1. ACL Laboratories A Current and Future View
Barbara Bigler, President
July 26, 2011

2. Overview My first six months ACL overview and “fun facts”
Accomplishments first half of 2011
Where is this taking us?
Questions / Comments / Rumors 2

3. A bit about me . . .
The Biglers 3

4. Now, on to an ACL Overview4

5. ACL Laboratories Core Service Area5

6. ACL Governance 6

7. ACL Laboratories Organization Structure
ACL Laboratories (“ACL”) is a joint management agreement for laboratory services between Aurora and Advocate Health Care systems
Agreement signed in May 2000
Governed by Lab Oversight Committee
ACL directly manages: 2 Central labs; 22 Hospital Rapid Response labs; 50+ Clinic based labs; 30 Patient Service Centers (draw locations)
Does not include laboratory sites we service without staff on-site; i.e. Advocate BroMenn, Advocate Eureka, Aurora Psych, etc.
No separate legal structure, tax ID or separate employees
Staff employed by Aurora (1,397 FTE’s) and Advocate (1,125 FTE’s) 7

8. A2CL Services, LLC Organization Structure
A2CL Services, LLC is the Commercial Laboratory (Outreach) jointly owned by Advocate and Aurora
Formed in 2007
Equal membership units of Aurora Ventures and Advocate Network Services, Inc. (100 each)
Purchases lab testing services from ACL Laboratories
Independent clients account for 15% of total laboratory volume
Separate tax ID
For Profit Status
Required to process Medicare/Medicaid billings for physician practices as performing laboratory (AMG & Lakeshore)
Also markets & sells laboratory testing to non-affiliated entities
Performs non-hospital billings (third party and direct client billings) for Outreach clients 8

9. Advocate Aurora 11 Hospitals 15 Hospitals 2 Children’s Hospitals
~3,361 Beds
5,600+ Physicians
Advocate Medical Group
Dreyer Medical Group
Advocate Physician Partners
30,000 Employees
$4.5 Billion Revenue
Largest Health System in IL
Aurora
15 Hospitals
~3,000 Beds
4,000+ Physicians
Aurora Medical Group
Aurora Advanced Medical Group
Lakeshore Medical Group
30,000 Employees
$4.0 Billion Revenue
Largest Health System in WI 9

10. ACL Laboratories Profile
One of the largest hospital system laboratories in the US
Fifth largest operating expense compared to IL hospitals; second in WI
Provides services to 26 Hospitals; 2 Central Laboratories; 110+ Clinic settings & Patient Service Centers (PSC)
ACL if “pulled out” is a $2B company; generating $700M in new revenue for systems
Saves an annual $54M due to lower RVU
2,500 Associates/Caregivers
82 Pathologists; MDP (IL) GLP (WI)
20M laboratory tests performed annually (50k a day)
4,000+ Clients outside of our systems
Couriers: 80+ vehicles, > 3.6 million miles annually
Client Services handles ~1000 in-bound calls day 10

11. Product Lines Hospital Services Ambulatory Services Nursing Homes
Anatomic Pathology
Forensic Toxicology
Heavy Metal Testing
Molecular Diagnostics
Cytogenetics 11

12. Accomplishments in first half . . .
(* just a portion of the great work) 12

18. Where is this direction taking us?18

19. The future is here and how to be a part of it
Pathology and Clinical Laboratory Medicine are pulled to the forefront of integrated patient diagnostic information (order, interpret, diagnose, recommend treatment options)
An organization where:
Physicians want to provide care
Patients want to receive care
Staff feel a sense of purpose, of doing worthwhile work and of making a difference
High reliability organization (Hardwiring Excellence – Quint Studer)
Advocate Experience / Patient Experience

20. Advocate and Aurora Health Care
ACL exists to support Advocate and Aurora
All decisions within ACL, should be driving us to the overall benefit of our 2 systems
They drive our priorities too – even if that means pacing ourselves to them
The patient’s physicians are looking to us for the integration of Pathology and Laboratory information – tell them what it means; help guide treatment plans
The systems are looking to ACL to provide laboratory utilization information related to physician ordering practices - are the providers ordering the right tests in the right place? 20

21. Laboratory culture which displays high reliability performance in standard process and delivery of safe patient care
Lean
Root Cause Analysis (RCA)
Rapid Improvement Events (RIE)
CAP (ISO standards) ???
Standard process
Consistent – reliable – accountable care
Pathologists are central to our organizational success 21

22. What do you see the future being of Health Care?
How can ACL best support you in this enhanced patient care and patient leadership role? 22

23. Question / Comments 23

24. Summary 24

25. ACL Strategic Priorities - Summary
The Patients we serve and those caring for them
Advocate and Aurora Health Care
Pathologists providing patient diagnosis and integrated laboratory information (AP, Clinical, Molecular = Pathology)
Staff is trained in a standardized way with supporting ongoing competency training
ACL is seen as the provider of education and interpretation of laboratory information
Laboratory culture which displays high reliability performance in standard process and delivery of safe patient care

26. Thank You 26