1. MiPCT ADT PO User Group Patient Ping Overview

2. AGENDA 1.MiPCT ADT Current State Recap 2.Interactive Patient Ping Demonstration a)Firm History and Existing Clients b)Patient Ping Product Demonstration c)MiPCT ADT Vendor Functionality Review 3. Discussion and Feedback

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4. ADTs: From Alert to Care Delivery Alert appears in web-based member listing Care Manager acknowledges Repeat reminders to prompt activity Care Mgr Receives Electronic Alert Care Manager accesses health system EMR, discharge summary, or available clinical information Care Manager communicates with facility discharge planning contacts or via call to patient Care Manager accesses available patient info. Medication reconciliation and TOC activites Identification of patient needs and initiation of follow-up care Bill (G/CPT) if applicable Initiate Near Real Time Transition of Care Activity 4

5. 5 1) Patient goes to hospital which sends ADT message via substate to MiHIN 2) MiHIN checks MiPCT patient-provider attribution file (ACRES) and matches with ADTs received 3) MiHIN sends matched ADT to MiPCT ADT Vendor 4) MiPCT ADT Vendor matches MiPCT ADTs with PO-provided Care Manager mapping 5) MiPCT ADT Vendor sends ADT to mapped Care Manager MiPCT ADT Vendor Health Systems Health Provider Directory Primary Care Care Coordinator Patient Patient to Provider Attribution (ACRES) Care Manager Mapping POs MiPCT/MiHIN ADT Notification

6. Two Functionalities Provided Now to MiPCT/MiHIN ADT Partners 1. Web-based MiPCT Member List with: Patient name Date of Birth Diagnoses Payer HDHP flag Risk scores ED, inpatient utilization history Care manager Etc. 2. Admission, Discharge, Transfer (ADT) Alerting for MiPCT Patients Alerting for MiPCT patients at HFHS, U of M, Trinity, Beaumont, and McLaren (Sparrow and St John’s in process of integration) Inpatient Admission Inpatient Discharge ED visit Observation patient

7. Functionality Enhancements: Clinical Summaries to Follow ADT Transmission Via partnership with MiHIN, MiPCT/MiHIN ADT PO partners will be the first roll-out (in Fall 2015) of the medication reconciliation module upon pilot completion

8. ADT Progress –Sample Alert Contents 8 Beaumont HSHenry Ford HS Message Types All Patient ID / Medical Record (MR) XX Patient Name XX Date of Birth XX Administrative Sex XX Address If Available Phone number – home If Available Patient Account Number XX Patient Death Indicator If Applicable Primary Care Physician (ID, Name) XX Patient Class IP, EROBS, IP, ER Assigned Patient Location (Room / Bed) XX Prior Patient Location N/A Attending Physician (ID, Name) IP Only Referring Physician (ID, Name) XX Consulting Physician (ID, Name) XX Admit Source XX Admitting Physician (ID, Name) IP Only Patient Type XX Discharge Disposition IP Only Admit Date XX Discharge Date XX Plan ID / Name XX Group Number XX Policy Number XX

9. The Vendor Field is Changing New vendors are entering the field The MiPCT is in process of due diligence with the MiPCT/MiHIN ADT PO Users’ Group to: ▫Explore alternatives, their feasiblity and desirability ▫Goal is to identify the best tool for facilitating timely information for prompt transition care for MiPCT patients 9

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11. Background and Clients Founded in 2013 Founder from CMS Innovation Center where he helped designed ACO, CPCI, Bundles, and other new payment models. Team includes physicians, policy, and IT product development experts Company backed by Google and Fidelity Current Clients ▫Michigan: MedNetOne, OPNS, Reliant ACO, Great Lakes OSC, Michigan Pioneer ACO, DMC PCPs, POM- ACO (SNF only), Total Health Care, many soon to join ▫Massachusetts: Nearly all of the state’s POs/ACOs ▫Pennsylvania: Largest POs in state ▫Connecticut: Largest PO in state 11

12. ©2014 PatientPing Inc. CONFIDENTIAL AND PROPRIETARY. Please do not distribute. THE PATIENTPING VISION: COORDINATE CARE EVERYWHERE 12 Hospital Physicians Organization Specialty Surgery Center SNF Home Health Specialty Clinic Emergency Room LTACH Our vision is to create a national care coordination community By connecting providers through real-time admission and discharge notifications, we aim to help providers transform the way care is delivered

13. ©2015 PatientPing Inc. CONFIDENTIAL AND PROPRIETARY. Please do not distribute. HOW CUSTOMERS USE PATIENTPING 13 Admitting facilities receive guidelines from the care team upon admission and discharge Who sees Guidelines? Admissions coordinators at hospitals, SNFs, home health agencies, and other admitting providers What’s in a Guideline? Patient’s full care team with contact information, instructions on how to work with care team, and history of hospital and other facility visits Providers receive real-time notifications (“Pings”) when patients are admitted or discharged anywhere Who gets Pings? Care coordinators, hospital social workers, health plan case managers, physicians, practice managers, or any other provider On which Patients? MiPCT, PGIP, ACO, bundles, commercial risk lives, all patients discharged from a hospital or other facility, or any other patient roster When and Where? When patients are admitted to/discharged from any ER, hospital, SNF, LTACH, or home health agency PINGS POINT-OF- CARE GUIDELINES Pings + Guidelines is a lightweight care coordination solution that empowers providers to improve quality and meaningfully impact total cost of care ©2015 PatientPing Inc. CONFIDENTIAL AND PROPRIETARY. Please do not distribute.

14. ©2014 PatientPing Inc. CONFIDENTIAL AND PROPRIETARY. Please do not distribute. PINGS A patient’s entire care team is notified in real-time when the patient is admitted, discharged, transferred, or deceased at any facility 14 ©2015 PatientPing Inc. CONFIDENTIAL AND PROPRIETARY. Please do not distribute.

15. ©2014 PatientPing Inc. CONFIDENTIAL AND PROPRIETARY. Please do not distribute. 15 REAL-TIME PINGS MedNetOne Lightweight, clean panel to track patient visits anywhere. Raw data available if recipient prefers to render notifications in existing technology platform. ©2015 PatientPing Inc. CONFIDENTIAL AND PROPRIETARY. Please do not distribute.

16. ©2014 PatientPing Inc. CONFIDENTIAL AND PROPRIETARY. Please do not distribute. 16 VIEW INDIVIDUAL PATIENT DETAILS Expanded view makes it easy to see patient demographics and care history MedNetOne ©2015 PatientPing Inc. CONFIDENTIAL AND PROPRIETARY. Please do not distribute.

17. ©2014 PatientPing Inc. CONFIDENTIAL AND PROPRIETARY. Please do not distribute. 17 VIEW PINGS BY FACILITY User: Care Coordinator ewa@mednetone.net Pings Patient Roster ©2015 PatientPing Inc. CONFIDENTIAL AND PROPRIETARY. Please do not distribute.

18. ©2014 PatientPing Inc. CONFIDENTIAL AND PROPRIETARY. Please do not distribute. 18 EASILY EXPORT PINGS User: Care Coordinator jane@mednetone.net Pings Patient Roster ©2015 PatientPing Inc. CONFIDENTIAL AND PROPRIETARY. Please do not distribute.

19. ©2014 PatientPing Inc. CONFIDENTIAL AND PROPRIETARY. Please do not distribute. 19 SORT COLUMNS User: Care Coordinator /// jane@mednetone.net Pings Patient Roster ©2015 PatientPing Inc. CONFIDENTIAL AND PROPRIETARY. Please do not distribute.

20. ©2014 PatientPing Inc. CONFIDENTIAL AND PROPRIETARY. Please do not distribute. 20 FACILITATE TEAM COLLABORATION User: Care Coordinator Pings Patient Roster Jane Smith jane@mednetone.net ©2015 PatientPing Inc. CONFIDENTIAL AND PROPRIETARY. Please do not distribute.

21. ©2014 PatientPing Inc. CONFIDENTIAL AND PROPRIETARY. Please do not distribute. PINGS: FLEXIBLE ROUTING Equip practices and physicians to better manage care by sending them real-time Pings on their patients through a variety of mechanisms 21 PO Practice PCP/Nurse PatientPing Web Application Mobile Notification Existing System Integration ©2015 PatientPing Inc. CONFIDENTIAL AND PROPRIETARY. Please do not distribute.

22. GUIDELINES Admission sites receive care guidelines and patient visit history upon admission and discharge 22

23. ©2015 PatientPing Inc. CONFIDENTIAL AND PROPRIETARY. Please do not distribute. PatientPing collects data on admissions and discharges HL7 ADT feeds or web application Admit Site identifies patient’s Care Coordinator PATIENT IDENTIFICATION User: Admissions Coordinator Loveland ACO @lovelandaco.com PO: Your PO

24. ©2015 PatientPing Inc. CONFIDENTIAL AND PROPRIETARY. Please do not distribute. 24 GUIDELINES AT ADMISSION SITE User: SNF Admissions Coordinator Patient: Giacomo G. PO: MedNetOne Care Team: PO care coordinator: Mr. Alberts PCP: Dr. Jane Instructions from PO: High risk, call PO nurse at 734-555-4567

25. ©2015 PatientPing Inc. CONFIDENTIAL AND PROPRIETARY. Please do not distribute. PurposeAdmit InstructionsDischarge Instructions Request additional data Please contact [PO Care Coordinator Name] at [Phone Number] to discuss details of the patient’s prior hospitalization. Please contact [PO Care Coordinator Name], the [PO Name] Care Coordinator, at [Phone Number] to discuss the patient’s discharge instructions. Request action be taken Call [PO Care Coordinator] to discuss any transition of care out of your facility in advance of transition. Please have the patient’s nurse contact [PO Care Coordinator] to discuss a warm handoff. Guide future care transitions Preferred HHA: Loveland HHA Preferred Hospice: Good Hope Preferred Neurologist: Eve Levine, MD Upon discharge, fax the PCP’s office, [Fax Number], the following: Discharge Summary, Discharge Instruction Sheet and Discharge Medication List Provide conditional contacts Call [PO Care Coordinator] with medication questions or concerns. If you have other questions, please contact [RN Care Coordinator] at [Phone number]. Call the PCP office contact [office contact] at [Phone Number], to schedule a transition of care appointment within 24 hours of discharge. Coordinate specific patients Please contact [High Risk RN] at [Phone Number] within 2 hours if CHF or COPD patients show signs of deteriorating health. Please notify [High Risk Nurse] within 24 hours of discharge for all patients flagged as high risk. SAMPLE CARE GUIDELINES 25 Loveland ACO @lovelandaco.c om Instructions: Call Kate within 24 hours of admission Patient: James Lovejoy PO: Your PO PCP: Mary Pizatto, MD Care Team Resources: Nurse Care Manager: Karen Phillips, 617-234-1923 High Risk Patient Support: Steven Wendor, 781-909-9321

26. ©2015 PatientPing Inc. CONFIDENTIAL AND PROPRIETARY. Please do not distribute. PO sends PatientPing: 1.Care manager-to-patient mapping (ACRS) 2.List of facilities from which it would like Pings 3.How PO would like to receive Pings PatientPing will: Confirm any ACRS updates Onboard post-acute facilities not in Community (via existing relationships with PAC chains and other onboarding techniques) IMPLEMENTATION IS RAPID AND SIMPLE ©2014 PatientPing Inc. CONFIDENTIAL AND PROPRIETARY. Please do not distribute. 26 PINGS POINT-OF- CARE GUIDELINES POs will be live after transmitting one Excel spreadsheet within 2 weeks PO sends PatientPing: Care guidelines to render at Admission Sites by adding additional columns on to the ACRS file

27. ©2015 PatientPing Inc. CONFIDENTIAL AND PROPRIETARY. Please do not distribute. ADT Pings when patients go to hospitals that are sending data to MiHIN ADT Pings to SNFs and HHAs in PatientPing Community Clean user interface that creates longitudinal encounter history, exporting, and reporting capabilities 24x7 live support with monthly participation in user group to discuss enhancements TODAY VS. TOMORROW ©2014 PatientPing Inc. CONFIDENTIAL AND PROPRIETARY. Please do not distribute. 27 More visibility into where patients receive care by onboarding more provider types: urgent care clinics, pharmacies, retail clinics, specialty clinics, and more More context to Pings with diagnosis, medication lists, and CCDs Smart Pings to prioritize high risk patients Clear identification of TCM eligible patients with solution to simplify TCM billing More robust analytics on utilization, readmissions rates, length of stay, and quality of care AVAILABLE NOW ON THE NEAR-TERM ROADMAP PatientPing releases product enhancements on a 2-4 week cycle

28. ©2015 PatientPing Inc. CONFIDENTIAL AND PROPRIETARY. Please do not distribute. 28 STRICT HIPAA COMPLIANCE AND DATA SECURITY The PatientPing platform is fully HIPAA compliant All technical, physical, and administrative safeguards are in place The PatientPing system is backed by data, security, and privacy insurance Absolutely no one who is not explicitly authorized to view patient data will have access to it Our database is designed to make improper data sharing virtually impossible