2015 Washington State of Reform Health Policy Conference Hilton Seattle Airport Conference Center January 8, 2015

Physicians of Southwest Washington, LLC Independent Physician Association established physician Unit Holders, both primary care and consultants Network of 400+ physicians, hospitals and other providers in Thurston and Lewis Counties Model: Global Capitation Risk Agreements, Medicare and Commercial HMOs including delegated credentialing, medical management and claims processing Current Agreements: MA only – Humana and Soundpath Health ~ 6000 risk lives Separate Non-Profit Foundation: Healthy Communities

PSW Mission Statement The mission of Physicians of Southwest Washington is to support the physician-patient relationship in the independent practice of medicine through: Fair contracting; Responsible resource utilization; and Prudently adopted innovations in health care delivery. PSW is committed to quality improvement, clinical integration and meaningful measures of value

PSW Financial Strategies Engaged, Informed, Motivated Physician Leadership Risk Adjusted, Capitated, Primary Care Reimbursement Clinical Integration Improved Clinical Care Transitions Provider Office Support for Accurate Documentation and Associated Risk Adjusted Coding Expanded and diversified ‘value’ and ‘risk based’ contracting Informed and Empowered Patients

2015+ Health System Challenges Reimbursement: - Uncertainty about pace of reimbursement transitions from volume to value - Near term reductions in FFS Delivery System Consolidations and Definitions Limitations in clinical data sharing among EMR’s Pending Provider Shortages Varying Definitions of ‘Waste’

2015 Strategies Expanded payor contracts Expanded role of Chief Medical Officer Implementation of clinical integration software platform to enhance population management capacity Expanded nurse case management program Support services for implementation of new ‘clinic without walls’ Investment in medical and administrative leadership development and succession planning Liquidation of equity interest in MA health plan

Recommendations Business Concepts to Consider: -New Employee Motto #1: Flexible or Former -New Employee Motto #1: Failure Isn’t An Option -Bigger may not be better – ability to move quickly may be more important -Financial “Risk” is an OK four letter word Focus on Quality Not Cost Seek Long Term Partnerships Across Blended Spectrum of Health Industry Data Transparency - Demand it from All Partners - Lets share what worked and what failed

For Further Information Mariella Cummings, CEO (360)