2

250+ Interviews Conducted Prior to MissionPoint Launch

Network Physicians

• Significant behavior change will only occur with “payer” control of 30 – 50% of a physician’s patient panel

• Models that require physicians to “do more” are at significant risk

• Primary Care Physicians favor capitation, as it evens out cash flow and allows them to meet productivity and financial goals without over scheduling

Members

• Non-clinical indicators are strongly predictive of cost

• Low percentage of patients account for high percentage of cost. Significant impact can be achieved by correctly identifying and working with these individuals

• Improvements in most clinical outcomes do not correlate to short-term cost savings

Employers

• Regional or National networks are required to cover 70% of employees that live outside a single market

• Willing to pay for access, but quality should be expected

• TPAs provide a variable amount of analytics to employers depending on size; however, data is not actionable and employers lack resources for effective interventions

Feedback Drives Design

3

Market Segmentation Requires Unique Management Strategies

Coverage Type Cost Per Beneficiary

Number of Beneficiaries

Market Size

Self-Insured $4,547 74 Million $332 Billion

Fully- Insured $4,292* 74 Million^ $318 Billion

Medicare (Traditional) $9,702 34.2 Million $332 Billion

Medicare Advantage $8,467 14.6 Million $127 Billion

Medicaid $6,982 54.7 Million $382 Billion

Medicare:http://kff.org/medicare/fact-sheet/medicare-spending-and-financing-fact-sheet/http://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/FFS-Data.html FFS Datat, 2008-2011 Medicare Advantage:http://kff.org/medicare/fact-sheet/medicare-spending-and-financing-fact-sheet/http://kff.org/medicare/fact-sheet/medicare-advantage-fact-sheet/Medicaid: http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/MedicareProgramRatesStats/Downloads/MedicareMedicaidSummaries2012.pdf PG 29Self-Insured:http://www.healthcostinstitute.org/files/HCCI_HCCUR2011.pdfhttp://www.ebri.org/pdf/publications/facts/fastfacts/fastfact05282008.pdfFully –Insured:• estimate based on premium level• ^estimate based on US Population

Total Market: $1.5 Trillion

Engaging Patients Across All National Markets

4

Progressive Employers Looking for Provider Partners

Managing HealthCare Cost Growth

Low Performers

10.3%

Median Best Performers

5.9%

2.2%

Study In Brief

18th Annual Towers Watson/National Business Group on Health Employer Survey

Comparative Annual Health Cost Growth

Employers Surveyed

Best at Holding Cost Growth More Likely to Focus on Provider Strategies

13%Contract directly with hospitals, physicians, ACOs

16%Adopt new accountablepayment models

16%Offer incentives for care

coordination22%

Offer performance-based payments

2%

7%

4%

5%

Best Performers

Low Performers

Products and Services

5

Diversified Product Offerings Designed to Meet Employer’s Unique Needs

Survey Support

Engage

Bio Metric Screenings

Health Risk Assessment

Population 360

Environmental Design

Complex Case Management

PCP Connect

Virtual Care Network

Healthy Eating

OnSite Clinics

Smoking Cessation

Readmission Program

Primary Care Membership

Stress Management

Clinically Integrated Network

Clinical Management

These products are focused on helping clients gain intelligence about the risks and opportunities in their population. We use a combination of clinical, claims, and non-clinical data to define each opportunity.

This set of products is presented based on the risk and opportunity profile of each employer. Each product has a flexible pricing model based on geographic, risk, and cost profile of the defined population.

These are the products we’re best known for. These products are often a blend of shared savings and PMPM pricing plus implementation fee – with full at-risk models available for certain clients in 2015.

6

Custom Network Design

Additional Physician IncentivesExtended Weekend Hours

Open SaturdaysOpen Sundays

Email with PatientsComprehensive Medication Review

SpecialistsOutpatient Facilities

Inpatient Facilities

MissionPoint Provider Network

Population Identification and Stratification

Care at a Distance

Wellness Partners and Services

Medical HomeInternal Med and Family Practice

Personal Care Team

Per Member Per Month Payment

Shared Savings Pool

MissionPoint Health Partners

MissionPoint Member

7

Contracts Standard Yet Flexible

Provider Flexibility

Physician Master AgreementMeets Clinical Integration Safe Harbor:• Committee Participation• Shared Quality Information• Care Collaboration

Addenda Provide Freedom and Flexibility:• Physician can decide what populations

to participate in• Each Addendum contains different rates,

shared savings amounts and quality metrics

• Addenda can have different terms and “opt-out” provisions

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8

Diverse Focus Areas Addressed on Three Health Partner Teams

Health Partner Solutions

Transitional Ambulatory Integrated Care

Patient Connects to Health Partner: Physician Referral

Self ReferralHospital Discharge

ED Visit

• Hospital Discharge• Long-term Care• Skilled Care• Home Visits

• ED• Disease

Management• Wellness

• Psychosocial Needs

• “Life” Resources• “Family”

Resources

Specialty Care

Primary Care Physician Virtual “Medical Home”

9

Payer TPA

Self-Insured

Employer

Options During Open Enrollment

Preferred Network (MPHP)Narrow Network

Dedicated Medical HomeLow Co-Pay Levels

Leveling Monthly PremiumsCoordinated Patient Record

Deep Wellness Support

In-NetworkNarrow Network

Expected Co-Pay LevelsRising Monthly Premiums

Wellness Support

Out-of-NetworkWide Open NetworkHigh Co-Pay Levels

High Monthly PremiumsLow Coordination

Little Wellness Support

Provides Shared Savings Option

Pays Claims and Network Service Fee

Employee Selects Medical Home

Creating Value for the Ecosystem

Employee

Employee/Member

MissionPoint Health Partner

Specialty A

Specialty B

Specialty C

Alliance Network

Partner A

Partner B

Partner C

10

Targeted, Fact-Based Solutions to Manage Populations

MPHP Strategic Approach

Identify Segment Prescribe Engage Sustain

Getting to know you:• Personal Health Reports• Clinical Population Analysis• Demographic Review

Find the Right Strategy:• Health Assessments• On-Site Clinics• Health Partners• Telehealth• Narrow Networks

Analytics and Aspirations• Utilization Costs• Location Costs• Avoidable Events• Behavior Modification• Care Experience

Personalized Plans• Type of Engagement• Frequency• Intensity• Duration

Right Time, Right Place• Quarterly Monitoring• Strategy Adjustments• Quality Reviews

Rising-Risk Patients

Low-Risk Patients

11

Patient Data Maximized to Guide Effective Interactions

Managing Patient Risk

Prioritize Highest Risk Members:Immediately deploy Health Partners to patients during “trigger events”

Target Members Showing Warning Signs:Track future risk scores and population trends for pro-active Health Partner engagement

Create Opportunities Across Members:Leverage highly effective, low cost screenings and preventative care for optimal health outcomes across members

Benefit Design Steers Members Towards Optimal Use of MissionPoint Network

81%

77%

65%

12

Continuous Improvement in Self-Insured Population

Tracking Progress

Quality Metrics by YearMedical Per Member Per Month Cost Trend

2011 2012 2013

8.99%

7.85%

30-Day All Cause Readmission Rate

Nov. 2011-Oct. 2012 Nov. 2012-Oct. 2013

2.23%

3.29%

4.50%

36.30%

71.28%

95.99%Chronic Disease Spend

Above Benchmark

% Avoidable Admissions

ED Visits per 1,000

% Generic Utilization