Why pricing transparency? Vast disparities in cost and quality among providers Consumers want more value for their healthcare dollars No clear correlation between cost and quality Employers seeking benefit plan designs that encourage lower-cost, higher value-based consumption

Health Cost Estimator+ Overview Health Advocate’s proprietary pricing transparency solution Supported by leading-edge technology and data analytics Multiple data sources for medical cost estimates, including clients’ paid medical claims supplemented by our national database Provides key information to select the highest-value providers Users can also compare costs for prescription drugs and dental procedures

Available on multiple platforms Available on multiple platforms including smartphone, tablet and PC Complete mobile application functionality Employees can call a Personal Health Advocate for added pricing support

Key program features Medical. Compare costs for medical procedures and services by ZIP Code Prescriptions. Search pharmacies and view out-of-pocket costs before filling a prescription Dental. Compare and view estimated out-of-pocket costs for dental procedures

Key program features (continued) Consumer-friendly design Proactive employee awareness and engagement program Detailed reporting package Competitively priced; no implementation fees

Key program features (continued) Personal Health Advocates Can Help Search for and locate qualified providers Make appointments Transfer medical records Facilitate pre-authorizations Help with next steps Answer questions

Medical Procedures + Services

Medical cost transparency Pricing estimates for doctors, hospitals and other facilities nationwide Real-time out-of-pocket estimates and user benefit status Quality indicators, safety scores and patient reviews Incentive tracking and rewards program Ability to integrate Reference-Based Pricing

Data-driven solution Shows actual client data based on paid medical claims Total estimated cost includes the entire episode of treatment, including professional and facility costs When client-specific claims data is not available for a specific service, uses “same-payer,” “Adjusted Medicare” or “all commercial” data from our database

Data-driven solution (continued) Some carriers restrict the use of data in transparency tools (i.e. most Blues plans and UHC) Several clients have successfully persuaded their health plan to allow us access to their data for transparency For clients with Blues plans, we can populate HCE+ using the BCBS Association’s National Consumer Cost Tool (NCCT) data for over 500 procedures

Sophisticated search engine Compare costs for hundreds of medical procedures and services nationwide

Real-time benefit status Personalized benefits information based on paid medical claims

View results by hospital, facility Results Include: Hospitals Other facilities (e.g., ambulatory surgery centers) Doctor affiliations Estimate breakdown Mapping function

Benefit and quality information Views Include: Health benefit status Estimated out-of-pocket costs Safety scores Consumer ratings

View cost breakdown for each estimate Details Include: Doctor fees Facility fees Anesthesia fees Total estimate Employer/plan pays Applied benefits

Powerful filter to narrow search results Sort By: Cost Quality Distance Consumer ratings

Health Cost Estimator+ quality indicators Hospitals Leapfrog Hospital Safety Scores Centers for Medicare & Medicaid (CMS) Patient Satisfaction Survey Average Annual Patient Cases Doctors Healthgrades Patient Satisfaction Scores CMS Quality Indicators Education; Group Affiliations Pursuing sources for clinical quality indicators

View results by location Weigh cost and distance Sometimes a lower cost choice is next to a more expensive one

Compare hospitals and doctors Compare Feature: Click on the “plus symbol” to batch results

View selected hospitals side-by-side Compare Feature: Estimated fees Procedures performed Safety score Consumer ratings Distance Save information to PDF

View results by Doctor/Specialist Results Include: Doctor profile Fee breakdown Hospital affiliations Consumer ratings Map functionality

Compare Doctor/Specialists side-by-side Compare Feature: Estimated fees Hospital affiliations Consumer ratings Procedures performed Distance Quality indicators Save information to PDF

Prescription Drugs

Pharmacy cost transparency Comparison-shop for medications through partnership with OneRX Compares costs for thousands of drugs nationwide, specific to employees’ insurance plan and location Results include co-payment amounts, pre-authorization required, cash price with coupons at different pharmacies and over-the-counter options Helps employees understand cost and insurance implications before filling a prescription Empowers them to discuss medication options with their doctor before they are prescribed

Dental Services

Dental cost transparency Compare costs for dental procedures through partnership with FairHealth Uses FairHealth’s national database of healthcare claims Estimates reflect professional fees (not negotiated rates available through insurance plans) View estimated out-of-pocket costs Employees can control variables to obtain more personalized estimates based on their dental plan

Communications & Engagement

Turnkey member communications package Electronic, print and video Introduce, raise awareness and reinforce utilization Integrate discussion of cost and quality into employee decisions Incentive tracking and rewards program Reference-based pricing customized to users’ benefits

Management Reporting

Detailed reporting package Utilization Report Medical Savings & Incentives Report Member Incentives Report

Key Benefits

Key benefits Reduces healthcare costs and the cost of providing benefits Empowers employees to become more engaged in their healthcare Provides key data pre-service, to drive more informed choices Helps employees understand and plan for their out-of-pocket costs Helps ensure success of consumer-driven health plans Convenient, multi-platform access; available 24/7 Seamless integration with all other Health Advocate solutions

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