About Memorial Not-for-profit community hospital Level 2 Trauma Center 3000 +Employees; 300+ physicians 412 Beds; 80+ clinics 16K Admissions annually 22K Surgical Cases annually 414K OP visits annually 70K ED Visits annually

Strategic Priorities Population Health Engagement / Care Coordination Physician Alignment Clinical Improvement Clinical and Financial Analytics Customer (Patient) Satisfaction Supports all priorities

Care Coordination Programs Community Health Initiative (CHI) Health Catalyst/Outpatient Navigator Preventative Chronic Care Management (CCM) - MD Revolution/Outpatient Navigator - 20 Minutes Billable Non-Face-to-Face Transition of Care Program - Emmi Solutions/Case Manager

Challenges Care Transitions: Challenges IMPROVE CARE COORDINATION $24-45B – National annual cost of poorly coordinated transitions CHALLENGE: CONSISTENT, EFFECTIVE, COMMUNICATION DRIVE SELF-MANAGEMENT 2x – Increase in readmits when patients lack knowledge & skills CHALLENGE: INCREASE PATIENT COMPETENCE AVOID & REDUCE READMISSION $25B – Annual cost of preventable readmissions CHALLENGE: IDENTIFY PATIENTS AT-RISK

Care Coordination Improvement Meaningful Outreach Contact Patients Drive Self - Management Understand Patient Status Report Patients Potentially At-Risk DO THIS FOR EVERY PATIENT

Emmi Emmi Transition Interactive call campaigns Reinforces key messages with patients/caregivers Tracks interactions and identifies risk factors Corresponding Emmi Engage programs Engages with Emmi’s soothing voice Collects vital information from patient Provides daily reports on patient status Notifies staff of patients at potential risk

Emmi Emmi Transition Topic List General Discharge General Orthopedic Two calls, three Emmi programs Stroke Five calls, two Emmi programs Pneumonia 15 calls, three Emmi programs Heart Failure Acute Myocardial Infarction 15 calls, two Emmi programs General Orthopedic 4 calls, one Emmi program COPD 6 calls, two Emmi programs Behavioral Health 9 calls first 3 weeks post-discharge Breastfeeding 12 calls in 12 weeks post-discharge Total Joint Replacement 10 calls in 90 days post-discharge

Emmi Memorial’s Successes 72% PATIENTS REACHED 82% PATIENTS REACHED INTERACTED ON MORE THAN HALF OF ALL CALLS SURVEYED PATIENTS REPORTED 81% Stated they had an improved opinion of their provider 76% Stated they were better prepared to manage their health 69% Stated they were more comfortable calling their provider

Emmi Memorial’s Successes “WE HAVE CASES OF IDENTIFYING ISSUES, THAT COULD HAVE QUICKLY BECOME LIFE THREATENTING, IF THEY HAD NOT BEEN ADDRESSED IN A TIMELY MANNER…DUE TO THE INTERCESSION OF THE EMMI PHONE CALLS AND THE INTERVENTION OF THE NURSE FOLLOWING UP ON RED AND YELLOW FLAGS…” Will discuss specific cases

MHG Care Coordination Readmission Case Manager

Medicare Readmission Reduction Program FY 13 1.0% Penalty FY 14 0.44% Penalty FY 15 0.08% Penalty FY 16 0.19% Penalty Will discuss specific cases

Medicare Readmission Reduction Program Pepper Report Short-Term Acute Care PEPPER 30-day Readmissions to Same Hospital or Elsewhere Memorial Hospital at Gulfport   Q1 = Oct-Dec Q2 = Jan-Mar Q3 = Apr-Jun Q4 = Jul-Sep Time Periods Target Area Discharge Count (Numerator) Denominator Count Percent (Numerator/ Denominator) Q1 FY 2014 253 1,350 18.7% Q2 FY 2014 252 1,400 18.0% Q3 FY 2014 294 1,395 21.1% Q4 FY 2014 278 1,343 20.7% Q1 FY 2015 266 1,352 19.7% Q2 FY 2015 270 1,396 19.3% Q3 FY 2015 267 1,393 19.2% Q4 FY 2015 1,325 19.1% Q1 FY 2016*ICD10 228 1,269 Q2 FY 2016 1,407 17.9% Q3 FY 2016 246 1,388 17.7% Q4 FY 2016 245 17.6%

Next Steps Additional Emmi Transition calls/programs Stroke/CABG Readmission Reduction projects Continued Care Coordination efforts in outpatient primary care Involvement of community (post acute providers)

Questions