Retail Healthcare in America: Where it’s Going June 2015 Image Area Walmart Health & Wellness - Confidential

2 Agenda Introduction & Overview Retail Healthcare Consumer Buying Decisions Summary, Q&A Walmart Health & Wellness - These are the thoughts of the Health & Wellness group. These are NOT the thoughts or programs of Walmart Human Resources.

Retail Healthcare Walmart Health & Wellness - Confidential

4 Retail Healthcare: Trends in Healthcare: Cost sharing increasing Alternative delivery models Chronic care management Personal accountability (do it yourself) Shopping (Mobile Apps) Patient Centered Medical Home (PCMH) Quality measures Value based reimbursement Practice to the highest level of licensure Convenience Population health (get into the system) Walmart Health & Wellness - Trends in Healthcare (cont.): Transparency Cost containment Competition between Health Systems HDHP account for >20% Deductibles up 150% since 2010

5 Retail Healthcare: Walmart Health & Wellness - Discretionary spending in Health Care is relatively new

6 Retail Healthcare: Walmart Health & Wellness - Recognize health related spending “choices” will be guided by consumers –Deductibles –Where the consumer is comfortable –Healthcare providers do NOT know consumers –“Shopping” experience –Options for “dollars” – “mobile bill or…?” Different demographics behave differently Brand recognition and “comfort” play a role in decision making Location and convenience play a role in selecting health care services

7 Retail Healthcare: Walmart Health & Wellness - The birth of the healthcare consumer, 2014, pwc Consumers perceptions & beliefs are changing:

8 Retail Healthcare: Walmart Health & Wellness -

9 Retail Healthcare: Walmart Health & Wellness -

10 Retail Healthcare: Retail clinic expansion: Health systems moving in this direction –Patient capture –Low cost treatment site –Convenience –ACO asset Major retailers –Discounters –Grocery –Drug stores Urgent care companies Tele-health options in clinics Narrow-Preferred networks Walmart Health & Wellness -

11 Retail Healthcare Conditions commonly treated: State dependent Acute conditions Chronic disease management Cold & Flu symptoms Dermatological conditions Conjunctivitis: “Pink eye” Ear irritations Sore throat Urinary tract infections (not sexually transmitted) Vaccinations Walmart Health & Wellness - More than 10 million retail clinic visits in 2014!

12 Retail Healthcare: Walmart Health & Wellness -

13 Retail Healthcare: Walmart Health & Wellness - Provide care for “out of system” population

14 Retail Healthcare: Walmart Health & Wellness -

15 Retail Healthcare Walmart Health & Wellness -

16 Retail Healthcare: Consumer perspective: –Widespread dissatisfaction with HC system –Concerns over Costs & Cost trends Value Engagement –Changing expectations: Younger consumers: “Isn’t this a digital marketplace?” Trust issues –Employer opportunity to “leave” market Walmart Health & Wellness - What is our role?

Consumer Buying Decisions Walmart Health & Wellness - Confidential

18 Consumer Buying Decisions Walmart Health & Wellness - Address how members feel Add comfort into the decision making process United Hopeful Empowered Savvy Passive Consumers Confident Consumers Adapted from: 2015 Consumer Mindset Survey, Aon, NBGH 2015

19 Consumer Buying Decisions Consumer Frustrations: Complexity Competing life priorities $’s Time Clear information Terminology Inconsistencies across offerings Expectations Lack of experience Simplicity of Amazon, Walmart.com, others Change!! Walmart Health & Wellness - Respond to consumer wants: Simple choices & process Comprehensive communication Incentives Personalized & relevant Third party trust with recognizable brands! Customizable Peer interaction Chat features Forums Brand recognition within offering

20 Consumer Buying Decisions Walmart Health & Wellness -

21 Consumer Buying Decisions Walmart Health & Wellness - The birth of the healthcare consumer, 2014, pwc Know your population

22 Consumer Buying Decisions Bigger is not always better –Retail healthcare is acceptable –Networks need to be adequate –Appropriate facility care is a must Employer decision points do not reflect consumer decision points –Cost is an issue based on income & disposable income –X does NOT equal y –Consumerism can work Tools and modeling are a “Must have!” –Transparency –Cost sharing& Total costs –Access modeling –Terminology and dictionary Trusted brand recognition is relevant –Providers –Carriers Walmart Health & Wellness -

Questions Michael S Jacobs RPh Walmart Health & Wellness - Confidential