HELPING PEOPLE MAKE SMARTER HEALTH CARE CHOICES

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THE CAUSE WE SHARE

69% Specialty drug spending predicted to grow from $87B to $402B by 2020

Outrageous pricing

is widespread

• Knee Surgery costs $11,317 in Alabama, $69,654 in New York

• X-Ray Read $7.48-$164

• Gauze Pads $77

Of those experienced medically-related bankruptcy were insured at the time of filing

62%Of bankruptcies are related to illness or medical bills

56M Americans under 65 will have trouble paying medical bills

THE CONSUMER’S ROLE IN DECISION MAKING IS INCREASINGLY IMPORTANT

2003 2005 2010 2012

7%10%

18%

20%

High-deductiblehealth plan enrollment

Individuals with deductible of $1,000 or more

Source: Collins R, et al. “Insuring the Future” The Commonwealth Fund, April 2013, available at www.commonwealthfund.org

Primary care

Specialist

Ultrasound

MRI

Endoscopy

Cataract surgery

Heart failure admission

Renal failure admission

Hip replacement

Consumers paying moreout-of-pocket

Fall within PPO deductible1

Fall within HDHP deductible2

1) $733 based on KFF report of average PPO deductible2) $2,086 based on KFF report of average HDHP deductible

Source: http:/ehbs.kff.org/?page=charts&id=1&sn=13&ch=2764 , http://www.newchoicehealth.com/;

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PRICE VARIATION IN MARKETS IS STAGGERING…

OPTION 3

Total: $17,000-$24,000OOP: $3,400

OPTION 1

Total: $11,000-$17,000OOP: $2,750

OPTION 2

Total: $5,000-$7,000OOP: $1,200

SHOCK WAVE TREATMENT FOR KIDNEY STONES IN SEATTLE, WA

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AND CONSUMERS STILL AREN’T SURE WHERE TO LOOK FOR COST & QUALITY…

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NEW TOOLS HELPS BRING TRANSPARENCY INTO FOCUS…

helps consumers

find the care they deserve at prices they can afford

OPTION 2

Total: $5,000-$7,000OOP: $1,200

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CONSUMERS SEEK A BALANCED REVIEW OF

COST AND QUALITY…

cost

quality

convenience

social

social

cost

convenience

Real Cost EstimatorsShows how much a member pays for total care, based on their plan, benefits, and coverage

Patient Reviews Offers insights into patient’s actual experiences with providers

Provider SearchAllows consumers to find doctors, specialists and facilities who meet their needs

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CURRENT AND PROJECTED SHOPPING TRAFFIC TRENDS ARE INTERESTING…

Search Term% of All Searches

Dentist 1.35%

Pediatrics 1.21%

Obstetrics & Gynecology 0.94%

Family Medicine 0.81%

Dermatology 0.79%

Internal Medicine 0.78%

General Practice 0.47%

Primary Care 0.43%

General Dentistry 0.41%

General Acute Care Hospital

0.38%

2013 2014 2015 2016 2017

124,192

260,264

354,349

1,822,470

4,646,066

40,145,

702

49,563,

968

66,732,

750

73,406,

025

84,416,

929

Cost Estimates

Searches

Cost Estimate% of All Cost Estimates

Vaginal delivery 5.30%

Bariatric surgery - laparoscopic gastric bypass 2.26%

Bariatric surgery (lap band) 2.15%

Screening colonoscopy 2.05%

Chiropractic Treatment 1.96%

C-section delivery 1.95%

Vasectomy 1.68%

Colonoscopy with biopsy 1.56%

Obstetric care, Global 1.35%

Existing Patient Preventative Checkup for an Adult (Age 18-64)

1.24%

USING PREDICTIVE ANALYTICS AND PROACTIVE ALERTS TO DRIVE SAVINGS HAS HUGE POTENTIAL…

9CONFIDENTIAL. Redesigning Health Care.

• RX Brand vs Generic suggestions

• Place of service suggestions

• Community participation

• ER alternatives

• Live Chat prompts

• Concierge access

Alerts can be used for:

PERSONALIZED HEALTHCARE ADVICE & SERVICE IS THE NEXT WAVE…

10CONFIDENTIAL. Redesigning Health Care.

• Find a doctor

• Understand cost

• Help explain quality

• Hand off to Tele Health

• Understand Rx spend and options

• Review benefits

• Schedule appointments

Concierge can provide:

• Offer incentives for lower priced treatments and doctors that make sense

• Support with claims questions

• Review the bills after treatments and appointments to see if there are areas to save cost

• Become employee advocates to get the prices reduced

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“I’m fortunate to have a health savings account, but it wouldn’t have covered the full cost of my delivery. Since I found out what I should expect to pay in my first trimester, I was able to create a savings plan and I’m prepared to pay everything upfront. Paying off my medical expenses allows me to get a five percent discount from the hospital too…”Megan, expectant mother and HealthSparq user

HELPING PEOPLE MAKE SMARTER HEALTH CARE CHOICES

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COST SAVINGS CAN BE REALIZED THROUGH CONSUMER EMPOWERMENT…

Avoidable EDGetting appropriate care at lower-acuity settings and/or not get care at all

Brand vs. Non-Brand RxChange repeat-use brand name pharmaceuticals to generic alternatives

Change Site of Service (Surgery) Change sites of service to outpatient and free standing center

Change Provider (Non-surgery)More affordable providers for office visits, tests, imaging, or immunizations

9.8% OF SPEND COULD BE ELIMINATED*

• Based on savings algorithms that HealthSparq users benefit from• All figures are representative of an average population opportunity of $34 PMPM

($82 PEPM) savings on $356 PMPM ($870 PEPM) total spend. Actual savings opportunity will vary by population and/or employer.

66% of spend is sensitive to shopping

0.9%

0.2%

4.1%

4.6%

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WE’VE PROVEN THAT THE TOOLS WORK

GALLBLADDER REMOVAL

Inpatient Outpatient Surgical

$19,102 $11,107 $6,360

Cost Estimator users choose

Non-users choose

Average Cost

Least expensiveMost expensive

41% 55%

10% 70% 20%

4%

(2 year period of regional health plan’s claims history)

Over the years, I’ve had a lot of MRIs so I know how much they’ve cost me at my local hospital. When my my doctor recommended another, I wasn’t sure I could afford it. I started hearing about HealthSparq at work and from emails. I also go a postcard at home which finally convinced me to give it a try. I am so glad I did. I learned I could save $400 on an MRI at an imaging center that is just a few miles down the road from me. In addition to saving money, HealthSparq helped me take charge of my overall health.

- Todd H., Utah State University

INFORMED DECISIONS DRIVE COST SAVINGS

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”

“

16CONFIDENTIAL. Redesigning Health Care.

Analytics, alerting, and dashboards

Personal Health Record

Employee incentives

Scheduling and access

Billing audits

Telehealth/medical tourism

Cash / prompt-pay pricing

Provider selection / shopping

Cost & quality transparency

Private exchange support

Consumer advocacy / Concierge services

HSA bank F

THE CONSUMER HAS TO BE AT THE CENTER

PAYER & EMPLOYERS CONSUMER/EMPLOYEE PROVIDERS & NETWORKS