1. ©AAHCM Rodney Hornbake MD, FACP Essex CT drhornbake@comcast.net 860-918-4556

2. Consulting contract with Gentiva Health Services (NASDAQ: GTIV) Board of Directors and stock holdings Capital Senior Living (NYSE: CSU) ©AAHCM

3.  Group practice in rural North Carolina: 1979-1992  Management of hospitals, health systems and for profit companies 1993-2002  Return to clinical practice: 2002-present  Career-long devotion to home-based care as part of a primary care practice (2013: 3933 patient visits including 202 home visits) ©AAHCM

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5.  Solo practice  EMR implementation  Group practice formation (3 physicians)  Level 3 PCMH  Merger with large primary care group practice (>250 physicians and mid-level providers) 9/1/12  Accountable Care Organization began 1/1/13 ©AAHCM

7.  Reengineered primary care AND  A new financial model that supports a value based payment system BUT NCQA and other certifying bodies ONLY address the structure, process and results of reengineering. AND reengineering is costly and must be offset by enhanced payment. THEREFORE you must assess the likelihood that enhanced payment will materialize. ©AAHCM

8.  Dominant payer(s) demand it  Dominant payer(s) provide strong incentives that more than offset the costs of achieving recognition.  An ACO offers your practice the opportunity to provide HBPC to a carefully selected panel of patients, offers FFS and shared savings, and insists on PCMH recognition. ©AAHCM

9. NCQA http://www.ncqa.org/Programs/Recognitio n/PatientCenteredMedicalHomePCMH.aspx http://www.ncqa.org/Programs/Recognitio n/PatientCenteredMedicalHomePCMH.aspx Patient Centered Primary Care Collaborative http://www.pcpcc.org/ ©AAHCM