review of The Standard IEHP Monthly Reports d. Marketing Reports 2) Medi-Cal Mandatory - Families Aid Codes Enrollment Report (February 2019)

Month IEHP* % of IEHP Molina** % of Molina Mandatory in % Mandatory Total Families FFS & Excluded in FFS & Mandatory Zips Excluded Zips Recipients*** July 2018 747,664 74.8% 89,720 9.0% 162,616 16.3% 1,000,000 August 2018 747,524 74.8% 89,703 9.0% 162,773 16.3% 1,000,000 September 2018 745,203 74.5% 89,424 8.9% 165,373 16.5% 1,000,000 October 2018 743,286 74.3% 89,194 8.9% 167,520 16.8% 1,000,000 November 2018 746,255 74.6% 89,551 9.0% 164,194 16.4% 1,000,000 December 2018 742,989 74.3% 89,159 8.9% 167,852 16.8% 1,000,000 January 2019 738,916 73.9% 88,670 8.9% 172,414 17.2% 1,000,000 February 2019 743,247 74.3% 89,190 8.9% 167,563 16.8% 1,000,000 Sources: * IEHP's Marketing Management Report #1 - Data as of 15th of the month ** Projected Molina based on market share *** http://www.dhcs.ca.gov - Projections based on Medi-Cal Beneficiary Counts Pivot Table, county-level and state-level data, Mar 2018.

23 Inland Empire Health Plan Supplemental to Board Report #288 March 11, 2019

ADMINISTRATION 1. Review of The Standard IEHP Monthly Reports d. Marketing Reports 3) Medi-Cal Mandatory – Seniors & Persons with Disabilities (SPD)Aid Codes Enrollment Report (February 2019)

Month IEHP* % IEHP Molina** % Molina Mandatory in % Mandatory Total SPD FFS & in FFS & Mandatory Excluded Zips Excluded Zips Recipients*** July 2018 64,577 68.0% 7,749 8.2% 22,674 23.9% 95,000 August 2018 64,598 68.0% 7,752 8.2% 22,650 23.8% 95,000 September 2018 64,709 68.1% 7,765 8.2% 22,526 23.7% 95,000 October 2018 64,905 68.3% 7,789 8.2% 22,306 23.5% 95,000 November 2018 65,021 68.4% 7,803 8.2% 22,176 23.3% 95,000 December 2018 64,995 68.4% 7,799 8.2% 22,206 23.4% 95,000 January 2019 65,030 68.5% 7,804 8.2% 22,166 23.3% 95,000 February 2019 65,446 68.9% 7,854 8.3% 21,700 22.8% 95,000 Sources: * IEHP's Marketing Management Report #1 - Data as of 15th of the month ** Projected Molina based on overall market share *** http://www.dhcs.ca.gov - Projections based on Medi-Cal Beneficiary Counts Pivot Table, county-level and state-level data, Mar 2018.

24 Inland Empire Health Plan Supplemental to Board Report #288 March 11, 2019

ADMINISTRATION 1. Review of The Standard IEHP Monthly Reports d. Marketing Reports 4) IEHP’s Medi-Cal Non-Mandatory Aid Codes Enrollment Report (February 2019)

Month Medi Medi's* Foster Others* Total IEHP Non- Percent IEHP Total Non- Children* Mandatory Mandatory*** July 2018 65,401 13,439 4,470 83,310 55.5% 150,000 August 2018 65,912 12,743 5,197 83,852 55.9% 150,000 September 2018 65,919 12,764 5,385 84,068 56.0% 150,000 October 2018 66,053 12,823 5,480 84,356 56.2% 150,000 November 2018 66,671 12,984 5,566 85,221 56.8% 150,000 December 2018 67,069 13,332 5,611 86,012 57.3% 150,000 January 2019 67,017 13,286 5,589 85,892 57.3% 150,000 February 2019 67,366 13,158 5,548 86,072 57.4% 150,000 Sources: * IEHP's Marketing Management Report #1 - Data as of 15th of the month ** http://www.dhcs.ca.gov - Projections based on Medi-Cal Beneficiary Counts Pivot Table, county-level and state-level data, Mar 2018 and Dual Eligible report, January 2013. *** Excluded Medi-Medis who are enrolled in IEHP Medicare DualChoice.

25 Inland Empire Health Plan Supplemental to Board Report #288 March 11, 2019

ADMINISTRATION 1. Review of The Standard IEHP Monthly Reports e. Marketing Reports 5) IEHP’s Medi-Cal Expansion Aid Codes Enrollment Reports (February 2019)

Month LIHP Transition Medi-Cal Expansion Total IEHP Medi-Cal (L1) Adults (M1 & 7U) Expansion July 2018 389 342,887 343,276 August 2018 406 340,157 340,563 September 2018 309 343,434 343,743 October 2018 249 343,555 343,804 November 2018 222 344,934 345,156 December 2018 204 345,075 345,279 January 2019 189 343,753 343,942 February 2019 167 344,531 344,698 Sources: * IEHP's Marketing Management Report #1 - Data as of 15th of the month Note: Members with L1 aid code will be transitioned to M1 at their annual eligibility redetermination.

26 Inland Empire Health Plan Supplemental to Board Report #288 March 11, 2019

ADMINISTRATION 1. Review of The Standard IEHP Monthly Reports d. Marketing Reports 6) IEHP Medicare Enrollment Report (February 2019)

Month Total IEHP Cal MediConnect July 2018 26,198 August 2018 26,408 September 2018 26,597 October 2018 26,812 November 2018 26,920 December 2018 27,057 January 2019 26,938 February 2019 27,128 Sources: * IEHP's Marketing Management Report #1 - Data as of 15th of the month

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