3. SHHADE’S AWARD WINNING TEAM

4. ADVISORY BOARD  Insurance - Dr. Sumfest  Market Vice President/ Medical Officer Humana  Health Sector Policy and Management – Dr. Ullman  Director of Health Sector Policy and Management  Emergency Room - Dr. Ta  Previously Director of the ER, Currently assistant CMO to Jackson Hospital  Health Information Systems - Dr. Ram Prasad  Professor of Health Information Systems

5. ADVISORY BOARD  Healthcare Law - Dr. Cava  Professor of Healthcare Law at University of Miami  Entrepreneurship and IT – Dr. Plant  Professor of CIS and Entrepreneurship at University of Miami.  Managements, strategy, and administration – Dr. Werther  Corporate strategy - formulation and execution

8. DR. BRENNER, COULD YOU EXPLAIN HOT-SPOTTING AND HOW IT APPLIES TO HEALTHCARE COSTS?

9. HOT-SPOTTING:  Is The Strategic Use of Resources  Unfortunately, we are “Utterly un-strategic in healthcare”

10. DR BRENNER: SO,THESE PATIENTS HAVE TO GO BACK TO THE ER…… HOW OFTEN DOES THIS HAPPEN?

11.  113 times.. in ONE YEAR  324 times … in FIVE YEARs  450 times in ONE YEAR  Leading high utilizer

12. COULD YOU HELP US UNDERSTAND THE SCOPE OF THE PROBLEM?

13. 20% of patients make up 80% of total costs This is true in almost every group  suburbanites  Privately insured  Medicare recipients

14. PATIENTS WITHOUT ACCESS TO CARE OVER UTILIZE THE ER …. I ASSUME THE MAJORITY ARE UNINSURED. COULD YOU TELL US WHAT KIND OF MEDICAL PROBLEMS THEY HAD?

15. Almost All Patients who over- utilize hospital and ER services are actually INSURED

16. I DON’T SEEM TO UNDERSTAND WHY INSURED PATIENTS KEEP GOING TO THE ER?

17.  Wait times for appointments  Transportation barriers  Economic barriers  Cultural barriers

18. Why Do You Think This is?

19.  There is NO EVIDENCE showing that TELEPHONIC CASE MANAGEMENT WORKS ….  YET THIS IS THE DOMINANT MODEL THROUGHOUT THE COUNTRY

20. WE MUST GO OUT AND VISIT PEOPLE INTO THEIR HOMES AND THEIR COMMUNITIES

22. MARKET OVERVIEW  Declining supply of Primary Care Physicians  14 Million Newly Insured Patients in 2014  Rapidly Aging Population $38 Billion $30 Billion

23. 3 KEY FACTORS  Declining supply of Primary Care Physicians  14 Million Newly Insured Patients in 2014  Rapidly Aging Population

24. MARKET OVERVIEW  Pilot Study  Hypertension  Diabetes  Ashtma  Chronic Obstructive Pulmonary Disease  Congestive Heart Failure  Potential Future Markets  Chronic Kidney Disease  Acute Coronary Syndrome  Chronic Pain Management  Pediatric Primary Care  Influenza Swat Teams  Psychiatric  Geriatrics  Hospice Care  Chronic Venous Disease

25. MEET MARY

26. 4 CORE COMPETENCIES SHHADE's Core Competencies Mobile Primary Care Services Remote Patient Monitoring Care Coordination Health Coaching

27. 4 CORE COMPETENCIES SHHADE's Core Competencies Mobile Primary Care Services Remote Patient Monitoring Care Coordination Health Coaching

28. 4 CORE COMPETENCIES SHHADE's Core Competencies Mobile Primary Care Services Remote Patient Monitoring Care Coordination Health Coaching

29. 4 CORE COMPETENCIES SHHADE's Core Competencies Mobile Primary Care Services Remote Patient Monitoring Care Coordination Health Coaching

31. PILOT STUDY: STRATEGIC BUSINESS UNITS MD CNA 25 Pt’s Respiratory:Hypertension: Congestive Heart Failure: Diabetes Mellitus:

32.  Strategic Business Unit (Nationally Scalable Model)  Each CNA will see no more than 25 patients  Each NP will oversee no more than 100 patients  Each MD will oversee no more than 300 patients. MD NP CNA NP CNA NP CNA AsthmaCOPDCHFHTNDM

33. FINANCIAL OVERVIEW MDMD NP CN A NP CN A NP CN A AsthmaCOPDCHFHTNDM Start-up Costs For One Regional Center (SBU): $200,000 Monthly Salaries for one SBU: $95,000 Monthly Revenue at Capacity (300 pts): $555,000 Pharmacy, Office Space/Supplies Insurance, Remote Monitoring Tech, Website

34. FINANCIAL OVERVIEW MDMD NP CN A NP CN A NP CN A AsthmaCOPDCHF HTN DM Start-up Costs For One Regional Center (SBU): $200,000 Monthly Salaries for one SBU: $30,000 Monthly Revenue under Capacity (100 pts): $90,000 Pharmacy, Office Space/Supplies Insurance, Remote Monitoring Tech, Website

35. FINANCIAL OVERVIEW Pilot Program 5 regional SBU 11 regional SBU 18 regional SBU 26 regional SBU

36. GROWTH STRATEGY Regional Organic Growth  Proof of Concept – Pilot Study  Private Insurers  Humana SFL  BC/BS (Behavioral Health)  Gateway to Medicare Via Part D Market Penetration  Partner with National Distributor  Vitas  Vena + wound care centers of America  Introduce Barriers to Entry

38. LOOK AT MARY NOW

39.  “If you build it, they will come”  But often in business, and increasingly in healthcare, we find we must go to those in need, the hotspots

41. CONTACT US: WWW.SHHADEHEALTH.COM PH: 305-330-9818 SHADE.HEALTHSOLUTIONS@GMAIL.COM