Leveraging Integrated Hospital Care to Revenue Cycle Management

1. Leveraging Integrated Hospital Care to Revenue Cycle Management Pharmacist enabled chronic care cycle management

2. Foreword • Care cycle management of patients in the Meridian system require more integrated foundation and experience in order to increase total reimbursement mix. • Forward looking innovation coupled with risk minimization can drive cultural change and increase adoption speed towards market changes. • Drawing value and delivering accountable management techniques will decreasoeperationalfriction to improves outcomes, reduces waste and increase efficiency.

3. Objectives • Finalize current pilot initiative to expand, grow and leverage pharmacy operations to optimize HCAHPs scores. • Explore, pilot and demonstrate capabilities of pharmacist interventions at inpatient and outpatient setting aligned to hospital revenue goals of HCAHPs, Readmissions, Costs and Revenue generation. • Evaluate, initiate, develop and prepare processes for outpatient pharmacy program management including medication reconciliation and adherence, HCAHPs pull through, Annual Wellness Exam enrollment and Transition of Care Management initiation.

4. Overview • Cost Savings and Revenue Generation Options • All Unit HCAHPs Program • Transition of Care Management (TCM) • Medication Adherence (iMPAK Health Customer Validation) • Medication Reconciliation Process Change • Inpatient Program Expansion • Program Overview • Timeline • Implementation Keys • Process

5. Strategic Hospital and Corporate ValueService additions and program management leads to growth in operating margins

6. Strategic Value & Importance Weight of value predominantly relies on timing, location, benefit upside and immediacy of margin improvement Medication Reconciliation Process Change HCAHPs Program Roll Out iMPAK Health ED Pharmacist HCAHPs Program Low High Current Level Of Strategic Value & Importance Medication Adherence Pilot and Validation Outpatient Pharmacy TCM Program Transition of Care Management Service Role & Billing Annual Wellness Exam/CLIA Waived Exams

7. Program Roll Out Overview 5 Key Programs lead incremental improvements in operating margins and efficiency aligned to outcomes, talent management and patient journey improvement

8. 1. HCAHPs Nursing Unit Program Overview10 week comprehensive program enables nursing to own patient experience with ‘as needed’ interventions

9. 2. Transition of Care Program Overview CMS (CPT) Billing codes of transition of care management can be explored for enhanced discharging and profitability

10. 3. Med. Adherence Program Pilot Overview10 Week Program focuses on medication adherence and follow up validates iMPAK Health product acquisition value

11. 4. Med. Reconciliation Program OverviewProgram shifts work burden to pharmacy owned med rec upon admission and oversight of stay and discharge med rec

12. 5. Outpatient Pharmacy OptimizationRiverview Outpatient Pharmacy preparation and diligence are key to maximizing future hospital revenue and value

13. Program Timelines 1 1 1 2 2 2 3 3 3 Q1 4 4 March April May June J - S 1 2 3 4 Program Development (HCP Partnership) Exploration & Discussion Training Initiate Med Adherence (iMPAK Health) Program Medication Reconciliation Discussion TCM Program HCAHPs Program iPad Program Pilot Report 2 Report 1 Execute Report 2 Accountability Report 1 Monitoring Pilot Enrolment Monitoring Ends Role fulfilment Employment Assess KPI Assessment Product Assessment Program Begin

14. Implementation Process & Strategy • As ACO models continually shift against CMS changes for reimbursement, it has become more clear a team-based care approach would improve outcomes and reimbursement. • Key Execution Points • Individual practitioners require more conscious use of talent including knowledge of skill set building and enhancements. • ‘Group think’ surrounding feedback transparency with accountability reporting towards results will induce sentiment change. • Employee sentiments require increased desire to align towards results. (Multifaceted Drivers*) • Technology surrounding information and communication can optimize fluidity and continuity of care for patient satisfaction. • Partnership with commercial cross functional departments can leverage increased value to hospital stakeholders and carve out Riverview’s niche amongst future competition. Objectives: Review future pharmacy outlook and evolution. Understand potential upside and exploration points to enhance community perception. Align on program next steps and initiate communication needed.

15. Pharmacist Enabled Care Cycle Management 4. CRM Contact * 1. ER Pharmacist 2. Pharmacy Oversight 3. Video: Pharmacist