1. International Society of Orthopedic Centers Mayo Clinic Overview April 29 – May 1, 2010

2. Background of CEO Michael G. Rock, M.D., FRCS(c) Chief Medical Officer, Mayo Clinic Hospitals Practicing Orthopedic Surgical Oncologist B.Sc.; M.D. – University of Western Ontario, London, Canada Orthopedic Residency – University of Western Ontario, London, Canada Orthopedic Oncology Fellowships Mayo Clinic Rizzoli Institute Member Executive Board, Mayo Clinic Executive Board, Covenant Health Systems Executive Quality Council, Dubai Health Care City Board of Trustees, American Hospital Association

3. U.S. Healthcare System $2.3 Trillion Annual Spend 17% GDP; $7,200 per beneficiary per year 47 Million Uninsured15 Million Uninsured 44 Million Medicare77 Million Medicare 46 Million Medicaid?? Million Medicaid Fee for ServicePay for Value

4. Mayo Clinic Practice Sites Rochester, Minnesota Jacksonville, Florida Scottsdale & Phoenix, Arizona

5. Mayo Health System: A network of clinics and hospitals in 70 communities throughout Iowa, Minnesota and Wisconsin Mayo Health System

6. Mayo Clinic People and Facilities Mayo Clinic People Mayo Clinic in Rochester Physicians & Scientists 3,700 3,700 1,970 1,970 Residents, Fellows, & Students 3,200 3,200 2,780 2,780 Allied Health Staff 49,00027,200 Total55,90031,950 Mayo Facilities Operating rooms 224 224 116 116 Available beds 2,420 2,420 1,280 1,280

7. Mayo Clinic Patient Care Facts Mayo Clinic in Rochester Unique Patients 528,000346,000 Surgical Patients 122,000 55,000 55,000 Hospital Admissions 124,000 57,000 57,000 Patient Days 567,000294,000 Average Length of Stay 4.6 4.6 5.2 5.2

8. Mayo Clinic in Rochester Orthopedic Activities Surgeons 40 Operating Rooms 23 Available beds 120 Surgical patients 11,800 Admissions 5,700 Patient Days 19,400 Average Length of Stay 3.3

9. Financial Performance Metrics Operations Coordinating Group Process (OCG) Financial Metrics Department direct margin Cost per case Volume Metrics Surgical patients/surgeon patient care consultant/work day Core procedures OR utilization and on time starts

10. Teaching and Research Efforts Residents 52 Residents 52 Fellows 13 Fellows 13 Paid Research FTE 3.73 Paid Research FTE 3.73 First or Last Author139 First or Last Author139 Major foci of Research Major foci of Research –Disorders of musculoskeletal growth and development; –Musculoskeletal trauma, including bony, soft tissues, and repetitive injury; –Disorders of the Spine; –Degenerative disorders of the musculoskeletal system, especially Osteoarthritis; –Osteoporosis, especially problems associated with fragility fractures.

11. Strategic Plan Strategic clinical staff growth in targeted areas Strategic clinical staff growth in targeted areas Optimize “value” of services provided: quality (safety, service, outcomes)/cost Optimize “value” of services provided: quality (safety, service, outcomes)/cost Target revenue growth and expense management-become trusted and affordable Target revenue growth and expense management-become trusted and affordable Transform health care delivery process Transform health care delivery process Generate, collate, and manage knowledge delivery Generate, collate, and manage knowledge delivery

12. Future Challenges Maintaining economic viability post- healthcare reform Maintaining economic viability post- healthcare reform Integration of clinical services across the Mayo delivery system-standardization Integration of clinical services across the Mayo delivery system-standardization Providing patients access to our expertise in multiple formats-here,there,everywhere Providing patients access to our expertise in multiple formats-here,there,everywhere Translational research-molecular diagnostics and therapeutics; regenerative medicine Translational research-molecular diagnostics and therapeutics; regenerative medicine