Market for Primary Care Health Care Industry Committee Market for Primary Care Ready-to-Use Presentation Slides

Expanding the Outpatient Footprint Steady Volume Projections Across Next Decade Projected Hospital Outpatient Department Volume Growth Rates All Payer Volume Growth Projections 2012-2017 Cumulative, 2010-2020 Cardiac Services Vascular Services Orthopedics Neurosurgery Source: Advisory Board research and insights.

Traditional Primary Care at Full Capacity Shortage of PCPs1 Driving Long Waits, Decline in Patient Access Primary Care Physicians Accepting New Patients by Insurance Type Worth the Wait? 20.3 days National average wait time for new patient seeking family practice appointment 45 days Average wait time for new patient seeking family practice appointment in Massachusetts Long-Term Supply Outlook Bleak 52,000 Estimated primary care physician shortage by 2025 Primary Care Physicians Source: Merritt Hawkins & Associates, “2009 Survey of Physician Appointment Wait Times,” available at: www.merritthawkins.com, accessed April 29, 2013; Massachusetts Medical Society, "2012 MMS Patient Access to Care Studies," available at: www.massmed.org, accessed May 1, 2013; Health Care Advisory Board interviews and analysis.

Redesigning Primary Care Services Medical Home Model Transforming Incentives Medical Home Practice Changing Referral Priorities, Partner Expectations NCQA1 PCMH2 recognition requires: Hospital partner must offer: “Whole-person” care Comprehensive care services Coordinated, integrated care across care system Health information system interoperability; care management resources High-quality performance Evidence-based care protocols Team-based care Staff communication protocols, interdisciplinary care team meetings NCQA PCMH Model Widely Adopted Approximate number of clinicians practicing in certified medical homes 5,000+ NCQA-certified medical homes 26,000 National Committee for Quality Assurance. Patient-centered medical home. Source: NCQA, “PCMH Eligibility,” “NCQA and Pfizer Publish Strategies For Becoming A Patient-Centered Medical Home,” both available at: www.ncqa.org; Health Care Advisory Board interviews and analysis.

Non-Traditional Providers Meeting Unmet Demand Walgreens Aims to Become the Premier Health Destination 2013: Launches three ACOs; begins diagnosing and managing chronic disease 2009: Launches flu vaccine campaign Simple Acute Services Vaccinations and Physicals Chronic Disease Monitoring Chronic Disease Diagnosis and Management 2007: Acquires Take Care Health Systems 2012: Offers three new chronic disease tests Case in Brief: Walgreen Co. ” Not Just a Drugstore Largest drug retail chain in the United States, with 372 Take Care Clinics In April 2013, became first retail clinic to offer diagnosis and treatment of chronic diseases “Our vision is to become ‘My Walgreens’ for everyone in America by transforming the traditional drugstore into a health and daily living destination...” Walgreen Co. Overview Source: Japsen B, “How Flu Shorts Became Big Sales Booster for Walgreen, CVS,” Forbes, February 8, 2013, available at: www.forbes.com; “Take Care Clinics at Select Walgreens Expand Service Offerings,” Reuters, May 31, 2012, available at: www.reuters.com; Murphy T, “Drugstore Clinics Expand Care into Chronic Illness,” The Salt Lake Tribune, April 4, 2013, available at: www.sltrib.com, Walgreens, “Company Overview,” available at: www.walgreens.com; Health Care Advisory Board interviews and analysis.

Walmart Eying the Health Care Industry Moving Beyond Basic Retail Clinics Potential Evolution of Health Care Products Basic Retail Clinic Full Primary Care Health Insurance Exchange Scope of Services ” “That’s where we’re going now: full primary care services in five to seven years.” Vice President Health and Wellness Payer Relations 33% Estimated portion of the US population that visits Walmart every week 4,600+ Number of Walmart stores in the United States Median distance between a residence and Walmart 4.2 miles Source: Holmes TJ, “The Diffusion of Wal-Mart and Economics of Density,” May, 2006; Zimmerman A and Hudson K, “Managing Wal-Mart: How U.S.-Store Chief Hopes to Fix Wal-Mart,” The Wall Street Journal, April 17, 2006, available at: www.wsj.com; Aboraya A, “Wal-Mart Plans to Offer Primary Care in 5-7 Years,” Orlando Business Journal, January 11, 2013, available at: www.bizjournals.com/orlando; Aboraya A, “Exclusive: Wal-Mart Exploring Private Health Insurance Exchange for Small Biz,” Orlando Business Journal, January 11, 2013, available at: www.bizjournals.com/orlando; Health Care Advisory Board interviews and analysis.