A Caravan of Travelers- Began with the NRACO Journey Lynn Barr, MPH CEO & Founder, Caravan Health; Founder & Chief Transformation Officer, National Rural Accountable Care Consortium; Former CIO at Truckee Hospital, Critical Access Hospital in Rural CA. While working at a rural hospital as Chief Information Officer, Lynn organized the National Rural Accountable Care Consortium to overcome barriers for rural health providers so they could participate in innovative payment models under healthcare reform. There was a group of rural leaders concerned about the ability of rural providers to preform under new Accountable Care Payment Models. In 2014 Caravan Health was formed to provide turn-key services to providers interested in population health programs in Practice Transformation Networks, Medicare and Commercial Accountable Care Organizations, MACRA, Comprehensive Primary Care, and other payment models. As Chief Executive Officer of Caravan Health, Ms. Barr has lead the development and execution of nationwide programs that bring better care to patients and help health care providers achieve financial success. www.CaravanHealth.com | Proprietary & Confidential, Not for Distribution

A Rural Model for Accountable Care Caravan Health supports more than 13,000 primary care providers and 250 community hospitals making the transformation to value-based payments, with affordable, simple solutions that achieve outstanding results. Ms. Barr is a popular speaker and a frequent collaborator with government and national organizations looking to improve our healthcare systems. A Rural Model for Accountable Care www.CaravanHealth.com | Proprietary & Confidential, Not for Distribution

Our Story-An ACO Model for Rural Healthcare Organizations MSSP Track 1 (MIPS) ACOs owned by providers Virtual groupings typically without shared patients Local control & accountability Group reporting Economies of scale Shared learning Care coordination that is LOCAL – Population Health Nurses Practice Coaching Regional Workshops PDSA Virtual Groupings are based in evidence- DHHS Peer counties. Important to meet CMS attribution requirements www.CaravanHealth.com | Proprietary & Confidential, Not for Distribution

Meet Tim Putnam - Critical Access CEO Tim Putnam, DHA, FACHE CEO of Margaret Mary Health, Batesville, IN 2014 NRACC Founding Member CAH SHO2 ACO Participants: Margaret Mary Community Hospital, Henry County Memorial Hospital, Internal Medicine of SE Indiana, Suzanne Martini, MD www.CaravanHealth.com | Proprietary & Confidential, Not for Distribution

Case Study- Margaret Mary Health Why form an ACO? Benefits to Margaret Mary Health Impact on patients Accountable Care as a Business and Quality Improvement Strategy. BENEFITS-Opportunity to provide more patient centered care- Waivers. Estimated 2016 Shared Savings= (SHO)ACO 2- $2,273,492,Estimated Margaret Mary Savings=

Top 10 by ATI Score (Ability To Impact) Column1 Birth Date Provider 12 Mo Costs ATI Score ER Visit Count Chronic Conditions Prob. High Total Cost Predictive Risk Score Patient 16 2/22/1932 RHC $18,971 9.65 7 16 0.08 1.664 Patient 9 10/12/1936 Provider 5 $16,011 9.61 8 15 0.21 2.716 Patient 22 6/23/1935 $11,587 12 0.1 1.845 Patient 23 4/23/1964 $7,513 9.58 10 0.04 1.054 Patient 26 1/18/1937 Provider 3 $84,350 9.56 6 17 0.69 6.796 Patient 28 12/30/1957 $37,523 9.53 14 0.28 3.156 Patient 10 4/5/1934 $19,744 11 0.11 1.975 Patient 12 8/11/1958 Provider 1 $7,111 9.46 1.648 Patient 5 12/26/1960 Provider 6 $21,167 9.45 9 1.914 Patient 32 12/6/1937 $13,790 9.43 0.13 2.106 ATI is a Lightbeam specific score. It stands for Ability To Impact and is a modified version of a regular risk score. It takes into account the patients current diagnoses, their utilization habits, but also sociodemographic factors such as if they are single/widowed, etc. As far as I’m concerned, this is the crown gem of Lightbeam and I’ve found it to be the most accurate and easy to use tool of it’s kind.

Meet Lee McCall – Rural PPS Hospital CEO Lee McCall, MPH, MBA, FACHE CEO of Neshoba Hospital and Nursing Home, Philadelphia, MS Rural PPS Hospital Magnolia Evergreen ACO 7 Rural Hospitals - 4 in Washington State, 3 in Missisippi www.CaravanHealth.com | Proprietary & Confidential, Not for Distribution

Case Study - Neshoba Health Why join an ACO? Benefits to Health System Impact on patients www.CaravanHealth.com | Proprietary & Confidential, Not for Distribution

Case Study Neshoba Health- Magnolia-Evergreen ACO 7 Rural Critical Access and PPS Hospitals 4 in Washington State 3 in Mississippi One large independent primary care practice in Mississippi. All independent and unaffiliated. www.CaravanHealth.com | Proprietary & Confidential, Not for Distribution

2016 Impact on Financial Performance - Mag/Evergreen Seven Rural Hospitals Local hospital revenue went up 7% while saving 8.4% per beneficiary. Net patient revenue went up $30 million while saving Medicare $11 million. Inpatient revenue increased $13 million while saving Medicare $7 million.

Questions? Lynn Barr Lbarr@caravanhealth.com Lee McCall Lmccall@neshoba-hospital.com Tim Putnam tim.putnam@mmhealth.org www.CaravanHealth.com | Proprietary & Confidential, Not for Distribution

www.CaravanHealth.com info@CaravanHealth.com 916.542.4582 Thank You www.CaravanHealth.com info@CaravanHealth.com 916.542.4582 www.CaravanHealth.com | Proprietary & Confidential, Not for Distribution