1. Advancing Healthcare Through Innovation, Quality and Culture One Community, One Patient and One Employee at a Time Cindy Stutts, MS, RN Bon Secours Virginia Health System Virginia Health Care Conference June 5 th, 2014

2. “Change is not something that we should fear. Rather, it is something that we should welcome. For without change, nothing in this world would ever grow or blossom, and no one in this world would ever move forward to become the person they’re meant to be.” Author Unknown

3. Volume 2013 Acute Care 9 hospitals Inpatient Beds1,500 licensed Employed Physicians460 providers Total Medical Staff3,000 Total Employees12,252 Emergency380,400 visits Discharges76,900 Surgeries91,700 Transforming Healthcare Throughout Virginia Good Help 190 Years of Good Help

4. Focused on Quality

5. Providing Care in the Community Driving Innovation

6. Mobile Outreach to the Community Total Fleet = 15 Vehicles 5 Vans 4 SUVS 1 Box Truck 1 Cargo Van 1 Passenger Van 1 Trailer 1 Truck 1 Mobile Learning Kitchen

7. Mobile Learning Kitchen Vehicle to educate the community, especially the underserved, about wholesome eating & lifestyle for preventative health and chronic disease management.

8. Providing Care for Employees and Families Driving Culture

9. Culture of Health and Wellness Tobacco-free campus 2009; Nicotine-free hiring began in November 2011. Annual Personal Health Assessments – about 90% participation. Bon Secours began using an Accountable Care Organization model with a focus on diabetes, obesity, and hypertension. Now piloting Partner for Health, a Bon Secours- created program with free advanced lab testing and personal health coaching. Driving engagement through Wellness Incentives – up to $900 off medical costs On-site health clinics. Healthy Foods Initiatives in cafeterias and vending. Recognizable Brand for Wellness. Movin’ Mania childhood obesity initiative.

10. 3 Components to the Bon Secours Wellness Incentive

11. o Targeted Health Coaching o Telephonic, Web Based, 1:1 o Condition Management o Diabetes o Hypertension o Building the Culture (Commit to be Fit Campaign) o Cycling o Walking paths o Stairwell Campaign o Healthy Foods o Wellness Focused Leader Day o Leadership Challenges o Dedicated Web Portal for Wellness o Wellness Wednesday’s o Good Health Onsite Clinics o Cleveland Clinic-Stress Management o HDL Advanced Laboratory Screenings Building a Healthy Culture

12. 1 The Business Case for Wellness 12

13. Driving Engagement 13

14. Bon Secours’ Employee ACO Journey Transition from High Risk Condition Management Population Health Management 2011-2012 2012-2013 2013-2014

15. What Advanced Lab Testing Taught Us Related to Diabetes and Heart Disease Advanced lab testing uncovered 32% of participants at risk for developing diabetes who may not have been identified by the typical Bon Secours PHA test. 62% of participants with high risk for CVD were not identified by the typical Bon Secours PHA test. (Total cholesterol, HDL) Targeted Coaching

16. Early Signs of Success 2013 -2.2% 2013 Total Health Insurance Benefit Expense vs. National Trends 2012