1. // High Tech, High Touch Health Care February 5, 2015 1 © 2015 Qualcomm Life. All rights reserved.

2. // Tectonic Shift in Care Delivery

3. // © 2015 Qualcomm Life. All rights reserved. 3 Home is the fastest growing care setting in the US. Source: AHRQ, Agency for healthcare research and quality

4. // Care is Moving Home © 2015 Qualcomm Life. All rights reserved. 4 13.6M # of patients age 65 years or older discharged annually in the US 1 19.6% % of Medicare beneficiaries rehospitalized within 30 days of discharge 2 $33.6B Loss in productivity attributed to employees caring for ‘aged dependents’ 3 1. CDC, National Hospital Discharge Survey, number and rate of hospital discharge, 2010 2. Jencks SF, Williams MV, Coleman EA. Rehospitalizations among patients in the Medicare fee-for-service program. New Eng J Med 2009;360:1418–28 3. Metlife Mature Market Institute and the National Alliance for Caregiving

5. // © 2015 Qualcomm Life. All rights reserved. 5 CMS bundled payment models Managing larger at-risk populations Desire to move patients to lower cost care settings – sooner The Tectonic Shift Hospitals will be responsible for readmissions Value-based reimbursement for health systems

6. // © 2015 Qualcomm Life. All rights reserved. 6 The Tectonic Shift ➡ Chronic Care Management (CCM) ➡ Transitional Care Management (TCM) New emerging care models Continuous, informed care in the home

7. // Chronic Care Management (CCM) in the Spotlight © 2015 Qualcomm Life. All rights reserved. 7 Effective January 1, 2015 Medicare will begin reimbursing eligible providers for remote chronic care management under CPT Code 99490 Average payment of $40.39 per patient, per month Total Medicare potential CCM reimbursement in 2015 $16B

8. // Chronic Care Management Requirements © 2015 Qualcomm Life. All rights reserved. 8 Two or more chronic conditions Provider must establish comprehensive care plan Provide at least 20 minutes of non-face- to-face care Provider must have five specific capabilities to perform CCM: Use a certified EHR Maintain an electronic care plan Ensure access to care Facilitate care transitions Remote coordination of care

9. // Enabling Technologies Powering Chronic Care Management

10. // Seamless Connectivity Platforms (RPM) © 2015 Qualcomm Life. All rights reserved. 10 1 C. Bock, L. Carnahan, S. Fenves, M. Gruninger, V. Kashyap, B. Lide, J. Nell, R. Raman and R. Sriram, “Healthcare Strategic Focus Area: Clinical Informatics,” National Institute of Standards and Technology, Technology Administration, Department of Commerce, United States of America, pp.1-33, September, 2005. 2 Population Health Management, Volume 0, Number 0, 2014a, DOI: 10.1089/pop.2013.0107 5 InteroperabilitySecurityScalability Benefits / Outcomes Interoperability among healthcare ICT systems would deliver a national annual savings of $77.8 billion 1 Remote monitoring reduces readmission by 44% 2 Secure exchange of vital information across health care settings

11. // Exception-Based Management © 2015 Qualcomm Life. All rights reserved. 11 1 Weintraub AJ, Kimmelstiel C, Levine D, et al. A multicenter randomized controlled comparison of telephonic disease management vs automated home monitoring in patients recently hospitalized with heart failure: SPAN-CHF II trial. Program and abstracts from the 9th Annual Scientific Meeting of the Heart Failure Society of America, September 18-21, 200, Boca Raton, Florida. Recent and late breaking clinical trials. Remote monitoring integration and visualization of data Reflex algorithms - near real-time alerts Smart dashboards for efficient care management Benefits / Outcomes Reduce rehospitalizations for HF by as much as 72% 1 Deliver population level interventions Focus resources based on documented needs Manage large at-risk populations effectively

12. // Asynchronous Communication © 2015 Qualcomm Life. All rights reserved. 1 de Jong CC, Ros WJ, Schrijvers G, The Effects on Health Behavior and Health Outcomes of Internet-Based Asynchronous Communication Between Health Providers and Patients With a Chronic Condition: A Systematic Review, J Med Internet Res 2014;16(1):e19 2 Steventon A, Bardsley M, Billings J, et al. Effect of telehealth on use of secondary care and mortality: findings from the Whole System Demonstrator cluster randomised trial. BMJ 2012;344:e3874 doi: 10.1136/bmj.e3874 (Published 21 June 2012) Secure record sharingNear real-time therapy and medication adjustments Dynamic care plan Benefits / Outcomes Decrease in physician visits 1 Increase in self-management/self-efficacy 1 Fewer emergency admissions (20% reduction) 2 Decrease in mortality rates (45% reduction) 2 Improve clinical collaboration 12

13. // Qualcomm Life CCM Solution © 2015 Qualcomm Life. All rights reserved. 13 Dynamic care plan Secure access and sharing Asynchronous communication On-line medication management tools Symptom tracking programs Wireless remote patient monitoring

14. // Opportunity to Set New Standards

15. // High Tech, High Touch Best Practices Brad Tritle President/CEO,vitaphone