1. 1 An Approach for Caring for Particular Types of Patients A Presentation by Chet Burrell President and CEO CareFirst BlueCross BlueShield December 16, 2010

2. Participation 12 percentage points upon enrollment Participation 12 percentage points upon enrollment Participation 12 percentage points upon enrollment Participation 12 percentage points upon enrollment Participation 12 percentage points upon enrollment Participation 12 percentage points upon enrollment 2 * Incentives and reward increases apply to all medical services and exclude supplies and drugs. PCMH: Designed to preserve and enhance PCPs’ ability to practice medicine the way they want to practice medicine – while improving quality and reducing costs 12% fee schedule increase upon enrolling 12% fee schedule increase upon enrolling New fees paid for Care Plan development and follow-up New fees paid for Care Plan development and follow-up Significant rewards* based on quality and efficiency Significant rewards* based on quality and efficiency Incentive 2

3. 10 Essential Elements 1.Medical Care Panels are the central building blocks 2.Patients ‘attributed’ to panels 3.Calculating the illness burden score 4.Establishing global expected care costs and tracking experience 5.Referrals to specialists: patient authorization and consent 6.Enhanced focus on patients with chronic illnesses – care plans / teams 7.An online member health record (MHR) 8.Measuring quality of care 9.Annual settlement and calculation of incentive awards 10.Signing on and complying with program rules 3

4. 4 Focusing on High-Risk Patients Targeted Group

5. Wellness/Illness Burden Pyramid – PCMH & Employers Example PCMH Panel Experience Example Employer Experience Percent of Population Percent of Cost 3%35% 7%25% 21%25% 19%9% 50%6% Percent of Population Percent of Cost 2%31% 9%29% 22%20% 17%15% 50%5% 5