1. AHIC Testimony Medical Banking Project May 2, 2007 American Health Information Community Department of Health & Human Services Testimony by John Casillas Founder and Executive Director The Medical Banking Project 320 Main Street, Suite 230 Franklin, TN 37064 615-794-2009 www.mbproject.org

2. AHIC Testimony Medical Banking Project May 2, 2007 What’s Medical Banking? “Medical Banking”™ –Using banking systems to improve healthcare “IOS” –As adjacent industry use EDI, IOS formations evolve B2B and B2C –MBProject steers this industry phenomenon to support better healthcare Mission: To convert digital savings into charitable resources “MBIOS”: medical banking IOS –Initial focus on improving payment / remittance systems –Evolving into real time processing in between healthcare actors Results are very encouraging –Increasing investment by banks in healthcare IT –Tighter linkage between banking and healthcare systems

3. AHIC Testimony Medical Banking Project May 2, 2007 Banks hospitals physicians health plans CONSUMERS nursing homes retail healthcare third party administrators community healthcare centers 55 million online banking customers One element for consumer empowerment

4. AHIC Testimony Medical Banking Project May 2, 2007 Public Trust 4 Phases of the Medical Banking Build Out –Phase 1: Policy Adoption and Application 12 HIPAA Policy Roundtable 2 Telebriefings with CMS 5 National Medical Banking Institutes –Phase 2: From Compliance to Interoperability Great American Interoperability Tour –Targeted 10 stakeholders over 14 months –Focus on the value proposition of medical banking

5. AHIC Testimony Medical Banking Project May 2, 2007 Public Trust 4 Phases of Medical Banking Build Out (cont’d) –Phase 3: Reference Architecture C.O.M.B.A.T. Initiative –Mission: To combat rising healthcare costs using medical banking principles and technology –Target: »Real time administrative processing in healthcare »On demand healthcare records –Phase 4: Common Medical Banking Platform BoardTrust™ and associated “Board of Governors” –Public Trust Advisory Board w/ Accreditation Review Council and Consumer Protection Council –Joint Taskgroup for Value In Health

6. AHIC Testimony Medical Banking Project May 2, 2007 Industry Involvement Members –Large banks PNC, Wachovia, US Bank, Mellon, Fifth Third, ABN AMRO –Health Plans / Providers –IT and consulting firms Sun, Fiserv, McKesson, PwC, BearingPoint, Foresight, DMP –Large employers Walt Disney Company, Sanofi-Aventis Advisory Board –Consumers Family Voices, CHCC, National Health Council, Center for Charitable Statistics/Urban Institute –Others HIMSS, NCHA, AHA, EHNAC, AIAG

7. AHIC Testimony Medical Banking Project May 2, 2007 The “Bank-Powered” Healthcare Consumer

8. AHIC Testimony Medical Banking Project May 2, 2007 Bank Infomediary ► As we understand it today focuses on 4 areas:  Administrative efficiency “eHealth Lockbox” for specialized payment/remittance process Card platforms improve Point of Service cash management Credit programs that expand liquidity  A new mechanism for clinical data exchanges and repositories: E/PHR Use Case Joint Taskgroup for Value In Health  The bank as health information broker for consumers: Delivery system: online banking portal (branches, ATMs possible)  The bank-driven Community Care Platform

9. AHIC Testimony Medical Banking Project May 2, 2007 Recommendations Engage A Cross-Industry Policy Dialogue –Public Trust above all else –Routine online meetings to discuss this important issue Appoint Liaison to E / PHR Use Case Participate in our Annual Institute –Help banks to understand the complex policy issues –Gain cross-industry views

10. AHIC Testimony Medical Banking Project May 2, 2007 Contact Information: John Casillas Executive Director The Medical Banking Project 320 Main Street, Suite 230 Franklin, TN 37064 V: 615.794.2009 F: 615.794.1481 johnc@mbproject.org More Info: www.mbproject.orgwww.mbproject.org Medical Banking Institute: http://www.mbproject.org/5MBI2007.phphttp://www.mbproject.org/5MBI2007.php Visit MBlog: www.mblog.mbproject.orgwww.mblog.mbproject.org