Worcester Rd Suite B Falmouth, MA Accountable Sustainable Excellence

Implementation of Spine Center Evidence based clinical pathway and Outcome metrics Operations and Marketing manuals Support, Training and Floor plans Spine Care Partners, LLC healthcare consultants

Spine Care Partners Team Ian Paskowski Tom Neuner Brian Justice John Ventura Collectively over 90 years clinical experience evaluating and treating spine pain Ian Paskowski – medical director spine center of Jordan Hospital Tom Neuner – clinician Michigan Head and Spine Institute and practicing attorney Brian Justice, John Ventura – among first in nation to achieve recognition status with NCQA Back Pain Recognition Program, clinicians with Unity Hospital spine center

Value: Jordan Hospital Experience JMPT 2011 Vol 34 No 2

VALUE: Jordan Hospital Experience PATIENTS 80% conservative 20% advanced care (MRI, PM, surgery) PATIENTS 95% rate care as excellent 80% pain reduction on average PATIENTS 518 new patients in first 6 months (1400 first year) ROI 3 additional triage docs 3 additional PTs 2 additional pain docs ROI surgical fast track within spine center Paskowski I, Ventura J, et al. JMPT 2011

ROI for physician groups: Jordan Spine Center experience Excellent clinical outcomes High patient satisfaction Extremely cost efficient per case 80% of spine pain managed conservatively <15% require MRI <15% require pain management <5% require surgical intervention

Trends $ Increased percentage bad debt/charity Recovery Audit Contractors $ Demand for cost containment – manage conditions Bundled payments $ Demand for patient centered, evidence based care Decreased patient volume American Hospital Association survey April 2010 Becker’s Hospital Review Jan/Feb 2011

Spine Care Market Martin BI. JAMA 2008; 299(6)

The Solution: Spine Care Partners, LLC SCP Spine Center Patient Centered Evidence Based Community Based High Value Care Lean Six Sigma Process Driven Increased Market Share Add Efficiencies to the market: 1.High patient satisfaction 2.Improved patient outcomes 3.Appropriate costs

Implementation of Spine Center Pathways and Metrics Manuals Support & Training Layout ‘Right Patient/Right Provider/Right Time’

Discovery and Implementation Spine Center Throughout our plan we will constantly perform the following DASIT elements: Discovery weighted mostly Day 1-3 and Proposal Analyze although performed throughout Strategize Implement weighted mostly Month 3-12 Track although performed throughout

Discovery phase 1) Payer Mix 2) Player Mix/ Cultural Survey (Power Brokers, Champion, Personalities Inventory) 3) Satisfaction Surveys (Patient, Surgeons, Clinicians, Staff) 4) Service lines 5) Care Pathways 6) Costs/Revenue logistics (per case, per provider or dept.) 7) Efficiency Factors (floor plan, patient flow, staff flow, EHR, impediments) 8) Productivity (room use, scheduling, documentation, EHR, unused) 9) Physical Plant (600 sq. ft additional space or re-tool, adequate proximity to support, patient access, flow-able, Disney-able) 10) Growth possibilities (or hindrance factors) of SC based on above combined with: Inter and Intra-Service Line cross pollination, Trends, unseen Variables

Thank You Accountable Sustainable Excellence John M Ventura (585)