1. Banner Health Deborah Dahl VP Patient Care Innovation November 6, 2015 One Providers View of Telehealth Regulation

2. Banner Health 29 Acute Care hospitals Heart Hospital Children’s Hospital Behavioral Hospital Banner Health Network ACO 400,000 members Banner Health Center and Clinics Banner Medical Groups ~ 1,900 Physicians 3.1 M visits/year Ambulatory Care Operations $7.2 Billion revenue AA- bond rating $444 Million in community benefit including $180 million in charity care (2015 thru September)

3. Telehealth across the Continuum Provide hospitals and health systems a sustainable model for 24x7 clinical support of patients across the care continuum Enable enhanced care delivery integrating a centralized Telehealth Center to leverage scarce resources and improve transitions for patients across care areas

4. The rule of 7’s 7 states 70 settings 700 health plans 7,000 Practitioners 7,000,000 members

5. Hope on the Horizon The Telehealth Modernization Act of 2013 (H.R. 3750) includes the following principles: Informed care: A healthcare professional should have access to and review the medical history of the individual he or she is treating via telehealth. Diagnosis: The health professional should have an interactive conversation with the patient adequate to establish any diagnosis rendered. Documentation: A health professional should document the evaluation and any treatment furnished to the patient, as well as generate a medical record of the encounter. No assurance of outcome: A health professional should make no assurance regarding an outcome, including receiving a prescription. Prescription requirements: Prescriptions provided by the professional should be issued for a legitimate medical purpose only. The prescription should not be a controlled substance and must be filled by a valid dispensing entity.

6. HR 3077 & HR 3750 HR 3077, the TELE-MED Act, would permit certain Medicare providers licensed in a state to provide telehealth services to Medicare beneficiaries in a different state. HR 3750, the Telehealth Modernization Act, would promote the provision of telehealth by establishing a federal standard for telehealth, and inducing all states to adhere to the regulations