About Gateway Health Plan^®

In 1992, Gateway Health Plan^®, Inc. was established as an alternative to Pennsylvania’s Department of Public Welfare’s Medical Assistance Program. For more than 15 years, members have benefited from services such as disease management, health and wellness programs and preventive care. Today, Gateway Health Plan^® is a top-ranked managed care organization that provides service to more than 244,000 members eligible for medical assistance. Gateway Health Plan Medicare Assured^®, a Special Needs Plan for those eligible for both Medicare and Medicaid, is one of the nation’s largest Medicare programs for the dual-eligible population.

Mission
Gateway Health Plan^® emphasizes the development and delivery of innovative programs to positively affect the personal health of its members. Gateway maintains a healthcare delivery system that assures the availability of high quality medical care for the Gateway member, based upon access, quality and financial soundness.

Prospective Care Management
Gateway’s goal is to help improve the health and well-being of its members. In an ongoing effort to accomplish this goal, Gateway developed Prospective Care Management (PCM^®), a proactive holistic approach to healthcare. By identifying the Behavioral, Environmental, Economic, Medical, Social, and Spiritual (BEEMSS^SM) issues a member faces, Gateway can design a plan to ensure that the member receives the care he or she needs.

• Medicaid HMO available in Pennsylvania
• Medicare Special Needs Plan available in Pennsylvania and Ohio

Unlike many health insurance companies, Gateway Health Plan^® focuses entirely on serving the needs of the most vulnerable citizens - the poor, elderly and disabled.

Since its inception, Gateway has focused on providing the best possible healthcare to a growing number of Medicaid members. Gateway offers care for all kinds of health needs – everything from regular doctor visits to emergency care.

In January 2006, Gateway expanded its services to include a Medicare approved Special Needs Plan, Gateway Health Plan Medicare Assured^®. This program is available to individuals who have both Medicare and Medicaid. As of January 2008, Gateway Health Plan Medicare Assured^® is available to individuals in 27 counties in Pennsylvania and 12 counties in Ohio – making it one of the largest plans of its kind in the country.

• All the benefits of Original Medicare
• No monthly premiums
• Prescription drug coverage
• Hearing and vision benefits
• Health and wellness education, such as heart disease, diabetes and asthma programs, and smoking cessation
• Fitness Assured^®, a fitness program to help members stay active
• Transportation

Membership/Network
Gateway Health Plan^® serves more than 244,000 members. Gateway Health Plan Medicare Assured^® has more than 24,000 members in Pennsylvania and Ohio. Gateway’s provider network includes more than 8,000 health care providers, over 100 hospitals, a network of pharmacies, home healthcare agencies and other related healthcare providers.

Quality Accomplishments
Gateway Health Plan^® holds an ‘Excellent’ rating from the National Committee for Quality Assurance (NCQA), an independent agency that accredits and certifies managed care organizations, for its Medicaid HMO product. This rating is only awarded to those health plans that meet or exceed NCQA’s rigorous requirements for consumer protections and quality improvements. Gateway’s ‘Excellent’ rating indicates the strength of the health plan’s overall member focus, from efficient and timely claims processing to assisting its members in receiving the care they need. In 2000, Gateway became the first Medicaid health plan to receive NCQA’s ‘Excellent’ accreditation and was the first to repeat that level of accreditation in 2006.

Gateway Health Plan^® is proud to be recognized with a five-star “Excellent” Member Quality Rating from the 2008 CAHPS^® Survey. This rating is based on how Gateway members rated Gateway’s overall quality in the survey. This honor is the result of passion, a commitment to excellence, and the dedication of a compassionate staff. Our work is a reflection of our guiding principles and our mission to distinguish ourselves as the health plan with superior quality and service.

Continuing Quality Care
Healthcare is an ever-changing field and Gateway strives to stay on top of its members’ needs. Gateway is committed to continuous improvement and providing high standards of quality in every aspect of service. This commitment is led by Gateway’s 18-member Quality Improvement/Utilization Management committee, made up of experts in a wide variety of medical fields. The QI/UM Committee evaluates Gateway’s ongoing efforts as well as new protocols and clinical guidelines in order to improve services and care for its members.

Wellness & Disease Management
Gateway is committed to improving the life of its members and working to find new ways to promote wellness, illness prevention and health education as demonstrated by the following programs:

• Preventive health care guidelines
• Free quit tobacco program
• Pediatric and adult immunization reminders
• Cardiac disease prevention program
• Free personalized programs to assist patients with diabetes, asthma and depression

Community Involvement
Gateway Health Plan^® is an active partner in the community through many outreach and community based activities. Gateway strives to improve the health and quality of life of its members as well as the community-at-large.

• Gateway participates in community events and sponsorships and provides assistance to community and social agencies that also serve a high-risk, vulnerable population.
• Gateway continually develops a variety of outreach programs for adults and children to provide education on health, wellness and safety issues. These programs are offered to the community at no cost.
• Gateway informs and partners with individuals and organizations through the Health Literacy Initiative. The goal of the initiative is to develop and implement programs that positively impact health and well-being by helping people better understand and navigate the healthcare system.

Awards and Honors
For the fourth consecutive year, Gateway Health Plan^® was named one of “America’s Best Health Plans” and ranked among the “Top 20” of all Medicaid health plans in the nation, according to U.S.News & World Report and the National Committee for Quality Assurance (NCQA). The most recent report dated November 7, 2008 ranked Gateway Health Plan^® No.19 nationally and second in Pennsylvania. The rankings are testament to Gateway’s continued exemplary performance as a top-ranked Medicaid plan.

Gateway Leadership
Michael Blackwood, President and Chief Executive Officer of Gateway Health Plan^®, was selected as the 2004 State Rural Health Leader of the Year, presented by the Pennsylvania Rural Health Conference coordinated by the Pennsylvania Office of Rural Health. This award is given annually to recognize the accomplishments of a rural healthcare leader who has made a notable contribution to the healthcare delivery system in his or her community through innovative and progressive efforts.