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CSS SOLUTIONS

CSS SOLUTION FEATURES BENEFITS

DataPath

Core technology

infrastructure

A robust patient registry that securely stores, organizes, and reports clinical and administrative

claims data.

Propriety decision analytics

Assists clients in identifying quality gaps, creating evidence-based action plans, and planning

visits.

Intuitive, web-based portals

Allows users to access data, perform analyses, manage patients, and create reports for a broad

range of care management and medication programs.

Revolutionary medication

and care management

services Rethinks the patient chart as a compendium of structured data elements and data archetypes.

Highly scalable

Provides efficient organization of both large and small populations with more than six million

lives under management.

Thought leaders in smart

data with robust decision

analytics that are evidence

based and include wellness

quality measures, such as

STARS, QARR, and HEDIS.

Uses administrative claims and clinical data to transform information into intelligent, reportable

data. Proprietary algorithms that produce informed decision analytics based on industry best

practices for medication, care management, and care coordination.

Medication

Management for

ACOs Optimized Drug Regimens

Medication Management services ensure that your patients have optimized drug regimens, and

are taking their medications as directed. Optimizing a drug regimen has the following benefits:

Decreased drug costs; Improved clinical markers of care for key disease states; Decreased

adverse events; Improved patient engagement.

New Rules of

Reimbursement Require

New Rules of Operation and

Expert Consultation

The ACO model presents numerous opportunities to improve patient care and decrease

associated costs. Making these opportunities real requires inter-disciplinary collaboration among

patients, physicians, pharmacists, nurses, family members, and caregivers. CSS' Medical

Management services will provide the following benefits:

Return on Investment: Medication management provides a short-term return on investment;

and, savings that can be reinvested in other areas of care

Medication

Management for

ACOs

Quality Improvement: Providing medication management to your patients is a sure way to

improve quality of care markers, such as HbA1c levels and LDL levels

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Patient Engagement: Spending time with your patients to coach them about their health and

medications is a great way to empower them, while ensuring that they are safe and well

Readmission Reduction: By making sure that your patients are taking the right medications the

right way, you are making sure that they maintain their best health, and prevent unnecessary or

return trips to the hospital

Pathfinder Warehouse

The Pathfinder Warehouse provides your ACO with a low cost web based data mart for medical

pharmacy claims, and connects you to your providers' EHRs and HIEs. If you don't have an HIE,

Pathfinder can be your entry point with all information that is stored as structured data.

Smart Data

Pathfinder contains over 1,000 evidence-based algorithms. These algorithms evaluate patient

data, and direct care recommendations to the MTMPath and EHRPath care portals.

MTMPath and EHRPath

Pathfinder care portals are configured for medication (MTMPath) and care (EHRPath)

management. Portals are web-based, and require no additional infrastructure for the ACO. A plug-

in model for seamless integration with practice workflow.

Medication Reconciliation

Pathfinder has SureScripts connection capability for medication reconciliation. Enter your

patients' demographic information, and you can use MTMPath or EMRPath to contact SureScripts

and obtain a medication profile.

Deploying MTM in

Your ACO

Establish Customized and

Collaborative Initiatives

Based on Your Goals Program Goals: Efficiency, Clinical, Quality of Life

Action Plan Inventory: Duplicate Therapy, Inappropriate Therapy, Cost Effectiveness,

Therapeutic Monitoring, Therapeutic Use, Adverse Effects, Disease Specific

Deploying MTM in

Your ACO

Minimum Data Set: Review of Systems, Social History, Family History, Vitals, Height/Weight,

Allergy, Vaccination, Medication, Depression, Adherence, Pain Assessment

ROI: Decreased Costs, Improved Clinical Markers, Improved Quality Metrics, Improved Patient

Perception of Health Status

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With your goals established, we select Smart Data algorithms from the Action Plan library that

will identify evidence-based gaps in patients' profiles. Smart Data algorithms allow pharmacists

and care managers to focus their recommendations and activity. From the selected Action Plans,

CSS will help you identify the minimum data set of clinical information required to conduct the

patient evaluation in a systematic, reliable way. Your entire medication management program is

configured in a clinician friendly, SOAP Note format.

Numerous Delivery Model

Options

Because the Pathfinder system is web-based, your ACO can select from a number of delivery

models.

Licensing: If you have a staff pharmacist and care managers, you can license Pathfinder system to

coordinate and document all MTM activity

Delegated: If you don't have staff, let our clinicians do the work for you

Homecare Network: CSS has partnered with Pharmaceutical Care Integration (PCI) to build local

networks of homecare pharmacists. PCI pharmacists visit high-risk patients in their homes,

reducing readmission risk, increasing adherence, and reducing associated costs.

CareRxConnect

Customized Pharmacy Care

Integration (PCI) Program by

CareRx

CareRxConnect in partnership with CSS identifies members most at risk for medication non-

compliance and hospital readmission, and provides them with the appropriate face-to-face

education and coaching to improve and maintain health. Medication management is conducted

in the patient's home, empowering their caregiver to improve adherence. The barriers to good

health are identified and eliminated.

CCTP-Specific

Programming

Supports Medicare's Care

Transition Initiative

CSS' software helps Community-based Care Transition Program (CCTP) coalitions and their

network of hospitals to track patients and document required interviews and other data, as

mandated by CMS. CSS' technology gives CCTP coalitions the ability to offer each patient access

to a Personal Health Record. Created under the Affordable Care Act, Medicare's CCTP seeks to

improve care for Medicare beneficiaries leaving the inpatient hospital setting and going to other

care settings, such as a private home or nursing home. The focus is on improving quality of care

and reducing hospital readmissions.

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MTMPath for

Physicians

Powerful Software for

Optimized Patient Care

The core of Medication Therapy Management (MTM) services is MTMPath, a software system

that allows you to create complete patient profiles by combining patient medical information

profiles and prescription data from your pharmacy records, patient assessments and interviews,

and physician medical records.

Turnkey Solution for MTM

Medication Pathfinder allows you to integrate all of your patient data so that you can provide

customized clinical recommendations to improve patient care and reduce costs. The software

provides patient data and recommendations in professional report formats for both patients and

physicians.

Five Dynamic Software

Modules DataPath: A Clinical Data Module

InterviewPath: A Patient Assessment Module

RecommendationPath: A Recommendation Generating Module

ReportPath: A Physician / Patient Report-Generating Module

BillingPath: A Patient and Insurance Billing Module

MTMPath for

Pharmacists

Add Revenue to Your

Pharmacy

Represents an important milestone for pharmacists and their delivery of therapy-focused

consulting services. Now that Medication Therapy Management (MTM) is a required component

of the Medicare Part D prescription program, today, more than ever, there are new opportunities

for independent and consulting pharmacists to offer this service to their patients. The Medication

Pathfinder Network provides users with the education, software, and marketing support that

they need to provide consistent and documentable MTM. If you already have a consulting

practice, think about Medication Pathfinder software for long-term care consulting; coagulation

management or lipid clinic management; and collaborative therapy practice.

Pharmacy First Collaboration

Pharmacy First has entered into an agreement with the Medication Pathfinder Network to

provide the Pharmacy First member network with Medication Therapy Management (MTM)

services. Through their partnership, they have developed a complete program for members who

wish to offer MTM services:

MTMPath Software

Patient and Clinical Consulting Services

Business Plan and Marketing Support

Continuing Education

Academic Research and Validation

PMR Smart Patient Personal Medical Record On Demand

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PMR Smart

On-Demand Personal

Medical Record

Increase patient loyalty and create a market edge by providing your patients with PMR Smart, a

web-based personal medical record that your patients can access on demand, wherever they go.

PMR Smart is the perfect tool for patients who travel, snowbirds with second homes, patients

who see more than one physician or specialist, patients with children who have chronic illnesses,

and caregivers. PMR Smart is maintained on a secure server and can be accessed from medical

offices, pharmacies, emergency rooms, hospitals - anywhere in the world on a computer with an

internet connection.

iDealWellness Empower Your Patients

Our iDealWellness™ Program empowers patients to take an active role in their own healthcare to

improve treatment outcomes and lower medical costs. Pharmacists can become an important

member of the collaborative healthcare team by providing wellness coaching using MTMPath™, a

web-based clinical documentation software that allows users to efficiently and effectively review

a patient's medications to assess appropriate therapy and optimize outcomes. MTMPath's user-

friendly interface guides pharmacist coaches through the data collection, patient assessment and

therapy recommendation process so that care can be accomplished in a standardized and

evidence-based manner. Coaches can provide a poly-pharmacy review of all prescribed and over-

the-counter medications and develop programs that focus on specific health issues or drug

management programs.

iDealTherapy

Retrospective DUR

Compliance

Clinical Support Services, Inc. (CSS) has developed iDealTherapy™, a program that assesses a

patient’s current drug therapy and determines if a more ideal medication may be a better value

for the condition being treated. Unlike many retrospective Drug Utilization Review (DUR)

processes, iDealTherapy incorporates current clinical information provided by the prescriber with

pharmacy claims data to evaluate drug therapy utilization. iDealTherapy supports retrospective

utilization management review of patients at risk of overutilization of the opiod class of

medication. It reviews pharmacy claims and plan eligibility data monthly, then flags patients of

concern by using predetermined selection criteria such as the number of prescriptions filled in a

number of pharmacies filling prescriptions for that patient. Medicare plans receive a data report

to determine the best course of action for that patient.

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EMRPath

Every Physician Can be a

Patient-Centered Medical

Home

Clinical Support Services (CSS) offers a software system, EMRPath™, that allows any physician

practice, large or small -- with or without an EMR -- to take major steps toward becoming a

patient-centered medical home (PCMH). EMRPath is a web-based, electronic medical record

software program designed to include workflow management and decision support functionality

for disease management purposes. Built around a robust patient registry, EMRPath has an easy-

to-use graphical user interface that allows users to enter, organize and manage clinical

information obtained from administrative claims and clinical data. Each program is constructed in

the S-O-A-P (subjective-objective-assessment-plan) Note format familiar to all clinicians. Included

in each account is AlertPath™, a messaging system that alerts clinicians when a patient’s current

health status falls outside of evidence-based care. A reminder system is also embedded within

the program that tags each patient record with an appropriate follow-up date. Case managers are

notified daily of patients who require follow-up. Users of EMRPath can provide their patients with

PMR Smart™ – an online, patient-oriented personal medical record. PMR Smart gives access to

objective clinical information (lab values, personal medication record, etc.) in a read-only format.

PMR Smart can be configured to allow patient entry of home-based clinical monitoring values (i.e.

blood pressure, weight, etc.). Physicians who are not yet prepared for EMR functionality within

their offices, CSS can provide clinical support using its VirtualClinic™ software tool. By faxing

progress notes, lab reports and other data to our offices, CSS can assist physicians by providing

them with a robust case management system that meets specific PCMH certification

requirements.

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CMRBooster: A

Part D Service

Tailored and Proactive CMR

Tools for STAR Ratings

The CMRBooster is the most important component of the MTM process, yet Comprehensive

Medical Reviews can be the most challenging to complete. This year is especially crucial. For the

first time, CMS is evaluating CMR completion rates as a STAR measure in 2015. CSS comes armed

with the necessary technology and clinical staff to target and counsel eligible, at-risk members

with improved outcomes. Using CMRBooster, CSS' clients beat the statistics, outperforming 60%

of their competitors for CMR completion. By including CMRBooster in their MTM program, CSS'

clients have realized a significant increase in CMR completion rates and member safety - meeting

their goals and CMS' expectations, and exceeding the national average of 15%. CSS' streamlined

protocol translates into more CMRs scheduled, more interviews completed, and more informed,

empowered members. CSS doesn't have to be your MTM provider to help your health plan

increase its CMR rate.

TMRBooster: A

Part D Service

Customized TMR Process for

CMS Compliance and

Performance

Targeted Medication Reviews are an easy way to improve your members' wellness while helping

your standing with CMS and reputation. Our program makes it easy for you to complete all

necessary TMRs. Just tell us what recommendation categories are important to you, and CSS will

do the rest! Our support will give your TMR rates the boost they need to help you achieve your

CMS goals.

Million Hearts

Campaign: A CMS

Initiative

Tailored Million Hearts

Campaign Compliance

Our Million Hearts Campaign helps you answer CMS' call to reduce heart attacks, strokes, and

blood pressure related disease by 2017. This MTM service is unique because it targets members

through their prescription medications, rather than through traditional MTM eligibility methods.

In turn, providing you with cutting-edge standards of care that will help you prepare for future

CMS metrics.

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