1. A Blue Cross and Blue Shield Association Presentation Consumers Take Center Stage 2007 Health Leaders Forum Federal Reserve Bank of Chicago and Detroit Regional Chamber Detroit, Michigan April 24, 2007 Scott P. Serota President & CEO

2. 2 27009 8 Meet Meredith Building a Better System Consumers Take Center Stage Consumers Take Center Stage The Blues Agenda

3. 3 27009 8 Blues are the strongest Brand in healthcare across America #1 Brand Solid Financials Quality Provider Networks Record Enrollment The Blues

4. 4 27009 8 Blues Enrollment Customers (in millions) Blues member enrollment is at an all-time record high

5. 5 27009 8 Extending the Brand into high-profile international markets International Markets BlueCard Worldwide offers U.S. customers access to medical assistance worldwideBlueCard Worldwide offers U.S. customers access to medical assistance worldwide 7,000 physicians in 200 countries7,000 physicians in 200 countries 850 hospitals in 84 countries850 hospitals in 84 countries BlueWorldwide Expat provides specialized insurance product for expatriatesBlueWorldwide Expat provides specialized insurance product for expatriates 100+ accounts100+ accounts 700 lives700 lives Blue Brands licensed to independent companies in 50 countries in Europe, Central America and South AmericaBlue Brands licensed to independent companies in 50 countries in Europe, Central America and South America 5.5 million international subscribers5.5 million international subscribers

6. 6 27009 8 Agenda Meet Meredith Building a Better System Consumers Take Center StageConsumers Stage The Blues

7. 7 27009 8 A New Healthcare Model for the Future A true consumer-centric healthcare system for the future should clearly focus on the wants and needs of consumers Current Model Provider Consumer Employer Payer Government Future Model

8. 8 27009 8 With more than 75 million lives, BHI leads in data scope and depth and is helping shape a future healthcare delivery model Shaping a Future Healthcare Model Shaping new care delivery modelShaping new care delivery model –Partner with providers on outcomes and care patterns –Robust information for consumer decision-making –Support policy development State-of-the-art informaticsState-of-the-art informatics –Precise data –More statistically valid measures –Benchmark data across geographies

9. 9 27009 8 Bank supports new Consumer-Directed Health Plans and HSAs, offering consumers integrated and easy-to-use service Support growing number of Blue Plan CDHPs and HSAsSupport growing number of Blue Plan CDHPs and HSAs Easy-to-use, seamless and fully integrated consumer serviceEasy-to-use, seamless and fully integrated consumer service Simplify healthcare spendingSimplify healthcare spending Full line of financial servicesFull line of financial services Chartered to serve all 50 statesChartered to serve all 50 states Serving Consumer Healthcare Financial Needs

10. 10 27009 8 Agenda Meet Meredith Building a Better System Consumers Take Center Stage Consumers Take Center Stage The Blues

11. 11 27009 8 Better Knowledge for Healthier Lives Engaging consumers to enable more informed healthcare decisions Collaborating with providers to improve quality outcomes and affordability Helping consumers make more informed decisions while helping providers improve health outcomes and affordability

12. 12 27009 8 Collaborating with Providers to Raise Standards Primary Care Medicine Specialty Care Medicine Raise standards, ensure more consistent quality care Other Organizations Surgical Care

13. 13 27009 8 Higher Standards Mean Better Care Bariatric surgery Cardiac care Transplants Cancer care Specialty Care Centers focus on most challenging conditions Developed in close collaboration with leading medical providers and specialty organizations

14. 14 27009 8 Centers for Specialty Care: Transplant There are 70 evidence-based Blue Distinction Centers for Transplants in local communities nationwide Blue Distinction Centers for Transplants

15. 15 27009 8 … and 125 Blue Distinction Centers for Bariatric Surgery Blue Distinction Centers for Bariatric Surgery Blue Distinction Centers for Transplants Centers for Specialty Care: Bariatric Surgery

16. 16 27009 8 Blue Distinction Centers for Cardiac Care Blue Distinction Centers for Bariatric Surgery Blue Distinction Centers for Transplants … and 375 Blue Distinction Centers for Cardiac Care Centers for Specialty Care: Cardiac Care

17. 17 27009 8 Higher Standards Yield Better Care Short-Term Major Complications for Bariatric Surgery Inpatient Mortality (Heart Attack) SM Mean Maximum

18. 18 27009 8 Investing in Patient Quality and Safety Blues contributed $5M to “5 Million Lives” campaign Campaign aims to protect five million lives through: – –Proven infection control practices – –Evidence-based practices for congestive heart failure – –Deployment of rapid response teams – –Reduction of adverse drug events Example: Partnership with Institute for Healthcare Improvement

19. 19 27009 8 Meet Meredith Building a Better System Consumers Take Center Stage Consumers Take Center Stage The Blues Agenda

20. 20 27009 8 Meet Meredith “I weigh more than I should”“I weigh more than I should” “I have a family history of heart disease”“I have a family history of heart disease” “My doctor just told me I need a coronary bypass”“My doctor just told me I need a coronary bypass” Meredith is confronting several serious health problems

21. 21 27009 8 Meredith’s Dilemma A few years ago, Meredith would have had limited options for help in deciding what to do about her health problems Get advice from friendsGet advice from friends Ask her doctor for recommendationsAsk her doctor for recommendations

22. 22 27009 8 More Options Today More Options Today With programs like Blue Distinction, Meredith has access to more pertinent information to make informed decisions Compare bypass centersCompare bypass centers Identify success criteria of several hospitals for treating heart diseaseIdentify success criteria of several hospitals for treating heart disease Manage costs while seeking best possible careManage costs while seeking best possible care Connect with and learn from the experiences of other bypass patientsConnect with and learn from the experiences of other bypass patients

23. 23 27009 8 More Useful Consumer Tools on the Horizon Market testing with hundreds of employees of Fortune 100 companies nationwideMarket testing with hundreds of employees of Fortune 100 companies nationwide Testing a broad range of cost and quality measuresTesting a broad range of cost and quality measures Identifying consumer preferences for display designIdentifying consumer preferences for display design Measuring impact on consumer decision-makingMeasuring impact on consumer decision-making Meredith and other consumers like her are helping shape healthcare decision-making tools to enhance transparency

24. 24 27009 8 Simplifying Information for Meredith Offer consumers valuable information that is easy to use Note: this picture is hypothetical and strictly for illustrative purposes Benchmarks and thresholds Care-specific clinical quality metrics Accessible logistical information Robust patient satisfaction data

25. 25 27009 8 Collaborating with stakeholders to create consumer PHRs Blue Cross and Blue Shield Companies Plan PHRs for 2008 Personal Health Records for Consumers

26. 26 27009 8 In the Future, Consumers Are Center Stage Picture a consumer-centric, information-driven system Hospitals Health Plans Financial services / tools Rx Pharmacy Other Providers (e.g. care managers) Physicians Labs Health and Wellness Consumer

27. A Blue Cross and Blue Shield Association Presentation Consumers Take Center Stage 2007 Health Leaders Forum Federal Reserve Bank of Chicago and Detroit Regional Chamber Detroit, Michigan April 24, 2007 Scott P. Serota President & CEO