Medication Dispensing Program

On-Site Employer Clinics Agenda Healthcare Services Urgent Care On-Site Employer Clinics ACOs Occupational Health Primary Care About ASM ASM program and capabilities What is in-office dispensing? How does it work? Key Benefits Repackaging components Dispensing Technology Additional services available through ASM Provider ROI 2

About ASM Nation’s largest supplier of on-site dispensing services. Founded in 1988, ASM (AllScripts) was the pioneer in medication dispensing and has 26 years in the industry. 85,000 sq. ft. automated, FDA/DEA approved, pre-packaging facility and VAWD accredited wholesaler. ASM utilizes an 88 step documented quality control production process to assure full compliance with all applicable cGMPs on every medication supplied. Our affiliation with Sav-Rx, a leading independently owned Prescription Benefit Manager (PBM) brings you all the capabilities of a full service PBM (mail order, on-site pharmacy and nationwide pharmacy expertise). Specializing in developing custom medication dispensing programs designed to solve your biggest problems. We handle all types of transactions from third party adjudication and workers comp to copay coupons, mail order and cash transactions enabling us to offer complete benefit packages. The only complete end to end dispensing solution! 3

Our Mission To strengthen caregivers by providing point-of-care treatment solutions that improve patient health, lower costs and enhance revenue streams. Accomplishing our mission by: Packaging medications in ready-to-use prescription containers. Offering user-friendly software to ensure compliance and efficiency. Supporting our clients with the tools and resources they need. Providing a dedicated account management team. Supplying the highest quality medications available. Negotiating the nations’ largest portfolio of insurance contracts for the in office dispensing marketplace. Listening and reacting to the needs of our customers, and responding with a sense of urgency.

Dispensing 101

Dispensing 101 What is Medication Dispensing? 90% of all treatment plans call for the use of prescription medications; making the prescribing of medications your client’s #1 most outsourced ancillary activity. By insourcing this activity not only do they maximize revenue streams but they also provide patients with a convenient alternative to the pharmacy. Programs Available: ASM will provides prepackaged medications (relieving the burden and manual counting or labeling), regulatory consultations (laws in your state specific to dispensing) and a software platform that allows you to keep proper records, track inventory and run a series of activity reports. These standard offerings have advanced on-site dispensing into a very turn-key operation. Goal: My goal today is to create a basic understanding of the value ASM can bring to you and your clinics and to create a roadmap for interested centers to implement and manage a world class dispensing program that will create a market advantage for you in the marketplace 6

In-Office Dispensing Model All medications come from our specialty distribution center located in Chicago. Medications come prepackaged, safety sealed and labeled specifically for in-office dispensing; eliminating the need to pour, count, and package each prescription. You can carry any medication currently prescribe to carry on-site at the clinic. Instead of sending the patient to the pharmacy, the on-site dispensary can provide the patient with a full prescription at the time of their office visit. Clinic uses software to dispense the medication and collect payment or file a claim. The dispensing software records the entire transaction and makes all the required documentation needed to exceed state and federal requirements.

Repackaging Components Our patented in-office medication dispensing program was designed by ASM for today’s physician’s office. Our program will increase the quality of service at your facility, while capturing revenue that is currently being referred outside your practice.

Dispensing Process- 5 easy steps that take less than 30 seconds ASM 340B Dispensing Process- 5 easy steps that take less than 30 seconds Create Rx Order in EMR & transmit order to Pedigree Rx. Remove bottle from it’s storage location. Scan the bar-code on the medication bottle, which is verified against real-time inventory. Print medication label and patient education sheet, available in English or Spanish. Apply patient-specific label and dispense! 9

Requirements: Valid medical license DEA registration (only required if dispensing controlled substances) Some states require an additional “dispensing license” usually from the practitioner’s board or the pharmacy board

Provider Revenue Opportunities

Prescription Cost Containment $32 Total Claim Value (co pay, reimbursement, dispensing fee & admin fee) $3 Medication acquisition cost from ASM $29 cost containment savings ASM’s dispensing program allows caregivers to ability to offer pharmaceutical benefits directly to the patient where it was not financially or operationally feasible in the past. The prepackaged solution decreases overhead, eliminates variable cost and provides wholesale direct pricing directly to the patient Can be applied to any self-insured, employer, institution or health plan capitation that factors in pharmaceutical treatment of patient. Savings for a single provider clinic often exceed over $250k per year!

Provider Pay Dispensing $15 Flat Fee charged per Medication $3 Medication acquisition cost from ASM $12 Practice Profit By The Numbers Average Provider scripts per week = 300 Average ASM Dispensing Sales Price = $5.85 U&C Physician Price = $15.00 Average Profit per dispensed Rx = $9.15 Weekly Profit Potential = $2,745 Realistic Profit for provider pay physician (annual) $20k - $30k

Pharmaceutical Claims Dispensing $17 Covered Amount (co pay & billable amount) $3 Medication acquisition cost from ASM $14 Practice Profit Workers’ Compensation prescriptions typically are co-pay free to the patient and a claim is submitted directly to the payer via Claim One or the caregiver Opportunity exists to contract with commercial payers such as BCBS to electronic submit prescription claims to through the clearinghouse. (Requires expensive contracting and training for the client) Not all commercial payers currently contract with dispensing physicians (Cigna)

Why Dispense with ASM? Pricing: ASM is the nations largest dispensing company and offers the industry’s most competitive pricing. Strengthen & Innovate: ASM is responsible for supporting the nation’s most successful dispensing programs and will work with clients to deliver a solution that is simple, efficient, effective, profitable, transparent and manageable. Industry Knowledge: ASM is confident in our ability to add value to your plan. We will provide you with the tools necessary to put you in charge of your program. All medication pricing, compliance tools, dispensing reports, invoices, pedigrees, etc… are available in real-time. Technology: ASM comes pre-interfaced with many popular EMR’s to optimize clinic workflow! We also offer inventory management, improved record keeping, real-time reporting and much more. Expertise: Our clinical pharmacists, account managers and customer service teams have the industry knowledge and skills necessary to provide you with all levels of support and program optimization. History of Innovation: ASM is the current and future market leader, and has grown by listening to our customers’ needs and implementing solutions. Clients can feel secure that ASM will rise to any future challenges, react to your enhancement needs and respond to any new regulations or requirements that are brought forward.

Key Contacts: AS Medications Sales / Customer Meetings: Brian Czochara, bczochara.asm@gmail.com, 312-505-1357