1. Pharr-San Juan-Alamo ISD Fourth Year Annual Review 2007-2008 An ounce of prevention is worth a pound of cure. - Benjamin Franklin Good Health Comes First

2. Overview Utilization Top 5 Diagnosis Diagnosis Summary Top 5 Medications Top 5 Referrals Overall Satisfaction Survey Results YTD Clinic Expense Total Paid Claims Primary Care Pharmacy 4 Year compensation Productivity Summary Employee Savings Overall Summary PSJA 2008 Medical Clinic Summary

3. Utilization 2,465 Total patient records 3,843 Average monthly enrollment 64% of the population have visited the clinic at least once PSJA 2008 Medical Clinic Summary Total Clinic Usage: 8,740 Employee: 7,493 Spouse: 717 Dependent: 530 2006 - 2007 Total Clinic Usage: 10,564 Employee: 8,962 Spouse: 820 Dependent: 782 2007 - 2008

4. Top 5 Diagnosis PSJA 2008 Medical Clinic Summary

5. A message from Free First Healthcare Clinic Diagnosing and treating upper respiratory infection (URI), cough, or bronchitis quickly and effectively can prevent severe infections resulting in less time away from work. When left untreated, infection and inflammation of the larger airways of the lungs lead to chronic conditions such as asthma and bronchitis. Severe cases can eventually become pneumonia. High Cholesterol is an excess level of fat in your blood. These fats can be triglycerides or cholesterol. Many people choose to use diet, exercise and weight loss as the initial step in treating the disorder. It does not bring the cholesterol or triglyceride level down to a normal range. Medication is recommended to prevent cardiovascular damage. High cholesterol is often associated with increased risk of heart disease or stroke. There are genetic disorders that predispose people to high cholesterol so even exercising and eating healthy is not preventive. Heart disease is the leading killer of both men and women which is also your top diagnosis. Uncontrolled and/or undiagnosed high blood pressure can lead to end stage organ damage, kidney or eye problems, early stroke and early heart attack. Diagnosing and treating high blood pressure early can prevent these problems and decrease the risk of end stage organ damage while improving quality of life. Diabetes, which is above normal blood glucose levels, can cause the blood to thicken and lead to end stage organ damage in the kidneys, eyes, and circulation of the body if left untreated. Poor circulation can lead to increased risk of infections and amputation of the lower extremities. Bronchitis is an inflammation of the mucus membrane of the bronchi. Bronchitis is usually viral in nature, but may occur from a bacterial infection. Often a person acquires Bronchitis after having a URI. Because Bronchitis is usually caused by a virus we are able to only treat the symptoms of bronchitis by drinking plenty of fluids and with cough suppressants. Diagnosis Summary PSJA 2008 Medical Clinic Summary

6. Top 5 Medications PSJA 2008 Medical Clinic Summary

7. Top 5 Referrals PSJA 2008 Medical Clinic Summary

8. Satisfaction Survey Results (Clinic) Survey Questions Availability of Appointments? Wait Time? Physician Patient Care? Nurse Patient Care? Overall Satisfaction ? PSJA 2008 Medical Clinic Summary 604 Surveys

9. Satisfaction Survey Results (Medication) Survey Questions Quickness of receiving medication? Availability of medication? Convenience of this program? PSJA 2008 Medical Clinic Summary 747 Surveys

10. YTD Clinic Expense PSJA 2008 Medical Clinic Summary

11. Total Paid Claims $421,899.74 Annual Savings $23.28 Reduction in PEPM PSJA 2008 Medical Clinic Summary

12. Total Plan Savings Primary Care Annual Savings $667,288.18 PSJA 2008 Medical Clinic Summary

13. Pharmacy 49% Overall savings $239,571.36 Total cost savings 96% Generic utilization PSJA 2008 Medical Clinic Summary

14. Approximate employee wage$14.50 per hour Number of employee office visits8960 visits Approximate time off to see physician in traditional setting180 minutes Approximate work value lost$42.00 per visit Total estimated work value lost$376,320.00 Approximate patient wait time20 minutes Approximate patient time with physician25 minutes Total approximate time off to see physician45 minutes Approximate work value lost$10.75 per visit Total estimated work value lost$96,320.00 Average work time gained2.25 hours Total estimated work value gained$280,000.00 Productivity Summary PSJA 2008 Medical Clinic Summary

15. Employee Savings Office copay: $15.00 Total clinic visits: 10,564 Employee Savings: $158,460.00 * Generic copay: $9.25 Total Generic Rx: 9,876 *Brand copay: $20.77 Total Brand Rx: 394 Employee Savings: $91,353.00 Employee Savings: $8,183.38 Total Savings: $257,996.38 *Prescription medication co-payments are an average of retail and mail order co-payments provided by PBM. PSJA 2008 Medical Clinic Summary

16. Primary Care Savings:$667,281.80 Total Pharmacy Savings:$239,571.36 Productivity Savings:$280,000.00 Total Savings: $1,186,853.16 YTD Cost: (Minus Pharmacy Cost) $612,140.94 Total Clinic Savings Minus Expenses:$574,712.22 Clinic Savings (less productivity):$294,712.22 Overall Summary PSJA 2008 Medical Clinic Summary

17. Thank you