Anil Hanuman, DO SMO, CareMore Value-Based Contracting for Specialty Care Anil Hanuman, DO SMO, CareMore 1

Health Spending & Chronic Disease 15% of the population spends 70% of the dollars (Kaiser Permanente) 70% of all healthcare dollars are spent on chronic diseases (Agency for Healthcare Research and Quality) Five chronic diseases make up the vast majority of this category* - Diabetes - Congestive Heart Failure - Coronary Artery Disease - Asthma Depression * Hypertension contributes to complications 2

CareMore Clinical Model 15% of the members account for 70% of the cost FRAIL POPULATION & CHRONICALLY ILL NON-FRAIL POPULATION Intensive management of frail and chronically ill members (approximately 15% of members) that account for 70% of medical costs. Close monitoring of non-frail members to proactively identify at-risk members and aggressive management of chronic conditions to prolong the onset of frailty. 3

CareMore offers a broad range of SNPs geared toward the frail and elderly DIABETES Chronic SNP BREATHE Pulmonary Chronic SNP HEART Cardiovascular Chronic SNP ESRD Chronic SNP TOUCH Institutional SNP CONNECT Dual Eligible SNP 4

Successful Congestive Heart Failure (CHF) Monitoring CHF Weight Program Wireless scale for weight monitoring at home provided to members with CHF Alerts CareMore Nurse Practitioner to contact member for rapid weight increase Same-day appointment at the CareMore Care Center if needed Program participants who record daily weights 97% RESULTS for program participants 45% fewer hospital days 27% fewer admissions 47% fewer readmissions CareMore 2013 Program Effectiveness Metrics. Based on program participants with diagnosis of CHF who received Ideal Life wireless scale (In Program) and individuals who did not (Not in Program). Company Confidential | For Internal Use Only | Do Not Copy | Do Not Share with Current or Potential Members 5

Proactive Chronic Obstructive Pulmonary Disease (COPD) Management COPD Program COPD Management and Self-Care Education with Nurse Practitioners and Dietitians Medication Management – routine and rescue meds Smoking Cessation Class for all smokers interested in quitting Updated 2/18/14 – Please review. RESULTS for program participants 33% fewer admissions 47% fewer hospital days CareMore 2013 Program Effectiveness Metrics. Based on individuals who receive supplemental oxygen at home who had at least 1 CareMore COPD Program visit (In Program) versus those who did not (Not In Program) Company Confidential | For Internal Use Only | Do Not Copy | Do Not Share with Current or Potential Members

ESRD Program Outcomes RESULTS 37% fewer admissions 64% fewer hospital days CareMore 2012 Program Effectiveness Metrics. Based on members in the ESRD Program in 2012. Medicare average is unadjusted 2010 data from United States Renal Data System (www.usrds.org) accessed July 2013.

Diabetes Program Outcomes RESULTS Amputation rate 65% lower than the national average Sub-Regions Los Angeles & Orange Counties CareMore 2012 Program Effectiveness Metrics. Non-traumatic lower extremity amputation rate per thousand members per year, excluding members with ESRD. Medicare average is for FFS beneficiaries, not age adjusted, from American Journal of Preventive Medicine, 2005. 3

Value-Based Contracting for Specialty Care Primary Care Capitated reimbursement only Bonus - STARS/HEDIS/Generic %/PAHAF submission Profit Share - BDK/ER visits   Specialists Aim for small number/high volume Need to Understand the CareMore Model Hospitals Per diem rate Profit Share Need to understand CareMore Model 9