Presbyterian Healthcare Services: Our Journey

2 Pursuing the Triple Aim Through Integration Medical Group Health Plan Hospitals

5 By the Numbers More than 680,000 unique customers in 2013 Hospitals Health Plan Medical Group 8 hospitals in 7 communities in New Mexico 435,000 members Commercial, Medicare, Medicaid More than 600 providers 73 multi-specialty clinics 1.3 million annual visits

4 $797.4 million $1.593 billion Projected Revenue 2014

TOP FIVE STATES New Hampshire73.8 percent Massachusetts72.9 percent Utah71.7 percent Minnesota71.4 percent Connecticut70.9 percent BOTTOM FIVE STATES Arkansas52.9 percent Mississippi52.1 percent Texas52.0 percent Louisiana49.9 percent New Mexico48.0 percent SOURCE: State-Level Trends in Employer-Sponsored Health Insurance, A State-by-State Analysis. SHADAC. April 2013 Employer-Sponsored Coverage 5

6 New Mexico’s new Medicaid program – estimated 1 in 3 residents will be enrolled Combines Medicaid, long-term care and behavioral health Seeks to bend the cost curve through intensive care coordination Presbyterian Health Plan has almost 182,000 enrollees Centennial Care

Hospital at Home 7 Clinical results equal to or better than inpatient setting 0 falls Readmission rate 0.3% lower Mortality rate 2.57% lower Patient satisfaction score of 97.9% (6.8% higher) 19% cost savings among Medicare Advantage/Medicaid patients with common acute care diagnoses

8 14,000 patients navigated in two years (10% of ED patients) 40% reduction in ED use post-navigation 25% reduction in ED use by health plan’s Medicaid population Repeat navigation rate of only 7% Emergency Department Navigation Program

Medicare HMO Ambulatory Sensitive Admission Rates DRGAdmits/1,000M&R Well Managed 193/194/195 Pneumonia/Pleurisy with and without CC/MCC (61) 190/191/192 COPD with and without CC/MCC (88) 291/292/293 Heart Failure and Shock with and without CC/MCC (128) 641 Nutritional and Misc Metabolic without MCC (52) 690 Kidney and UTI without MCC (49) 9

Lessons Learned Collaboration is key Align financial incentives Clinical leadership Rapid cycle improvement and flexibility Prepare to be uncomfortable Transformation is delivery system-led and health plan data-driven 10