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At the Cape

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No-Value Care (30%)

Necessary Utilization(70%)

Care That Doesn’t Produce Better Outcomes

$850 Billion Unnecessary Spend in 2014(Institute of Medicine)

No-Value Care:

.30 / Each $ Is Wasted

Low Value Care Drives Billing in Fee for Service

“#1 Weakness of FFS Payment System Is

Excess Use of Low Value Services”

Dr. Patrick Conway, Chief Medical Officer, CMS

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without the prior written consent of the Company, is prohibited.

No-Value Care:

CMS Is Paying on It

2016 World Economic ForumAnnual Meeting in Switzerland

On track to sunset 50% of FFS

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No-Value Care:

Market Advocates for It

In a series of white papers, HCTTF, following research,

recommends that payers, providers and CMS use low-

value care as evaluation criteria for success in pay for

value models and incentivize providers based on it to

create sustainable economic models for transition to value-based care.

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without the prior written consent of the Company, is prohibited.

“Millions of people are receiving drugs that aren’t

helping them, operations that aren’t going to make

them better, and scans and tests that do nothing

beneficial for them, and often cause harm.”

Dr. Atul Gawande, Professor, Department of Health Policy and Management at the Harvard School of Public Health & the Department of Surgery at Harvard Medical School.

No-Value Care:

Media Is Reporting on It

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without the prior written consent of the Company, is prohibited.

"It's no secret that patients often undergo unnecessary procedures that can be dangerous and costly." Through our collaboration with RowdMap, we are providing patients with meaningful information about these no- or low-value treatments, allowing them to make better, more informed decisions about their doctors, hospitals and medical care.”

No-Value Care:

Consumers Demand It

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without the prior written consent of the Company, is prohibited.

RowdMap has no-value care and population health benchmarks for…

every physician

every hospital

every zip code

…in the United States. What if you knew which providers would

drive your success?

No-Value Care:

RowdMap Has It

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You can have great outcomes…On a surgery you don’t need

You can have great patient experience...On a surgery you don’t need

You can have realtively low costs...On a surgery you don’t need

How Much Outcome Does Your Dollar Buy?

Guys, it’s $/Outcome.Think Moneyball

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How Much Outcome Does Your Dollar Buy?

RowdMap’s Risk-Readiness® benchmarks help health plans, physician groups, and hospital

systems identify, quantify, and reduce delivery of no-value care — a central tenet of successful

pay-for-value programs.

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Leading the way…

US CTO on RowdMap: “Visionary

Genius”

ABOUT ROWDMAPReception & Press

…in the shift from fee-for service to pay-for-value.

And featured in… RowdMap Partner

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Health plans and providers in 48 states and the District of Columbiause RowdMap’s benchmarks to reduce the delivery of no-value care.

RowdMap’s benchmarks help manage the $850 billion the nation spends on care that leads to no better outcomes.

The clients RowdMap serves collectively cover the lives of more than 100 million Americans.

RowdMap was founded in 2011 and has offices in Louisville, KY and Portland, ME.

ABOUT ROWDMAPRowdMap by the Numbers

Payers in Marketplace/Exchange, MA, Medicaid, Commercial and Government Programs

Providers including PCP & Specialty Groups, CINs & Systems, ACOs, Bundles & other CMMI Program Participants.

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Where It’s WorkedNetwork and Medical Economics• Built a high-performing specialist network that significantly reduced no-value care delivered

• Performed a network comparison against a plan’s competitors to determine which groups were essential to contract with when entering a new market

• Tripled a plan’s original goal of contracting with targeted providers by using RowdMap benchmarks as a basis for conversation (and in some cases, out of exclusivity arrangements)

Value-Based Innovation• Crafted value-based contracting strategies for leading specialist groups looking to move to

even more aggressive risk arrangements with payer partners

• Developed a five-year government programs expansion strategy that identified high-performing physician groups to put on a pathway to risk

Product Portfolio and Benefit Design• Launched high-end concierge plan that broke member price sensitivity and generated

significant profit, doubling original membership goal

• Reformulated a multi-state health plan’s exchange portfolio by considering network efficiency and population behaviors to increase profit today and succeed over time

Strategy, Growth, and Expansion• Created a plan’s expansion strategy for Medicare Advantage using RowdMap’s population

health, physician performance, and market-level benchmarks

• Moved a plan’s membership in high-performing physician groups from 2% to 30% in 12 months through new messaging and marketing tactics

Where we’ve done it…

ABOUT ROWDMAPMarket Adoption

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CMS: 50% of FFS will be gone by 2018

What if you knew which providers would

drive your success?

What if you knew which providers would sink you? WHAT WOULD YOU DO IF YOU KNEW

who will win and who will lose in value based arrangements

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Appendix

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At the core of Risk-Readiness® is

Unwarranted Variation:

RowdMap applies the Dartmouth Atlas forUnwarranted Variation methodologies to data on Medicare Parts B & D. This research has been repeatedly validated over the last 30 years and we now have a national data set to apply the methodologies at a large scale.

The estimated 30% of medical expense that goes to no-value care.

This unnecessary spending drives billing in a fee-for-serve economic model, but success in pay-for-value comes from managing and mitigating these pockets of variation. Every provider has a unique practice

pattern that informs Risk-Readiness®

WHAT WE DORisk-Readiness® – Practice Patterns

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WHAT WE DORisk-Readiness® – Practice Patterns

Providers in a Market

Groups

Individual Physicians

What is driving a provider’s Risk-Readiness®? Is it procedures, prescriptions, referrals or visits?

How big is a provider’s panel?

How ready is a provider to succeed in risk

compared to peers? By specialty?

Within a region?

Finger print with practice patterns that mitigate no-value care = Green Dot

Finger print with practice patterns that create no-value care = Red Dot

Benchmarks for Risk-Readiness®

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RowdMap provides data and analysis on Population Health factors that drive success in value-based programs:

WHAT WE DORisk-Readiness® – Population Health

Behaviors – Broader Definitions of Health with Behaviors

Utilization – Utilization and Costs of Procedures and Drugs

Prevalence – Major Diseases and Conditions

Supply – Number of Primary Care Physicians and Specialists

Socio-demographics – Income, Environment, etc.

Match your strategies to

your population to succeed in value-based

programs

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Great profile for aggressive risk

Tread carefully for some risk

Match Provider Practice Patternswith Value Based Programsbased on Population Health Behaviors

WHAT WE DORisk-Readiness® – Risk Arrangements

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WHAT WE DOWhat Payers Get – Menu of Analytic Use Cases

Get started by choosing some options below:

Network DevelopmentCreate a Risk-Ready Network• Network Explorer

• Network Builder

• Network Optimizer

• Network Calculator

Product Design & RiskDesign Profitable Products• Competitive Benefit Design Analysis

• Network Based Benefit Design

• Population Health Based Product Analysis

Sales & MarketingGrow into Profitable Membership• Network Based Growth Analysis

• Provider Growth Analysis

• Measuring Growth Analysis

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WHAT WE DOWhat Providers Get – Menu of Analytic Use Cases

Are you Ready for Risk?Manage Internal Variation Provider Contracting Strategy Provider Compensation Strategy Process Variation & Improvement Service Line Benchmarking Provider Reporting Provider Recruitment & CIN Build Value Chain & Leakage Reporting Medical Economics Reporting

Are Your Partners Risk Ready?Pick the Best Partners for Risk Arrangements Primary Care Referral Source Analysis Acute Care Partner Reporting Post Acute Partner Reporting Consulting/Specialty Partner Analysis Competing Groups/Orgs Analysis

What are my best Opportunities for Risk?Match Providers to Risk• Risk-Matching to Payers: Government & Private Payers • Payer Negotiation Reporting • Medical Economics Modeling

Get started by choosing some options below:

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WHAT WE DOAchieving Financial Sustainability

Grow into Markets / ProvidersProfitable Today & Tomorrow

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Government benchmark data serves as the common languagenecessary to build relationships with providers to improve the member experience and profitability

The benchmarks are available today with no IT involvement

The data already have a level of analysis on top, so you can see if a provider is over/under benchmarks

It’s from CMS; it’s a standard; it’s already used to day to drive reimbursement

WHAT WE DOPower of Government Data

Government Benchmarks

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Government Benchmarks vs. Claims

Over / Under CodingCounty & Zip Code

Under Coding Over Coding

Under-codingJacksonville

Overs-coding Miami

Government data outperforms claims i.e. - you don’t need claims history for cost projections or to identify over/under-coding

WHAT WE DOPower of Government Data