1. Maricopa Integrated Health System: Social Return on Investment, 2013 October 29, 2014

2. Introduction Seidman = consultancy arm of W. P. Carey School of Business, ASU Commissioned by MIHS to implement 3 analyses: – Economic Impact of MIHS in 2013 – Economic Impact of MIHS, 2015 – 2043 – Social ROI analysis Today’s presentation focuses on the Social ROI analysis

3. Partial Net Analysis: Annual Statewide Results Total Private Non-Farm Employment CY2015-43 8,327 8,527 to 11,718 Job Years CY2013 - Ratio of 1 MIHS job:1.13 PNFE jobs CY2015-43 - Ratio of 1 MIHS job:1.4 PNFE jobs Gross State Product Real Disposable Personal Income State Tax Revenue Total Private Non-Farm Employment CY2013 $834 M. $456 M. $37 M. $1.3 B. $844 M. $86 M.

4. Seidman’s Method Economic Cost of Ill Health = Medical Cost Cost of Presenteeism Cost of Absenteeism + + Cost of diagnosis, management and treatment Economic cost of lost work days due to illness Economic cost of underperforming workers due to illness

5. Economic Metrics: State of Arizona Condition Medical Treatment Costs Per Patient (2013 $) Absenteeism Annual $ Impact Per Patient (2013 $) Presenteeism Average Annual $ Impact Per Patient (2013 $) Allergy9792,1605,523 - 7,101 Arthritis1,3991,5463,945 - 7,101 Asthma1,9543,1544,734 - 7,101 Cancer4,6954,4491,578 - 5,523 Diabetes3,6575181,578 - 7,101 Heart Disease17,4521,7853,945 Hypertension1,7422414,734 Mental Disorder2,2966,7325,523 - 9,467 Migraine1,2612,8235,523 - 12,623 Respiratory Disorders21,7613,8727,890 - 11,045 Average – All 10 Diseases5,7202,7283,629 - 7,574 Sources: Milken Institute; MEDSTAT Group

6. MIHS 2013 Unique Out-Patient Data ConditionCHCFHC OP Aftercare/Follow Up3,926108 OP All Other131 OP Behavioral Health889314 OP Benign Neoplasms1,830126 OP Burns805 OP Cancer2,33287 OP Cardiovascular3,0561,435 OP Dermatology3,470468 OP Digestive3,112510 OP Endocrine5,7182,218 OP ENT1,653254 OP General Medicine7,9081,478 OP Gynecology2,942450 ConditionCHCFHC OP Infectious Disease2,617461 OP Neonates2963 OP Nephroplogy57388 OP Neurosciences5,4221,029 OP Newborn3228 OP Obstetrics4,35777 OP Opthamology6,487168 OP Orthopedics6,025619 OP Pulmonary3,562992 OP Rheumatology1,929268 OP Screenings/Exam8,7152,596 OP Urology2,475472 Total79,70914,235 Source: MIHS

7. MIHS Economic Benefit Estimates, 2013 25% Success Rate 50% Success Rate = = $267.4 - $360.7 Million $534.7 - $721.4 Million

8. Caveats and Conclusions Previous estimates are conservative – Use 25% and 50% successful intervention rates Based on MIHS’ 2013 CHC and FHC out-patients In SROI alone, MIHS could justify the total repayment of the Bond in approximately 2-5 years MIHS facility improvements, and potential for greater patient intervention success, post-Bond could increase the SROI

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