Pay-for-Performance Health Risk Management - Driven Onsite Clinic HR Specialty Products & Services Catalogue Executive Summary A No Frills Distillation of Vendor’s Marketing Collateral Thomas A Ference President & CEO Human Resources Mining & Distribution Co Locating, Validating and Accelerating HR Innovation Office: Cell: Fax: Website:

Pay-for-Performance Onsite Clinics Typical onsite clinic vendor focuses solely on providing healthcare services and not managing employee health risk Full time vendor-provided onsite health coach/clinician Primary, acute and episodic services for (at your option) occ-health, non-occ-health plus LM, DM, Rx and Fitness Center Automated evidence-based and decision support system originally begun 15+ years ago for the Department of Defense and now supported by over 30 full-time research clinicians Reduces 50% error rate found in physicians’ memory- based diagnoses and recommended treatments Integrated PHR/EMR for improved patient/clinician experience, measuring improved health management, evidence based care Health professionals skilled in motivation, education, personal goal setting, and behavior change coaching

Pay-for-Performance Onsite Clinics Clinic funded by dollars now being spent in the healthcare plan Fixed fees vs. cost-plus so as not bias service delivery Immediate medical savings by re-directing most primary care to convenient, lower cost setting. Also reduces lost work time Removes $500K of excess medical cost/1000ees/year Meaningful fees put at risk based upon improvement in health risk factors (e.g. smoking, obesity, etc.) as determined by the employer or a reduction in claims Real time executive dashboard reporting on ROI and all clinic utilization. Shows what services would have cost on the outside Need 350 employees plus their dependents per location or can deploy “circuit rider “ approach ROI = 1.5 Year 1 to 4.0 Year 3

Specialty referral rate  20% ER/UC utilization  20% Hospitalization rate  5%-10% Rx spend  5%-7% Value of Population Health Risk Model

Risk Mitigation at the Onsite Clinic Year 1 Results Body Mass IndexBlood PressureSerum GlucoseLDL CholesterolSmoking Outside Range Making Progress Within Range 34% 25% 12% 25% 50% 35% 24% 48% 25% 17% 40% 22% 11% 35% 18% MN Average 36.9% (NHANES) US Average 30.7% (NHANES) US Average 26% (ADA) US Average 16.6% (NHANES) MN Average 19.7% (NHANES) BMI > 30 > 140/90 mmhg > 100 mg/dl> 130 mg/dlPresent At outset 17% of the population had high cholesterol … 12 months later, 40% of those with high cholesterol had lowered it but were still at risk … And 22% had gotten their high cholesterol under control… Risk Mitigation (Year 1)

-3% Actual Trend Post Implementation 9% Annual Trend Expected Capture Measureable Savings

Next Steps This product/service is contained in the HR Specialty Products & Services Catalogue™ Operational level details about this particular service provider can be obtained in conference with the vendor The HR Mining &Distribution Co. is an independent and contracted representative of the vendor Upon your request, we will arrange for an introduction that can range from a simple, quick conference call to a services overview / system demo Tom Ference (Chicagoland area) or Thank you for your potential interest in this fresh thinking