Bending the Cost Curve A Case for Integration

Best Practice: >90% Case Utilization Driving Engagement A Case for Integration Advocacy 11% Benefits Gateway 17% Integrated Offering 40% Best Practice: >90% Case Utilization Average case utilization with just Core Advocacy: 11% Add Benefits Gateway and average utilization increases to 17% Integrate EmpoweredHealth and Wellness and see engagement jump to 40% These numbers can be much higher depending on the number of services added to the mix Best practices like targeted incentives, outbound calling and home mailings all increase the effectiveness of your health and wellness programs driving greater than 90% case utilization

Analyze data to identify gaps in care Leveraging Data Our comprehensive clinical model Apply data in personal member interactions and via member dashboards to close care gaps Proprietary algorithms leverage data to drive member and group health improvement Analyze data to identify gaps in care In addition to our high touch expert services, we also leverage data to drive improvements in member and group health/wellness. We have one of the leading medical claims analysis capabilities in the sector. We import data from every major healthcare carrier and other sources (pharmacy, labs, etc.) and analyze it to identify “gaps in care.” We then utilize this data to power our interactions with members to drive behavioral change. MOST IMPORTANTLY—it is our “trusted” compassionate personal health advocates who apply this data science in live interactions and via member dashboards. We have found that we are able to close 50%+ of the identified gaps in care in a population.

Best Practices Increase ROI from 2:1 to 9:1 Impacting Medical Costs A Case for Integration and Data Advocacy 11% Benefits Gateway 17% Integrated Offering 40% Data Integration Best Practices Increase ROI from 2:1 to 9:1 Advocacy: Gaps in care coaching to improve compliance with preventive care and screenings, evidence-based recommended care for chronic conditions and increase medication adherence Benefits Gateway increases opportunities to close gaps in care by 200% Adding Wellness, Personal Health Messaging and Chronic Care Solutions achieves incremental impact on medical costs. Best practices like remote monitoring of diabetics, outcomes-based incentives and targeted outreach result in twice the PEPY Savings and the greatest ROI Best practices like targeted incentives, outbound calling, home mailing all increase the effectiveness of your health and wellness programs driving 90%+ case utilization.

easier drives better results The numbers speak for themselves In 2016 Health Advocate Achieved: 2.5 million Interactions (calls & cases) $60 million Value of gaps in care closed $168 million Productivity savings Over 10,000 Member compliments 3:1 ROI savings EmpoweredHealth clients 9:1 ROI Best Practice Up to $531 PEPY Savings (engaged vs. non-engaged members)

Lower Administrative Costs easier drives better results Lower Administrative Costs Higher Engagement Better Outcomes Return On Investment Eliminate 4 - 7 vendors Integrate data across vendors One integrated report One bill Average engaged: 40% (Best Practice >90%) • Close >50% care gaps Over 2 years, the medical cost trend for members who interacted with Health Advocate was 28% lower than for those who did not engage with us Average: 110% - 120% EmpoweredHealth: ROI increases to 120% - 130%

Case Study Impacting Medical Costs

Case Study: School Consortium (50 schools, 10,000 employees) In an effort to lower overall healthcare costs and improve employee health and well-being, the Consortium implemented a multifaceted Health and Wellness program. The program achieved a 9:1 Return on Investment. The program consisted of four health and wellness components: Wellness with health and lifestyle coaching Advocacy with data-based gaps in care coaching Biometric screenings with health education on screening results Personal Health Messaging with proactive gaps in care outreach

Case Study: School Consortium Case Study Goals Compare healthcare costs for employees who engaged in the program and those who did not participate Examine the impact of the program on key health measures: Compliance with preventive care and screenings Recommended care for chronic conditions Medication adherence

Case Study: School Consortium Engagement Analysis Parameters The analysis tracked health outcomes over a full year using the year before the Health Advocate program started as a baseline. Baseline year -12/1/2014 - 11/30/2015 Current year - 12/1/2015 - 11/30/2016 Data included all employees and family members who had a claim and were continuously covered for health benefits by the Consortium Comparison Groups Letters Only: Members who received outreach letters for a care gap but had no other contact with Health Advocate Engaged Group: Members who received a letter but also interacted with an advocate, coach or health educator at a biometric screening Control Group: Members who did not have a gap in care and had no engagement with Health Advocate

Case Study: School Consortium Key Findings Interacting with the program at any level improved compliance and reduced costs Members in the “Engaged Group” (although older and sicker) had significant improvements in multiple clinical parameters compared to those in the “Letters Only” group Members in the “Engaged Group” experienced: Higher compliance with preventive screenings Higher compliance with recommended care for chronic illnesses Fewer inpatient stays and ER visits Better medication adherence for drugs related to chronic conditions

Case Study: School Consortium Overall Medical Cost Savings The Consortium’s total medical costs (PEPY) increased 23% The total medical costs for members who had any contact with Health Advocate increased at a much lower rate (13%), despite the fact that this group was more ill and at higher risk than the population that did not have any contact with Health Advocate This 10-point difference in PEPY medical cost trend saved the Consortium $4,870,899 10-point lower cost trend for the group who had any contact with Health Advocate = $1,010 PEPY = $1,010 x 4,820 employees = $4,870,899 savings per year

Case Study: School Consortium Savings Summary $4,870,899 per year ROI of 8.9:1 (nearly nine times the cost of Health Advocate’s programs)