1. House Calls Docs BUSINESS PLAN PRESENTATION CHRISTINE LEWANDOWSKI

2. Business Concept  House Calls Docs propose to provide a solution to the lack of access to care for the senior community of Orange, Osceola, and Seminole counties in Florida.  Home based medical care will be provided post-discharge from an acute care setting.  Chronic disease management will be closely monitored to ensure barriers are removed from better outcomes and achieve goals of self-management by means of educating patients.

3. “ ” The mission of House Calls Docs is to treat the senior population by managing chronic conditions and improving outcomes by treating the patient’s whole person, body, mind, and spirit. Providing care at the patients’ convenience

4. Market Segment

5. Demographics: Aging Society

6. Market Summary  Population Demographics for Seniors 65 +  Orange County:  Population Age 65+: 117,189  Medicare Beneficiaries: 110, 919  Osceola County  Population Age 65+: 32,428  Medicare Beneficiaries: 29,656  Seminole County:  Population Age 65+: 54,244  Medicare Beneficiaries: 50,677

7. Market Summary  Orange County  Population of people 65+ under poverty level: 10.6%  Median Income: $47,581  Disability Rate: 35.5%  Race:  White: 45.1%  Hispanic: 27.6%  African American: 19.7%  Other: 7.6%

8. Market Summary  Osceola County  Population of people 65+ under poverty level: 11.2%  Median Income: $43,891  Disability Rate: 41.7%  Race:  White: 38.9%  Hispanic: 46.8%  African American: 9.3%  Other: 5%

9. Market Summary  Seminole County  Population of people 65+ under poverty level: 7.8%  Median Income: $58,175  Disability Rate: 34%  Race:  White: 65.6%  Hispanic: 17.8%  African American: 10.7%  Other: 5.9%

10. Market Summary

11. Readmission Data

12. Readmissions and Follow-up Care  Of those Medicare beneficiaries that were readmitted,  Only 66% had a follow-up appointment with a primary care physician  Of those will a follow-up, 46.8% were subsequently still readmitted  92.5% of those patients were readmitted within 1-14 days  7.5% of those within 15-30 days.

13. Environmental Analysis

14. Opportunities  The current problem is high readmission rates  Reasons for high readmission rates can be related to a lack of access to follow up care  Lack of resources to adhere to discharge instructions  Lack of coordination in care settings following acute care discharge  Increase in Medicare reimbursement for non-face-to-face care  Medication therapy management  Chronic disease management  Reimbursed for coordination of care

15. Opportunities

16. Competition  In considering competition, all primary care physician services and home health providers were considered in addition to mobile physician services  Our unique services is only in direct competition with three physicians in the market area  Florida has a lower than national average of primary care physicians for every 1,000 people  Competitive Advantage

17. Goals and Objectives  Set up a joint venture with Florida Hospital Orlando and Florida Hospital Medical Group  Provide unique services to attract a market share in those patients who require or request services in their home setting (home, skilled nursing or assisted living facility)  Follow up with patients post discharge from an acute care setting within 24 hours  Manage chronic disease to prevent admissions and readmissions  Improve patient outcomes and increase self-management

18. The Team Florida Hospital Orlando Medical Director Florida Hospital Medical Group Administr ator Physicians SLPPT MSWNP RNHHA

19. Resource Requirements  List requirements for the following resources:  Physicians, Nurse Practitioners, Registered Nurses, Speech Language Pathologist, Social Worker, Home Health Aide, Administrator, Medical Director  EMR/EHR (Cerner)  $1.3 in first year capital expenses  Pay back > 1 year  Referrals from Hospitals  Commitment to improve patient outcomes

20. Financial Plan

21. Risks and Rewards  Rewards  Improved outcomes for community  Reduced readmission rates  Better self-management  Increased tenure for seniors in community  Substantial return on investment  Risks  High competition for similar service (Primary Care)  Lower than expected referrals  Difficulty obtaining buy-in to improve coordination of care/communication

22. SWOT Analysis  Strengths = Partnership with Florida Hospital and Physician Medical Group. Few competitors in mobile physician care.  Weaknesses = High readmission rates.  Opportunities = Only 2 competitors in direct service line of home physician care, opportunity to reduce readmission rates with transitional care model.  Threats = Many competitors in primary care available as alternatives to care, ACOs.