Diagnostic Testing Centers™ is the First Chronic-Centric Innovation that Consolidates Reimbursable Exams into Medical Clinics.

Diagnostic Testing Centers™ (DTC) provides proprietary products and services that impact the risk adjustment model for aged and disabled beneficiaries enrolled in CMS and Medicare Advantage (MA) plans that diagnose, monitor, and manage patients with greater clinical insight. The Diagnostic Testing Centers™ has offered diagnostic testing and treatments for patients living with chronic conditions in medical clinics and patient homes since 2010.

Today, our Diagnostic Testing Centers™ also include rentals of medical devices for in-clinic and in-home testing so that clients can be equipped with the newest state-of-the-art technology. The majority of our assessments use current and established billing codes from the American Medical Association (AMA) for Medicare insurance reimbursements. Our consolidated assessments help people living with diabetes to monitor the vital organs, which increases the risk of diabetes conditions (e.g., cardiovascular disease, kidney disease, eye disease, vascular disease, nerve problems, and many other diabetes-related conditions). Medical providers can immediately:

• Increase Financial Revenues

• Enhance Patient Outcomes

• Improve Quality Measures

Health Risk Assessments (HRA)

We supply health risk assessments to medical providers throughout the U.S. for their patients living with chronic conditions. The majority of our assessments are non-invasive and take approximately 3-minutes each to complete. Our evidence-based tools allow staff and medical providers time to better implement a patient's care plan at the point of care. Our program offers over twenty (20) services for people living with diabetes or other chronic conditions. Medical providers evaluate which patients are candidates for chronic-related assessments based on each patient's co-morbidities and medical necessity. Treatment goals and plans for the patients are based on evidence-based outcomes.

The benefit of consolidating preventive medicine and health risk assessments (HRA) at the Primary Care level is that patients would be referred to specialists who can expedite more aggressive interventions. Also, specialty providers requiring advanced patient care are at a higher reimbursable amount for Medicare and commercial insurances. A timely diagnosis may have important clinical implications as independent risk factors for diabetes conditions. The need for more objective screenings is indisputable and recognized by Medicare and insurance companies that pay for the preventive services. The benefits of consolidating patient assessment include:

• cost savings through efficiencies (e.g., geographic, co-pays, transportation, etc.)

• improved clinical integration and care coordination

• higher care quality and better health outcomes

• happier patients and better CMS Star ratings

CDC Morbidity & Mortality

Reducing morbidity and mortality and improving the quality of life for persons with diabetes is an ongoing challenge for healthcare providers and organizations, and public health practitioners. Interventions are available that focus on persons with diabetes, healthcare systems, families, and public policies. In 1996, diabetes was the seventh leading cause of death in the United States. Death rates are twice as high among middle-aged persons (i.e., persons aged 45-60 years) with diabetes than among those without diabetes. Mortality from diabetes is related primarily to heart disease. Adults with diabetes have heart disease death rates approximately 2-4 times higher than adults without diabetes.

Other diabetes-related conditions like Distal Symmetric Polyneuropathy (DSPN) are often overlooked as mortality risks but are the most common form of Diabetic Peripheral Neuropathy (DPN) and are the most troublesome complication of diabetes mellitus. In a meta-analysis, diabetic neuropathy in its cardiovascular form was associated with a three-fold risk for mortality in myocardial ischemia prevalence. Additionally, foot complications in people with diabetes start with common foot disorders such as calluses, nail fungus, foot ulcers, etc. It is these complications that can lead to more significant foot complications, amputations, and eventually death. Subjective medical evaluations may lead to more unnecessary, time-consuming, and costly testing. It may often include diagnostic imaging, blood tests, punch biopsies, electromyography (EMG), nerve conduction velocity (NCV), and more. Simple, objective tools that measure large and small nerve fiber instantly are available today.

Among persons with diabetes, the rate of Lower-Extremity Amputations was more than 40 times greater than that for persons without diabetes. In type 2 diabetes, the prevalence of cardiovascular autonomic neuropathy (CAN) also increases with diabetes duration and may be present in up to 60% of patients with type 2 diabetes after 15-years. A timely diagnosis of CAN may have important clinical implications, as CAN is an independent risk factor for cardiovascular mortality, arrhythmia, silent ischemia, any major cardiovascular event, and myocardial dysfunction. The need for an objective screening method to identify neuropathy is indisputable. Unlike the standard tools used today, the Diabetic Neuropathy Device™ is the first FDA Cleared multi-objective innovation in over 80-years that identifies, measures, and standardizes peripheral neuropathy exams at the point-of-care.

Mitigating Risks

The example of diabetic peripheral neuropathy (DPN) and its progressive loss of proprioception, diminished sensation, and weakness may lead to an imbalance with a more significant fall probability. Risk mitigation and the failure to diagnose lower-extremity diabetic neuropathy directly affect a patient's safety and mortality. DPN is a substantial contributor to falls and fractures through more advanced small-fiber and large-fiber dysfunction, loss of sensory, proprioception, temperature discrimination, and pain, ultimately leading to an increased risk of falls. Recent studies suggest that subjective tools may be the most significant causative factors preventing therapeutic interventions from occurring promptly.

According to the CDC, missed opportunities to diagnose neuropathy appropriately can ultimately lead to lower-extremity amputations of the toes, feet, or legs. U.S. courts have found medical institutions and physician defendants liable for medical malpractice due to their failure to adopt new technologies or procedures. Having been demonstrated in the case that set legal precedence in the U.S. Washington v. Washington Hospital (1990). Risk mitigation initiatives require clinicians to stay informed of emerging best practices based on clinical evidence. A collective refocusing on prevention and a reallocation of resources can lead to the appropriate therapy, leading to fewer inpatient and outpatient visits and improved quality of life. The Diabetic Neuropathy Device™ (DND) is a modern evidence-based tool that improves productivity, patient outcomes, and an organization's overall reputation for mitigating risks.

Precision

Our medical tools are an evidence-based approach toward comorbidity care that tailor disease prevention, environments, and lifestyles. With the advancement of technology, we can better assess people with chronic health conditions. Examples of our non-invasive technology include tools such as an autonomous fundus camera (static or portable) for diabetic retinal exams (DRE), the Diabetic Neuropathy Device™ to measure diabetic peripheral neuropathy (DPN), and peripheral arterial disease (PAD) to identify the level of vascularization in the lower-extremities - all of which improve a patients outcomes, and an organization's overall reputation for mitigating risks. Our treatment services are à la carte, so organizations may choose which HEDIS gap closures they would like to focus on using our modern point-of-care services.

Workflow

Diagnostic Testing Centers™ (DTC) maximizes the time and resources of the medical providers and staff with the efficiency and workflow for Primary Care Providers or Specialists and their patients that have been diagnosed with chronic conditions. The workflow maximizes the workflow design to analyze how an organization works and implements new measures to increase productivity. Workflow design in the health sector is recognized as a vital component to the successful integration of Electronic Health Records (EHR) and closing gaps in care.

Efficiency

Connect all of your diagnostic instruments, regardless of manufacturer, in one secure, web-based platform on a flexible telehealth monthly plan. Diagnostic Testing Centers™ (DTC) can connect hundreds (100's) of devices, regardless of manufacturer, with quick access on a single screen – DICOM or not. The software organizes all of your data within a single screen utilizing a responsive interface that enables you to view data from a traditional PC or mobile device. The software also provides your exam data access with a single-click, performs a historical comparison, and quickly cycles through the different report histories. The interface reduces time spent managing patient exam data by giving physicians and staff a seamless EMR integration and control over every instrument in the practice.

Consolidated Testing Reaches More Patients

• 95% of Medicare Advantage plan members with diabetes were monitored for kidney disease¹

• Only 52% of diabetes patients in the managed security service provider (MSSP) ACO program was documented to have had a diabetes eye exam¹

• By implementing eye exams, primary care practices and Medicare Advantage plans can bring STAR/HEDIS compliant eye exams to patients at the point-of-care

1. Centers for Medicare & Medicaid Services (CMS) standard analytical file “2018 Shared Savings Program ACO Interactive dataset”, Accessed December 23, 2019,

Raise STAR Ratings & HEDIS Scores

Medicare Advantage Star Ratings and HEDIS directly affect the bottom line. Our diagnostics increase STAR ratings and HEDIS scores. It is widely agreed that some costly re-admissions could be prevented with better care management and represent inefficient care delivery. Identifying any potential complications and addressed in the Annual Wellness Exams can improve the overall metrics. These tests are performed under a medical provider's direct supervision and may be done in the clinic or at a patient's home by trained and certified staff. The HEDIS domains of care are:

• Effectiveness of Care (e.g., evidence-based technology)

• Access/Availability of Care (e.g., telemedicine, remote patient monitoring)

• Experience of Care (e.g., simple, objective, instant)

• Utilization and Risk-Adjusted Utilization (e.g., Hierarchical Conditional Categories)

• Health Plan Descriptive Information (e.g., PCP, network providers, services)

• Measures Collected Using Electronic Clinical Data System (e.g., EMR, IoT, data management)

Medicare Preventive Services

Our technology assessments are à la carte, so you can choose which STAR/HEDIS gap closures you would like to focus on and expand services, including the following:

1. Alcohol Misuse Screening and Counseling

2. Annual Wellness Visit

3. Cardiovascular Disease Screening Tests

4. Counseling to Prevent Tobacco Use

5. Depression Screening

6. Diabetes Screening

7. Diabetes Self-Management Training

8. Diabetic Retinopathy and Glaucoma Screening

9. Intensive Behavioral Training (IBT) for Cardiovascular Disease

10. Intensive Behavioral Training (IBT) for Obesity

11. Initial Preventive Physical Exam

12. Medical Nutrition Therapy

13. Medicare Diabetes Prevention Program

14. Obesity Screening and Counseling

15. One-Time 'Welcome to Medicare' Preventive Visit

16. Prolonged Preventive Services

17. Yearly Wellness Visits

Evidence-Based

Our assessments and treatments are a WIN for the patients, a WIN for providers, and a WIN for health plans because our services help Close Gaps in Care.

Economics

OUR ASSESSMENTS AND TREATMENTS ARE SOLUTIONS! Not all of the products and services work in each state. We ensure that the organizations have been thoroughly trained on our technology and have been certified with the following:

• State-of-the-Art Products

• Reimbursement Support and

• Trained and Certified Personnel (optional)

CMS and insurance companies will pay the clinics in the same manner as they do currently, and our company will bill the practice a flat rate for equipment rental or a per-test fee. Abnormal test results require more aggressive care on a monthly or quarterly basis and reflect trend graphs of a patient's longitudinal care.