© 2015 navmd, All Rights Reserved ETG & ERG Overview

© 2015 navmd, All Rights Reserved Symmetry ETG ® : Episode Treatment Groups The Symmetry ® Suite ETG (licensed by OptumInsight) has been integrated throughout navmd Analytics. ETG ® s define a specific medical condition or episode Calculate the true cost of conditions Identify related prescription uses & costs Score the severity Determine whether the condition is active or inactive

© 2015 navmd, All Rights Reserved Symmetry ETG ® : Before & After Before ETG GroupingAfter ETG Grouping Diagnosis / Rx# of ClaimsTotal Cost Diabetes3$780 Pneumonia2$315 Foot Ulcer3$3,550 Cough2$105 High Fever3$180 Rx: Antibiotic1$29 Rx: Insulin3$1,255 TOTAL17$6,214 Episode #1# of Claim s Total Cost SeverityActive? Diabetes9$5,5853 out of 4 Yes Member: Robert Smith Incurred Claims: 1/1/2015 to 7/31/2015 TOTAL17$6,21 4 Episode #2# of Claim s Total Cost SeverityActive? Bacterial Lung Infection 8$6291 out of 2 No

© 2015 navmd, All Rights Reserved Symmetry ETG ® : Severity Example 1 Member: Daniel Miller Disease: Ischemic Heart Disease

© 2015 navmd, All Rights Reserved Symmetry ETG ® : Severity Example 2 Member: Tyler SmithDisease: Ischemic Heart Disease

© 2015 navmd, All Rights Reserved Symmetry ERG ® : Episode Risk Groups The Symmetry® Suite ERG (licensed by OptumInsight) has been integrated throughout navmd Analytics. ERGs allow member-level risk to be incorporated throughout navmd Analytics ERG’s scoring methodology uses ETG results. This allows ETG-specific parameters to be used for risk scoring, such as disease severity, progression, co-morbidity/complication interaction, etc. Both retrospective and actuarial/prospective models are available Risk indexes can be presented at the member level, by subpopulation, or the entire plan population. Risk is calculated based on the patient’s underlying condition instead of individual services provided in their treatment Pharmaceutical data is included as part of the risk scoring. Alternative to a health risk assessment (HRA) in the absence of an HRA.

© 2015 navmd, All Rights Reserved Symmetry ERG ® : Timeline Example Risk Index 8/1/ /31/2015 8/1/ /31/2016 Prospective Risk Index 2/1/ /31/2017 Actuarial Risk Index 7/31/2015 End of experience period 1/1/2014 4/1/20147/1/201410/1/ /1/20154/1/20157/1/201510/1/ /1/2016 4/1/2016 7/1/201610/1/ /1/2017 ERG example using a group with medical and pharmacy claims data, paid from 1/1/2014 to 7/31/2015 1/1/2014 Beginning of experience period

© 2015 navmd, All Rights Reserved Symmetry ERG ® : ERG Scoring Example 1 Member: Robert SmithGender: Male Age: 58 ConditionSeverity Level ERG Risk CategoryRetrospecti ve Risk Index Prospective Risk Index Actuarial Risk Index Diabetes2 Diabetes with significant complication / comorbidity, I Congestive Heart Failure 1 Ischemic heart disease, heart failure, cardiomyopathy, III Ulcer3 Other moderate cost gastroenterology, II Acne1 Lower cost dermatology, I Acne1 Lower cost dermatology, I ––– Demographic Risk Group: Males, 50 – 64– Total Risk Score

© 2015 navmd, All Rights Reserved Symmetry ERG ® : ERG Scoring Example 2 Member: Janice SmithGender: FemaleAge: 35 Condition Severit y Level ERG Risk Category Retrospec tive Risk Index Prospecti ve Risk Index Actuarial Risk Index Carpal tunnel syndrome 1 Other moderate cost neurology, I Pregnancy, with delivery 2 Normal pregnancy, delivery, I Demographic Risk Group: Females, 35 – 44– Total Risk Score