1. CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. which are independent licensees of the Blue Cross and Blue Shield Association. ® Registered trademark of the Blue Cross and Blue Shield Association. ®′ Registered trademark of CareFirst of Maryland, Inc. PROPRIETARY AND CONFIDENTIAL March 13, 2013 CareFirst - Making a Difference CareFirst Commitment Making a Difference in our Communities City Julie Wagner Grants Program Manager

2. PROPRIETARY AND CONFIDENTIAL The CareFirst Organization… 2  The largest insurer in the Mid-Atlantic region, serving 3.4 million members  Employs about 5,000 associates and contractors in Maryland, Washington, D.C., Northern Virginia, West Virginia and North Carolina  Has the largest provider network in the region, with more than 80 percent of the region’s health care providers participating in one or more networks  Launched the nation’s largest Patient-Centered Medical Home (PCMH) program of its kind  Since 2008, through our CareFirst Commitment program, we’ve contributed more than $340 million to community programs designed to increase health care access, affordability, safety and quality throughout Maryland and the National Capital Area

3. PROPRIETARY AND CONFIDENTIAL A Corporate Memberships Community Sponsorships Targeted Health Giving Through Others Programmatic Initiatives Subsidies and Enhanced Access Programs Catalytic Giving  Our community giving program is strategic and carefully guided by an overarching goal of dedicating resources to initiatives that catalyze change and create systemic efficiencies in the health care delivery system.  In priority order, our giving is focused on:  Subsidies to enhance health care access  Catalytic giving to improve the health system  Targeted giving to organizations that seek to improve health, and  Community sponsorships and memberships Strategic Giving…

4. PROPRIETARY AND CONFIDENTIAL Catalytic Funding… 4 CareFirst funds innovative community initiatives and programs throughout our service area: to improve the region’s health care delivery systems, identify and seek to promote change on broader health initiatives, and ultimately, to affect the long-term health of our community. More specifically, we’ve focused our efforts on five key areas to address these objectives: –Improving Maternal and Child Health; –Battling the Obesity Epidemic; –Empowering the Region’s Safety Net Clinics; –Addressing the Region’s Shortage of Nurses; and –Expanding CareFirst’s Patient-Centered Medical Home Concept –Improving Maternal and Child Health

5. PROPRIETARY AND CONFIDENTIAL Supporting the Community… 5 Corporate Memberships & Sponsorships Associate Volunteerism American Heart Association Internal Fundraising United Way Campaign Volunteerism We sponsor over 344 events, region-wide, with nonprofit partners per year, throughout our entire region. These events support the operating budgets of nonprofit organizations and provide CareFirst well over 150,000 direct impressions and countless others through the media. - Promote participation using the latest tools and technology - Incentives such as matching funds and recognition

6. PROPRIETARY AND CONFIDENTIAL Grant Funding… 6 Grant Applications Review applications in 3 grant cycles Special RFP Issued Awards & Reporting

7. PROPRIETARY AND CONFIDENTIAL Case Study… 7 Safety Net Health Centers (SNHC) Patient-Centered Medical Homes (PCMH) Initiative

8. PROPRIETARY AND CONFIDENTIAL SNCH PCMH RFP Process… 8 2011 July Guidelines for Grant Applications CEO Information Sessions August Grant Submissions Sept Evaluation Teams OctRecommendations NovFinal Awards DecMOU Development

9. PROPRIETARY AND CONFIDENTIAL Populations Targeted by SNHC PCMH Projects… 9 Behavioral Health Issues Chronically Ill HIV+ Homeless Individuals Diverse Communities Low Income Patients Underserved Populations Uninsured Patients

10. PROPRIETARY AND CONFIDENTIAL SNHC PCMH Grantees… 10 CareFirst Safety Net Health Centers Patient-Centered Medical Homes Initiative Grantees Organization Grant Service AreaGrant AwardGrant Period Arlington Free ClinicArlington, VA$350,0003 years Baltimore Medical Systems, Inc.Baltimore City, MD$498,9052 years Calvert Healthcare Solutions, Inc.Calvert County (MD)$287,7622 years Chase Brexton Health Services, Inc.Baltimore City$250,0002 years Choptank Community Health System Caroline, Dorchester, Talbot Counties (MD) $400,0002 years Community Clinic, Inc.Montgomery and Prince George’s Counties (MD) $1,585,5213 years Health Care for the Homeless, Inc.Baltimore City, MD$750,0003 years Mary’s Center for Maternal and Child Care Washington, DC and Montgomery County (MD) $596,6653 years Primary Care Coalition of Montgomery County Montgomery County (MD)$599,5143 years Spanish Catholic Centers of Catholic Charities Washington, DC$300,0003 years Total Health CareBaltimore City, MD$1,994,8763 years Unity Health CareWashington, DC $913,801 3 years

11. PROPRIETARY AND CONFIDENTIAL 4 4 3 Regions Serviced by SNHC PCMH Projects… * Figures represents number of projects servicing that area.

12. PROPRIETARY AND CONFIDENTIAL PCMH Measurements Key: Black – Organization Defined Goals Blue – CareFirst Goal Additions Project Metrics… Organization Grant Award Project DescriptionPCMH MeasurementTarget Population Number Targeted Arlington Free Clinic$350,000Complete transition to patient- centered medical home. Care for patients with multiple chronic health conditions. Quality, Health Outcomes, Utilization, ER Diversion, Hospitalizations, Cost Per Patient, Cost Savings Chronically Ill, Low Income, Underserved, Uninsured 1,600 Baltimore Medical Systems, Inc. $498,905Address unmet health needs of adults with behavioral health issues and chronic health conditions. Quality, Health Outcomes, Utilization, ER Diversion, Hospitalization, Cost Per Patient, Cost Savings Behavioral Health Issues, Chronically Ill, Low Income, Underserved, Uninsured 750 Calvert Healthcare Solutions, Inc. $287,762Coordinate care for chronically ill adults who are between 117% and 200% of the poverty level. Quality, Health Outcomes, Utilization, ER Diversion, Hospitalizations, Cost Per Patient, Cost Savings Behavioral Health Issues, Chronically Ill, Low Income, Underserved, Uninsured 276 Chase Brexton Health Services, Inc. $250,000Empanel to care teams, chronically ill patients who are non-adherent or at risk of non-adherence to recommended health services. Health Outcomes, Utilization, Cost Per Patient, Cost Savings Chronically Ill, HIV+, Low Income, Underserved, Uninsured 200 Choptank Community Health System $400,000Enroll in a yearlong diabetes management program all uninsured patients with elevated HbA1c. Health Outcomes, ER Diversion, Utilization, Hospitalizations, Cost Per Patients, Cost Savings Chronically ill, Low Income, Underserved, Uninsured 250

13. PROPRIETARY AND CONFIDENTIAL Project Metrics… Community Clinic, Inc.$1,585,521Target people with diabetes, hypertension, asthma, and HIV/AIDS for participation in the patient-centered medical home. Quality, Health Outcomes, Utilization, ER Diversion, Hospitalization, Cost Per Patient, Cost Savings Chronically ill, HIV+, Low Income, Underserved, Uninsured 2,566 Health Care for the Homeless, Inc. $750,000Develop a patient-centered medical home model tailored for the unique medical and social health issues of homeless people. Quality, Health Outcomes, Utilization Behavioral Health, Chronically Ill, Homeless, Low Income, Underserved, Uninsured 750 Mary’s Center for Maternal and Child Care $596,665Using staff and technology, enhance care coordination given to individuals with asthma, hypertension, and diabetes. Quality, Health Outcomes, Utilization, Cost Per Patient, Cost Savings Chronically Ill, Immigrants, Low Income, Underserved, Uninsured 2,973 Primary Care Coalition of Montgomery County $599,514Transform two safety net health centers into patient centered medical homes and enhance support and care for people with multiple chronic illnesses. Quality, Health Outcomes, Utilization, Cost Per Patient Multiple Chronic Illnesses, Low Income, Underserved, Uninsured 500 Organization Grant Award Project DescriptionPCMH MeasurementTarget Population Number Targeted

14. PROPRIETARY AND CONFIDENTIAL Project Metrics… Spanish Catholic Centers of Catholic Charities * $300,000This project has been closed due to leadership changes, challenges with project design and staff recruitment.**** Total Health Care *$1,114,000Transform one safety net health center into patient centered medical homes and enhance support and care for people with multiple chronic illnesses to reduce inappropriate use of emergency departments. Quality, Health Outcomes, Utilization, ER Diversion, Hospitalizations, Cost Savings Multiple Chronic Illnesses, Low Income, Underserved, Uninsured 1,200 Unity Health Care$913,801Reduce misuse of the emergency department among patients with multiple chronic health conditions. Quality, Health Outcomes, Utilization, ER Diversion, Hospitalizations, Cost Savings Multiple Chronic Illnesses, Low Income, Underserved, Uninsured 19,000 OrganizationGrant AwardProject DescriptionPCMH MeasurementTarget Population Number Targeted

15. PROPRIETARY AND CONFIDENTIAL Grant Project Performance Quality Health Outcomes Utilization Emergency Dept. Diversion Hospitalizations Cost Per Patient Cost Savings CareFirst Support Offering of Quality Technical Assistance Offering of Relevant, Quality Training Grantee Engagement Timely Submission of Reports Participation in Collaborative Meetings Participation in Care Coordination Meetings Participation in Trainings & Utilization of Technical Assistance Promoting Project Success…

16. PROPRIETARY AND CONFIDENTIAL Successes and Challenges… SuccessesChallenges Increased Preventive ServicesImplementation Delays Early Adoption by StaffCost Saving Data Measures Hispanic OutreachDelays from Ancillary Organizations HiringStaff Recruitment Care Plans in EMR SystemPatient Recruitment Partnership Communication, Protocols & Guidelines Communication with Grantee Partners Value Added Closer Relationships with our non-profit partners Better understanding of non-profit challenges (e.g. Medicaid etc…) Shared learning

17. PROPRIETARY AND CONFIDENTIAL 2013… Monitoring & Evaluation Technical Support February 27Creating a PCMH Culture (in-person) 27Recruiting and Retaining PCMH Participants (in-person) March 13PCMH Program Monitoring and Evaluation (webinar) 20Measuring Patients’ Perceived Health Status (webinar) 26Health Literacy/Plain Language – Part I (webinar) April 10Integrating Data Integrity Into the PCMH Clinic Culture (webinar) 16Considerations for Integrating Care Plans With Information Systems (webinar) May 21Health Literacy/Plain Language – Part II (in-person)

18. PROPRIETARY AND CONFIDENTIAL Questions… Contact: Julie Wagner 410-528-7111 julie.wagner@carefirst.com