1. Digital Savings Solution
REMOVE BEFORE PRESENTING
New to HCBB version
Digital Savings Solution

2. Healthcare Costs Continue to Rise
U.S. Healthcare Expenditure1
Spend in Billions
NOTE: 2015 stats are most recent available
1 Centers for Medicare & Medicaid Services, 2015

3. Employees Feel the Impact of Cost Shifting
Cumulative Increases in Health Insurance Premiums, Workers’ Contributions to Premiums, Inflation, and Workers’ Earnings*
Increase in how much employee pays for healthcare
Increase in employee pay
40% of Americans have medical debt and 1 in 5 have credit impairments – most are fully insured
1 Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2015

4. Digital Tools Can Help 95% of Americans own a mobile phone.1
46% of consumers have used 3+ categories of digital health tools (telemedicine, wearables, mobile apps)—up from 19% in
Almost 70% of consumers appreciate getting texts or s from healthcare providers.3
We know people are more connected than ever through smart phones, tablets and wearables. We need to engage people where the live, work, and play.
1 Pew Internet, 2017
2 Rock Health National Consumer Survey, 2016
3 Kentico Global Survey, 2015

5. What is CoreSource’s Digital Savings Solution?
Innovative marriage of consumer-centered healthcare tools designed to save employers and members money by creating informed, confident healthcare consumers who take an active role in seeking cost-effective care.
Backed by an ROI guarantee; CoreSource guarantees clients will save more than they pay, or we’ll credit the difference.*
* Certain qualifications apply to ROI guarantee
Details for ROI are on slide 24.

6. Tools with a Consumer Engagement Foundation
Points to call out on this slide:
Consumers need solutions that are affordable, accessible, and convenient.
Consumers need to know what care options are available to them.
Member engagement is the foundation for the bundle, it’s the “secret sauce.”
We need to engage the members through targeted and personalized messages via digital channels.
We want to help members become smart, confident, and informed healthcare consumers.

7. Combining Consumer Cost-saving Tools
Telemedicine
Cost & quality
Same on-demand digital medical doctor visits your members already use
New telebehavorial health for ongoing visits with behavioral professionals
Continued reduction of costly ER and urgent care utilization
Quick and easy digital solution serves members whenever, wherever
Transparent and easy-to-use ranking of cost and quality scores
Allows consumers to shop for care
Member awards for using cost-effective providers*
Creates savvy healthcare shoppers
Points to call out on this slide:
Previous slide starts with tools with a consumer engagement foundation, and this slide goes deeper into the consumer-centric tools.
The client should be familiar with telemedicine general med consults via Teladoc so call out TeleBH because it is a new feature. More details are on slides 11 – 13.
Walk through the cost and quality features b/c this is new to the client. HCBB starts on slide 15.
*Awards must be offered and cost is not included in PEPM

8. Support to Guarantee Success
In addition to these telemedicine and cost and quality transparency tools, our Digital Savings Solution includes active member outreach to engage and support members:
Personalized SMS messages through myCoreSourceWire
Regular targeted outreach
Print materials
12-month communication plan & customized toolkit
Points to call out on this slide:
This is the “secret sauce” the “glue.”
Active member outreach via multiple channels (text, , print)
Tailored and targeted messaging that is designed to drive member engagement
More details of what’s on the communication plan is on slide 22.

9. myCoreSourceWire
Through myCoreSourceWire we can send members messages about:
Targeted reinforcing congratulations for visiting cost-effective providers
Targeted reminders about shopping for cost-effective providers
Targeted reinforcing congratulations for utilizing telemedicine
Reminders about available telemedicine and cost & quality transparency tools
Points on this slide:
These SMS messages tailored to DSS.
These messages are additive. Members will still receive the general wire messages too.
Testimonials about available tools
Seasonal healthcare tips

10. Telemedicine and Telebehaviorial Health Powered by
The following slides go into detail on Tele-behavioral health. We’ll have a general slide on fees for both services at the end of this section.

11. 56% 400M $190B Behaviorial Health
American adults with a mental illness did not receive treatment in the last year1
400M
Disability days per year resulting from depression2
$190B
Healthcare cost per year as a result of workplace stress3
Telebehavioral Health is new service available
1 Mental Health America, 2017
2 Journal of Clinical Psychiatry, 2015
3 HBSWK.HBS.Edu – National health cost could decrease if mangers reduce stress, 2015

12. Treat Now to Save Costs Later
Mental disorders increase the cost of treating chronic diseases:
Depression leads to lost productivity and more short-term disability leave:
9.9 days
avg. annual sick days due to depression
4.6 hrs/wk
presenteeism loss
COPD (w/ depression)
COPD (no depression)
Diabetes (w/ depression)
Diabetes (no depression)
Healthcare costs per member per month
Stats from Milliman 2008, Chronic Conditions and Comorbid Psychological Disorders; Milliman 2011 Revisiting Chronic Conditions and Comorbid Psychological Disorders

13. Behavioral Care from the Safety of Home
Nurse outreach
Follow-up
Member speaks with provider, who may prescribe Rx if needed
Member1 requests initial visit for support with:
Eating disorders Anxiety Family difficulties Grief Depression More
Member chooses a licensed provider:
Psychiatrist Therapist Psychologist Counselor Social worker
Member schedules phone/video session2
During normal office hours of the provider
Walk through demonstration of the member experience
1 Not available for minors.
2 Behavioral health visits can only be scheduled online or through the app and cannot be scheduled through the call center.

14. Telemedicine Fees1 General Medicine Telebehavioral Health2
Consultation visits $45 fee
Telebehavioral Health2
$80 fee for consultation with non-psychiatrist
$160 fee for initial medication evaluation with psychiatrist, subsequent visits $90 fee
1 Telemedicine fees are subject to the terms of the plan, including any applicable deductible and coinsurance provisions. All fees apply to 2017 and are subject to change.
2 Telebehavioral health services are not available to minors.

15. Cost and Quality Transparency Powered by

16. Shop Around to Save Money
Consumers don’t shop around for healthcare.
3x to 10x variance in price and quality
within networks for the same service, and employees and their families are in the dark.1
1 Based on studies conducted by Healthcare Bluebook on their book of business

17. Shop for the Biggest Impact
Outpatient, elective or schedulable, non-emergent procedures have the biggest cost variance:
colonoscopies sleep studies MRIs CTs
These tests and procedures represent about 1/3 of most employers’ medical spend.1
Awards reward members for using a cost-effective provider for select procedures.
Check mailed directly to member
No forms to submit
Points to call out regarding rewards:
Why Rewards:
They incentivize good behavior.
Even with the cost of the rewards, the employer will still achieve savings for going to a green provider.
Rewards increments are $25, $50 or $100.
The average dollar awarded is $50.
There are 16 rewardable procedural categories: A list can be provided upon request.
Employees will receive a check issued by HCBB when they receive care from a green, high value provider.
Rewards eligible procedures are identified directly below the price variance bar, as displayed in the screenshot above.
Rewards are processed on a bi-monthly cycle.
There is no administration fee for rewards. The employer will be invoiced for the rewards. HCBB will fund the rewards up front, and CS will invoice the employer.
Q: What if a member just happens to go to a green provider without using the tool? They shouldn’t get a reward!
A: We want to reward good behavior regardless. The reward serves as an opportunity to reinforce the value of shopping for cost-effective providers. By praising a good choice, even if it wasn’t a conscious choice, maybe the next time the green provider visit won’t be by chance but on purpose. Either way, the employer saves!
1 Based on studies conducted by Healthcare Bluebook on their book of business

18. Price Variability Colonoscopy (No Biopsy)1
Each horizontal line along the Y axis represents an in network claim in a given network for a colonoscopy (without biopsy)
Prices along X axis represent the allowed amount (billed charges – network discounts) or the maximum reimbursement allowed by a member’s health plan; true cost to the employees
Claims are also represented by two major components: physician fee (light blue) and facility fee (dark blue); when applicable, Anesthesia fee will also be illustrated.

19. It’s not the physician cost…
Remove the facility component to illustrate the reason HCBB does not focus on doctor shopping
Very little variance in the physician component of a claim across any given market
Summary to members: Use the physician you know and trust, but be intentional/specific about where you go to receive care. Physicians often have admitting privileges at more than one facility.

20. … it’s the facility cost
Add back in the facility component of the claim. You can see that the major cost driver.
Note: some patients only paid $800 while others paid $3,700 for the same procedure in the same market. This shows the large variance in price within networks.
HCBB Fair Price – The price a patient should reasonable expect to pay for a specific procedure
The HCBB Analytics team studies the natural breaks in the cost curve of the claims data and determines a Fair Price. Typically falls somewhere between the 33rd – 55th percentile.
HCBB Fair Price is never the lowest price and never an average or mathematical algorithm

21. Custom Member Communication Plans & Toolkits

22. Tailored Communication Plan & Toolkit
Month-by-month overview of member communication pieces
Toolkit with materials members will receive
CoreSource manages member s and myCoreSourceWire messages
What to call out on this slide:
CoreSource will do the work, but we also need your support to!
We have designed a member engagement plan to drive the right behavior.
Our goal is to ensure members are aware of tools and services that are available to them.
We want to help them to be smart, informed healthcare consumers which translates to savings for them as well as you (employer).
The calendar is subject to change and cannot be customized.
As we understand how your population is performing, we may tweak the messaging.
As we learn more on how the member wants to be communicated, we may tweak the digital channel.
Because we’ve designed the messages to optimize awareness and utilization, the order, quantity, and content of messages can’t be changed.
Types of messages are:
Getting them connected to the Wire
Triggered HCBB green reward messages
Triggered telemedicine utilization messages
Tool awareness messages
Cohort personalized messages to encourage individuals to complete important tasks like the HCBB scavenger hunt, registering a profile on Teladoc, and opting into the Wire.

23. Package Details

24. ROI Guarantee with Customized Support
Our Guarantee
CoreSource guarantees clients will save more than they pay, or we’ll credit the difference.
ROI Qualifications
Provide member addresses
Ensure 50%+ of members agree to electronic communications and/or myCoreSourceWire messages
Ensure 50%+ are opted into electronic EOBs
Support the supplied, tailored member communication plan
Utilization x Savings – Cost = ROI
(Any ROI credit will be given on next plan year invoice)
Points to call out on this slide:
ROI guarantee is on cost and transparency tool and telemedicine general med visit utilization.
ROI is based on the performance of the entire package
On avg. the savings for using telemedicine service is ~$472 and HCBB is ~$1500 (using a green provider)
We’ll look at total utilization and total fees paid (including rewards) to come up with the ROI. For example:
500 EE employer, based on breakeven threshold
If 1.6% or 8 people went to a Green Provider, and if 5% or 25 people used telemedicine, the calculation would be:
(8 x $1500) + (25 x $472) – (500 x $3.80)12
$12,000 + $11, $22,800
$23,800 - $22,800
$1000
Even if on avg. the 8 ppl received $50 – that would be $400
The employer would achieve a net $600 savings (breakeven) or 1 : 2.6
(Gains – Costs)
ROI = X 100
Costs
We’ve set our benchmark based on actual BOB, which is much higher than the break-even thresholds.
Also note that we look at the performance of the entire package. Therefore, ROI can be achieved by one service outperforming the other service.
Credits will be given for the following plan year.

25. Client Dashboard Monthly reports Year-in-review ROI scorecard
Telemedicine utilization (general med & behavioral consults)
Green provider utilization
Year-to-date savings
Member engagement against industry benchmarks Open rates Click-throughs Percent opted into digital channels and eEOBs
Performance against CoreSource book of business and industry benchmarks
Year-in-review ROI scorecard
Year-in-review scorecard will be ready by month 13 or 14, not at 12-month mark. This allows for claims runout for HCBB.
Green provider utilization is based on who received rewards

26. Digital Savings Solution Price
REMOVE BEFORE PRESENTING: PACKAGE A
adjust price and remove red and brackets. Price listed is lower limit.
Digital Savings Solution Price
[$3.80] PEPM
Plus the cost of awards1
Telemedicine consultation fees included.2
Members pay $0 for telemedicine visit.
SALES OR CMS: Select Package A or B depending on group, delete other package’s slide, adjust price, and remove red and brackets. Prices listed on slides are lower limits.
Package A members’ copay for telemedicine can’t be changed (it’s always $0)
1 Awards for going to a green provider average between $25–$ Telemedicine gen medicine fees are included in the PEPM. Behavioral health fees are not included in the PEPM, and the fee amount will appear on check register.

27. Digital Savings Solution Price
REMOVE BEFORE PRESENTING: PACKAGE B FOR CDHP/HDHP POPULATION
adjust price and remove red and brackets. Price listed is lower limit.
Digital Savings Solution Price
[$3.10] PEPM
Plus the cost of awards1
Telemedicine consultation
fees not included.2
Members pay for
telemedicine visit.3
SALES OR CMS: Select Package A or B depending on group, delete other package’s slide, adjust price, and remove red and brackets. Prices listed on slides are lower limits.
Package B is designed for clients with CDHP or HDHP population
1 Awards for going to a green provider average between $25–$100.
2 Telemedicine fees for gen med and behavioral health consults visit are not included in the PEPM, and the fee amount will appear on check register. 3 Telemedicine fees are subject to the terms of the plan, including any applicable deductible and coinsurance provisions..