CMS National Conference on Care Transitions December 3,

Business Case for Investing in Care Transitions Robert W. Pryor, MD, MBA Scott & White Healthcare Chief Operating Officer President and CEO Designee 2 2

Overview Scott & White Healthcare in our community Care transition impact on safety and quality Economic impact of care transitions 3

Scott & White Healthcare is Embedded in our Central Texas Community Integrated delivery system Multispecialty physician group practice Primary and specialty care Hospitals, long-term acute care, skilled nursing Home health, hospital Accountable for the health, quality of life, and cost of high quality care of our community Care transitions allow the right care at the right place and time Occur within and across systems, from systems to home Allow right-sizing of our hospitals 4

Scott & White Healthcare’s Business is the Health of Our Community 5

Medicare Total Non-Capitated Per Beneficiary Reimbursement (2006)

Our Central Texas Community

Care Transitions Impact Safety, Quality Safety −Medication errors, other adverse events from patient and/or system errors −Disease exacerbation, deconditioning, hospital-born illness Quality −Metrics are publicly reported, internally monitored for progress toward our goals −Accountability for patients’ health includes known consumer needs post-discharge 8

Economic Impact on Communities For consumers −Co-payments, additional treatment −Caregiver time/resources −Daily functioning, quality of life For community agencies, organizations −Employers −Long-term care facilities −Home Health agencies −AAAs with care coordination, transitions programs 9

Economic Impact on Healthcare System – Earn community trust, consumer loyalty – Protect operating margin Open beds to high acuity patients Open beds to payers with more favorable payment structures Avoid penalties for excess readmissions (PPACA SEC. 2035) – Optimize efficient use of resources, economies of scale, productive staffing ratios 10

Scott & White Healthcare Approach – Success requires implementation and effectiveness Can be implemented in our system, community Confers value (mission relative to cost) – “Personalized Transitions:” matched to needs, preferences, and consumer goals – Systematically evaluate to fill evidence gaps What consumer characteristics and behaviors predict readmission? What interventions address identified risks? 11

For more information, contact: Robert W. Pryor, MD, MBA Scott & White Healthcare Chief Operating Officer President and CEO Designee 12