Provider Financial Strategies in the New Order: Physicians of SW Washington Perspective

1. Provider Financial Strategies in the New Order:Physicians of SW Washington Perspective 2015 Washington State of Reform Health Policy Conference Hilton Seattle Airport Conference Center January 8, 2015

2. Physicians of Southwest Washington, LLC • Independent Physician Association established 1995 • 90 physician Unit Holders, both primary care and consultants • Network of 400+ physicians, hospitals and other providers in Thurston and Lewis Counties • Model: Global Capitation Risk Agreements, Medicare and Commercial HMOs including delegated credentialing, medical management and claims processing • Current Agreements: MA only – Humana and Soundpath Health ~ 6000 risk lives • Separate Non-Profit Foundation: Healthy Communities

3. PSW Mission Statement The mission of Physicians of Southwest Washington is to support the physician-patient relationship in the independent practice of medicine through: • Fair contracting; • Responsible resource utilization; and • Prudently adopted innovations in health care delivery. PSW is committed to quality improvement, clinical integration and meaningful measures of value

4. PSW Financial Strategies • Engaged, Informed, Motivated Physician Leadership • Risk Adjusted, Capitated, Primary Care Reimbursement • Clinical Integration • Improved Clinical Care Transitions • Provider Office Support for Accurate Documentation and Associated Risk Adjusted Coding • Expanded and diversified ‘value’ and ‘risk based’ contracting • Informed and Empowered Patients

5. 2015+ Health System Challenges • Reimbursement: - Uncertainty about pace of reimbursement transitions from volume to value - Near term reductions in FFS • Delivery System Consolidations and Definitions • Limitations in clinical data sharing among EMR’s • Pending Provider Shortages • Varying Definitions of ‘Waste’

6. 2015 Strategies • Expanded payor contracts • Expanded role of Chief Medical Officer • Implementation of clinical integration software platform to enhance population management capacity • Expanded nurse case management program • Support services for implementation of new ‘clinic without walls’ • Investment in medical and administrative leadership development and succession planning • Liquidation of equity interest in MA health plan

7. Recommendations • Business Concepts to Consider: -New Employee Motto #1: Flexible or Former -New Employee Motto #1: Failure Isn’t An Option -Bigger may not be better – ability to move quickly may be more important -Financial “Risk” is an OK four letter word • Focus on Quality Not Cost • Seek Long Term Partnerships Across Blended Spectrum of Health Industry • Data Transparency • - Demand it from All Partners • - Lets share what worked and what failed

8. For Further Information Mariella Cummings, CEO mariellac@pswipa.com (360) 943-4337