Iggbo is proposing an on-demand network of healthcare professionals to help insurance payers close gaps in care identified by HEDIS measures, especially for diabetic patients. Payers currently struggle to achieve high HEDIS scores due to costs of implementing programs and non-compliance from members. Iggbo's solution requires no implementation costs and allows payers to order collections through an online portal. A sample calculator shows how Iggbo could collect information to close gaps and earn payers incentive payments that exceed Iggbo's costs per collection. An initial Iggbo pilot for a Medicaid payer was able to close 20% of gaps in care within 3 weeks at no cost to the payer.

1. I-590*

2. HEDIS WHITEPAPER | JANUARY 2017
Shaiv Kapadia, MD | Blake Wehman, MHA
Abstract
“Gaps in Care” is a term used to describe the delta (difference) between the average rate of care received
by members of both commercial and government payers and the members receiving care at the 90
th
percentile. Historically, there has been a delta greater than ten percentage points between the average
and the excellent.
1
As a result, the National Committee of Quality Assurance (NCQA) created a set of
clinical measures to monitor and close “Gaps in Care.” The measures are collected and reported to the
Healthcare Effectiveness Data and Information Set (HEDIS), which NCQA describes as follows:
“A set of standardized performance measures designed to ensure that purchasers and consumers have
the information they need to reliably compare the performance of health care plans.”
2
As a result of the NCQA’s HEDIS measures, insurance payers have built programs specifically to address
these concerns. This includes Comprehensive Diabetes Care, which has the following measures:
3
1. Hemoglobin A1c (HgA1c)
2. Urine Microalbumin
3. Retinal Eye Exam
4. Blood Pressure
1
http://www.ncqa.org/publications-products/other-products/quality-profiles/focus-on-diabetes/addressing-the-quality-gaps
2
http://www.hopkinsmedicine.org/johns_hopkins_healthcare/downloads/Tips%20to%20Improve%20Your%20HEDIS%20Measures-final3-29-12.pdf
3
http://web.southcarolinablues.com/UserFiles/scblues/Documents/Providers/HEDIS%20Measure%20Provider%20Matrix%20O32415.pdf

3. HEDIS WHITEPAPER | JANUARY 2017
Problem Statement
Every year there are 4,300 to 9,600 preventable deaths due to poorly managed diabetes. If all diabetics
received the best care available, nine cases out of ten could be prevented. Proper diabetes prevention
and management would save the US Healthcare System $570 million per year by avoiding unnecessary
medical procedures.
Today, healthcare systems targeting diabetes have proven that increased outreach and monitoring can
help close gaps in care. Specifically, ensuring that patients have their annual HgA1c, retinal exam and
urine microalbumin evaluated directly correlates to improved outcomes. Therefore, many payers contract
with disease management vendors today to help improve the outcomes of their members.
Iggbo is transforming this disease management space with an on-demand network of collectors,
equipped to close all three gaps in care necessary to monitor and provide comprehensive diabetic care.
Background
Iggbo is an on-demand network of highly qualified healthcare professionals ranging from phlebotomists to
registered nurses. While Iggbo primarily offers on-demand venipuncture, the network capabilities include
(but are not limited to) blood pressure, weight measurement, and drug screening. Iggbo’s network of on-
demand healthcare professionals gives market segments, ranging from health systems to laboratories to
payers, instant reach and access with a sustainable variable cost model.
The problem payers face is with implementing a plan to close the gaps in care identified from their HEDIS
reports. As exhibited below in Figure 1, many payers are struggling with managing the care of their
members, especially their diabetics. Although payers are aware of the staggering direct and indirect costs
that patient mismanagement adds to their health plans, there are few that take on the operational
resources necessary to manage their members to the 90
th
percentile. For diabetic patients as an
example, one out of every three inpatient days for patients with cardiovascular, neurological and renal
conditions are due to patients battling diabetes. To make matters more difficult, the prevalence of
diabetes in America continues to rise (see Figure 2 below).

4. HEDIS WHITEPAPER | JANUARY 2017
Figure 1: Average Medicare Health Plan Score (Majority Between 3 & 4)
Source: Deloitte analysis based on CMS average star quality ratings on four diabetes measures.
Therefore, more Americans battling diabetes relates directly to the increased investment payers have to
make in disease management programs. Although payers clearly understand the downstream costs of
poorly managed diabetic members, there’s still an average rating of comprehensive diabetic care
amongst health plans of 3.01-4.0. It’s a combination of member education, operational costs for payers,
and member non-compliance that is preventing payers from delivering the care they aim to provide.
10%
21%
41%
28%
2014
1.00–2 2.01–3 3.01–4 4.01–5
9%
24%
46%
21%
2015
1.00–2 2.01–3 3.01–4 4.01–5

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Figure 2: Prevalence of Diabetes in the United States of America
Source: Data from Centers for Disease Control and Prevention, National Center for Health Statistics, Division of Health Interview
Statistics, data from the National Health Survey. Statistical analysis by the Centers for Disease Control and Prevention, National
Center for Chronic Disease Prevention and Health Promotion, Division of Diabetes Translation.
Solution
Iggbo’s mission is to deliver personalized medicine to everyone by optimizing and streamlining current
systems of care. Health insurance companies, for years now, have received offers from disease
management companies aimed at reducing their costs, increasing their revenue from HEDIS
reimbursements, improving outcomes, and changing other population health management metrics. The
common threads among all companies focused on population health
management are:
• The return on investment ($3 earned for every $1 spent; $5, etc.)
• The implementation cost ($10,000/month to implement; $1 million annual costs, etc.)
What makes Iggbo’s solution to the marketplace unique is that it can address HbA1c, blood pressure,
retinal exams and various other metrics while requiring no implementation costs. Iggbo’s online portal can
be primed for use quickly — and the network can be embedded with tools that the payer can leverage for
the right labor at the right place at the right time. Iggbo’s on-demand network of collectors helps payers
achieve their goals. The calculator below was built to help outline the returns payers can achieve through
Iggbo.

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Figure 3: Sample Iggbo HEDIS Calculator
IGGBO ASSUMPTIONS % MEMBERS
COLLECTED
TOTAL
IGGBO COST
GROSS
REVENUE TO
PAYER
% of Women Full Cdc Package + Bcs* 10% 20,625 $3,609,375 $8,043,750
% of Women Full Cdc Package No Bcs 50% 103,125 $13,921,875 $35,681,250
% A1c Only 20% 41,250 $1,650,000 $4,702,500
% Retina Exam Only 20% 41,250 $1,650,000 $1,320,000
% Of Men Full Cdc Package 50% 84,375 $11,390,625 $29,193,750
% A1c Only 25% 42,187.50 $1,687,500 $4,809,375
% Retina Exam Only 25% 42,187.50 $1,687,500 $1,603,125
Max Total Members Served 375,000
Max Costs $35,596,875
Max Revenues $ 85,353,750
Max Profits $ 49,756,875
* Comprehensive Diabetes Care (CDC) and Breast Cancer Screening (BSC)
Understanding the above table helps both the payer’s HEDIS team and the Iggbo project management
team calibrate their expectations and goals. To calculate the savings in the sample above, Iggbo collects
the information in the table below:
PAYER BREAKDOWN #
Total Number of Members 6,000,000
% Diagnosed with Diabetes 25%
Gross Total Diabetic Members 1,500,000
% Members: Women 55%
% Over 40 75%
% Members: Men 45%
Gross Women Total 3,300,000
Women Over 40 2,475,000
GROSS MEN TOTAL 2,700,000

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From here, Iggbo can begin to calculate the goals for each measure based on the national benchmarks
set by the NCQA that year, as exhibited below:
HEDIS MEASURES METHOD INCENTIVE
90TH
PERCENTILE
A1c Collection
Venipuncture or
Siemens POC Device
$114 90%
Retinopathy Screen RetinaVue or IRIS $38 90%
Nephropathy Screen Urine collection $32 80%
Blood Pressure Blood Pressure Cuff $147 80%
Bmi Assessment Height ruler and scale $15 95%
Breast Cancer Screening SureTouch device $44 90%
Max Potential Per Male Member $346
Max Potential per Female Member $390
AT RISK DIABETIC
BREAKDOWN
DELTA TO
REACH
INCENTIVES
MINIMUM
COLLECTIONS
NEEDED
NET
MEN
NET
WOMEN
NET WOMEN
OVER 40
% With Outstanding A1c 15% 225,000 101,250 123,750 92,812.50
% With Outstanding
Retina Screen
10% 150,000 67,500 82,500 61,875
% With Outstanding
Nephropathy Screen
5% 75,000 33,750 41,250 30,937.50
% With Outstanding
Blood Pressure
10% 600,000 270,000 330,000 247,500
% With Bmi Assessment 5% 300,000 135,000 165,000 123,750
% With Outstanding
Breast Cancer Screening
10% 2,475,000 N/A N/A 247,500
Iggbo can determine the members with gaps in care for specific measures, the projected earnings per
member if the incentives are achieved, and the costs of Iggbo per collection.
With the combination of Iggbo’s seamless online ordering system and its compliance messaging system,
the payer’s HEDIS team can simply deploy the on-demand collectors to close the necessary gaps in care.
There are no costs for implementation and Iggbo charges on a per collection basis; however, Iggbo also
offers shared savings models where payment is collected after the results are returned. In either model,

8. HEDIS WHITEPAPER | JANUARY 2017
the costs are significantly less than the incumbents in the market. As a result, Iggbo provides payers the
following, all at a reduced cost:
• Optimized operations and outreach
• Enhanced patient outcomes
• Unlocked STARS/HEDIS reimbursements that were previously unreachable
Results
Iggbo implemented its on-demand network for a regional payer managing their state’s Medicaid
population (and their Medicaid-Medicare dual eligibles) and realized immediate results. An Iggbo pilot
project was introduced, scoped and implemented at no cost to the payer in less than three weeks. Iggbo
created individual accounts for fifteen patient coordinators who were able to close 20% of their gaps in
care. The payer’s HEDIS team received daily goals and quotas. Through the first two-weeks, every
individual met their daily quota. At the conclusion of the pilot, the payer surpassed their goal of securing a
neutral rating and unlocking previously unattainable reimbursements from HEDIS and STARs.
Iggbo drove 90% compliance through its Glidepath messaging platform. As depicted below, Glidepath
provided patients the opportunity to easily and seamlessly reschedule their appointments. In addition, the
system sent reminder messages through a variety of channels in order to meet all communication
preferences.
Figure 4: Iggbo’s Glidepath Compliance Messaging System

9. HEDIS WHITEPAPER | JANUARY 2017
By leveraging Iggbo’s on-demand workforce, the health system was able to provide a mobile, flexible
catchment in one of America’s densest metropolitan statistical areas that was both convenient for the
patient and compliant with the system’s laboratory protocols. The Iggbo Solution Scorecard was built to
illustrate the net-impact the Iggbo model had on the system. The Scorecard is a financial calculator linked
back to the aforementioned Iggbo PHM Calculator. It demonstrates the health system’s true cost savings
and earnings from implementing Iggbo across their entire HEDIS service line.
IGGBO SOLUTION SCORECARD
Outreach Success 90%
Number of Patients With Gaps in Care 2250
Total Patients Scheduled Per Day Per Member 3
Number of Team Members 15
Eligible Days to Close Gaps in Care 45
Total Patients Scheduled 2025
Total Patients Completed 1923
Iggbo Compliance 98%
Baseline Hedis Rating 79%
Net Hedis Rating Post-Iggbo 94.96%
Average Reimbursement Per A1c Gap Closed $120
Number of A1c Patients 1500
Gross Reimbursement Per A1c $180,000
Iggbo Costs + Operational Expenses Per Patient $50
Total Expenses $75,000
Net Profit $105,000
The result of the Iggbo implementation was a projected net-HEDIS rating of 94.96%, nearly four
points above the neutral rating. The average incentive payment from NCQA to payers for closing gaps
in care for A1c collections averages $140.00 per member. It is projected that the payer actualized a
potential revenue of $180,000 — much of which was previously unattainable.

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Conclusion
The American healthcare system has focused on the Triple Aim for nearly two decades: reduce costs,
increase quality and improve outcomes. Through Iggbo’s on-demand network of healthcare labor, payers
can accomplish this goal, as proven by Iggbo’s case study with a payer tasked at closing its gaps in care
in record time. In this case study, Iggbo was able to unlock incentives for the payer previously thought to
be unattainable — and is projected to be a key operational tool in their upcoming year.
• To see how Iggbo can help your members, download our calculator here and contact Iggbo
at info@iggbo.com.
• For more information about how Iggbo can help you or your system, please contact Iggbo
at info@iggbo.com.