Pratter Inc. | The Pratter Effect: Revolutionizing Healthcare Cost Transparency

1. Pratter, Inc. Bill Hennessey, MD, CEO bill.hennessey@pratter.us Health Benefit Innovator Award Winner

2. The Pratter Effect • Help millions save billions on medical care • Create Medical Cost Transparency to encourage competition and generate a win-win for employers and their employees. • Allow employers to control and manage their healthcare costs via web-based solutions designed for ease-of-use. • Medical cost transparency definition: know charge (retail rate) and known claim allowable (“discount” real price paid) before the time of service

3. The Problem: Employers Cannot Manage Health Costs • Real consumerism does not exist resulting in advantage to the carriers and hospitals. • In-network pricing for the same care item has HUGEpricing variation. • Employees, aka health care consumers, don’t care or, aren’t incentivized to care, about helping the company manage its medical care costs. • Employers pay medical bills blindly with no ability to manage costs proactively. TM

4. Pratter 4 Question Value Prop • Do you audit your medical claims? • Do you know your top 20 medical cost drivers by medical test name? • Have you itemized your top 20 medical cost drivers? • Can you quantify a medical cost savings solution you implemented? • Bonus question: If not, why not? TM

5. Pratter’s Medical Cost Transparency TM • Known pricing creates smart shopping. • Known pricing creates competition. And with competition, the consumer wins every time with lower prices. • You manage what we measure. • An itemized medical bill for employers to review. • ERISA health benefit fiduciary compliance.

6. The Other Guys(not Pratter) TM • Misaligned financial incentives. • Talk discounts, points and benchmarks – all smoke and mirror terms. Let’s talk real money numbers. • Do not know what type of medical claims data is stored or how to access it. • Never address ERISA health benefit fiduciary. • Never address specifically why the health plan cost goes up each year.

7. Pratter’s Focus: Outpatient Care • 27 to 64 year olds receive mostly outpatient care • Outpatient care = Routine care = Commodity care • Outpatient care: • Blood work • Imaging • Surgery center procedures, eg upper GI scope • Urgent center care TM

8. 5 Places to Purchase Healthcare TM • Hospitals • Independent Surgery Centers • Freestanding MRI/CT centers • Independent blood work centers • Private practice doctors Our focus is on substantially reducing the hospital facility fees that drive medical costs up faster than company or salary growth. *listed in order from most to least expensive

9. Medical Facility Fee Example“Lumbar MRI” TM Facility Monroeville Imaging Center Relevant Healthcare Jefferson MRI UPMC Mercy UPMC Magee Presby Range of Fees Charged $ 350.00 $ 475.00 $ 1,157.00 $ 2,734.00 $ 4,413.00

10. GOAL: Known Pricing and Money Incentives TM • Provide known pricing for common procedures, just like the rest of your life

11. The Cause: Secret Pricing • 33% of a company’s medical spend can be saved on routine care. • 500% to 1,000% - the typical pricing variation of in-network cost drivers at the claim allowable. • Top 10 routine care items make up 40% to 50% of the routine medical spend, yet employers don’t know these cost drivers by test name to create focused solutions. • Routine care does not have itemized pricing, just like everything else we purchase. • Carriers make more when employees spend more; misaligned financial incentives as carriers keep 20% of revenue as profit per ACA. TM

12. The Pratter Solution TM • Use self-insured employers’ real paid medical bills. • The Pratter Report. Our MCSA (medical cost savings analysis) prepared by the Pratter team of analysts. Identify, itemize and target cost drivers for savings. • Pratter.us search and save engine – real employer data goes here. • Pratter money maps – best-priced commodity care providers per carrier network. • Pratter Savings Cards – the “money map in your wallet” customized to where you live. • Cost Concierge Service with medical billers. • Pratter guides employees to low cost in-network medical providers to save medical money.

14. Pratter.us Cost Search Enginesearchable by Zip Code TM

15. Pratter maps it out! TM • Pratter’s non-hospital, medical cost transparency network, in-network medical providers for commodity care, color-coded by provider type

16. Pratter Savings Cards TM • The “money map in your wallet” • An “insurance card,” two per household, customized to the network as well as where each employee lives • MasterCard money reward for care at these in-network providers

17. The Pratter MasterCard Reward Card TM • Money Motivates  Money Map care  MasterCard cash reward • MasterCard reward for best-priced, commodity care medical facilities where employees can go to receive medical care for free; identified by the Pratter map and all in-network • MasterCards are white-labeled with company logo and personalized by name; in partnership with ADP’s existing Global Cash Card technology and service • How much medical money is in your wallet?

18. Pratter Price Tag Guarantees TM • Pratter pursues price tag guarantees from low cost to in-network medical providers • Best pricing marked with orange price tag! • Make medical providers compete for your business • Healthy narrow network for cost drivers

19. Independent TPA Solutions TM • Healthy narrow network for cost drivers • Health plan tier design for cost drivers • Direct provider contracting • On-site and near site clinics and DPC doctors • Medicare reference-based pricing • HRA preferred commodity care network, aka “Pratter network” • MasterCard money reward card

20. BUCA TPA Solutions TM • MasterCard cash reward card • HRA preferred commodity care network, aka “Pratter network”

21. Pratterization Methods TM • Money map • Pratter.us search and save • Pratter savings cards • Cost concierge service • MasterCard cash reward

22. 10% of Health Plan Spend Can Be Saved TM • Save 1/3 of 1/3 or 10%on outpatient care • Ex: $10M plan spend - $3M potential savings – 1/3 due to pricing variation - $1M savings or 10% of $10M spend. • 30% to 40% of the outpatient care spend could be saved by empowering and incentivizing employees to receive medical care at lower priced places in-network, specifically knocking down facilities fees that drive costs up

23. Get Prattered! TM • Leverage your medical claims • Understand the five places to purchase healthcare • Guide employees to low cost, in-network medical providers for routine care • Incentivize with money • ERISA compliance as the health benefit fiduciary • More money left in the company coffers to fuel company growth • For the first time in history provide a true cost transparency network! A true WIN-WIN for both employer & employee!

24. Bill Hennessey, M.D. CEO Pittsburgh Office Email: bill.hennessey@pratter.us Cell #: 724.787.3925 Questions?