P ALOMAR H EALTH H EALTHCARE F INANCIAL M ANAGEMENT A SSOCIATION N OVEMBER 3, 2015 D ELLA K. S HAW, EVP S TRATEGY P ALOMAR H EALTH

Palomar Health is a California Health Care District Hospitals Palomar Medical Center Palomar Health Downtown Campus Pomerado Hospital Skilled Nursing FacilityVilla Pomerado Ambulatory / Outpatient Centers San Marcos Ambulatory Care Center Pomerado Outpatient Pavilion Palomar Outpatient Behavioral Health Retail Healthexpresscare - Temecula Expresscare - San Elijo Expresscare -Escondido Expresscare - Penasquitas Medical FoundationArch Health Partners

Palomar Health by the Numbers (FY14) Licensed Beds714 Medical Staff900 + Employees4,350 Inpatient Discharges29,849 Outpatient Visits113,919 ED Visits51,692 Surgeries18,593 Traumas1,373 Births4,525

Mission Sustaining Financial Performance Customer Value Quality | Cost | Experience| Brand People Outcomes Operational Excellence Clinical Integration | Efficiency and Effectiveness Hassle Free Experience | Consumerism Organizational Capabilities World-class Workforce | Technology Process Patient First Culture 4

5 The Population Health Roadmap Understand the Cohorts Reach out to all constituencies Establish Data Warehouse & Analytics Keep the Well Well Deploy Behavior Change & Economics Reduce Health Risks Focus on the Chronically Ill Eliminate the Medically Homeless Focus on Catastrophic Understand the Demographics Provide Health Advocacy Reach out to all the constituencies Utilize Information Therapy & Patient Education Eliminate Health Disparities Market Wellness

Adopted: Population health leading lights summit. The Advisory Board Company Population Health Changing Health Scope 6 Social Organizations Community Groups Schools Public Safety Extended Health System Scope Transportation system Government Housing Assistance T RADITIONAL H EALTH S YSTEM S COPE P HYSICIANS H OSPITALS P HARMACY

Population Health Program Application Low Intensity High Intensity Health Coaching Source: Cooper Institute Awareness Education/ Motivation Intervention Behavior Maintenance Monthly Topics & Other Education Programs HRA/ Biometric Screening & Tracker Targeted Group Programs and Self- Tracking Tools Ongoing Wellness Programs P roprie t ary & C onfid e n t ial A ll Rig h t s R es e rv e d ENGAGEEDUCATE MOTIVATE ACTIVATE 7

Population Health Information Challenge From Caring Provider Patient Visit Diagnosis Coding Link Content to Code Sent to Patient Getting the right content to the right patient at the right time in the right channel from the right provider 8

Population Health Analytics Progression 9 Descriptive Analytics Value Difficulty Prescriptive Analytics Predictive Analytics Diagnostic Analytics Information Optimization What happened? Why did it happen? What will happen? How can we make it happen? Hindsight Insight Foresight Gartner

Palomar Health 2013 Strategic Initiative | Road to Population Health Population Health Steering Committee (Physician / Multi-disciplinary membership) System wide gap analysis performed to establish baseline and roadmap Post-acute multi-disciplinary team create process flows for all handoffs Think Big, Start Small, Act Fast - 10,000 Lives pilot Progress - Process

Palomar Health 2013 Strategic Initiative | Road to Population Health Information Systems – Internal Data Warehouse – San Diego Health Exchange – Cerner Interoperability Platform Progress – Information Systems

Community Education Programs Community-based Care Transitions Program (CCTP) Centers of Excellence – Total Joints, Spine, Neuroscience, Bariatric Surgery, Obstetrics, Minimally Invasive Gynecology, Cardiovascular, Cardiology Community Action Councils 12 Palomar Health 2013 Strategic Initiative | Road to Population Health Leveraging Existing Best Practice

Cerner Interoperability Platform launch Clinical Integrated Network development Improve access for medically homeless Behavioral Health access needs Expand Community Action Councils’ role in influencing community health and lifestyle Application to our workforce 13 Palomar Health 2013 Strategic Initiative | Road to Population Health 2016

14 The Population Health Roadmap Understand the Cohorts Reach out to all constituencies Establish Data Warehouse & Analytics Keep the Well Well Deploy Behavior Change & Economics Reduce Health Risks Focus on the Chronically Ill Eliminate the Medically Homeless Focus on Catastrophic Understand the Demographics Provide Health Advocacy Reach out to all the constituencies Utilize Information Therapy & Patient Education Eliminate Health Disparities Market Wellness Drive Safely!!