The Qliance Direct Primary Care Medical Home: Improving Care and Reducing Costs Presented to: CLG Employer Resources

1. The Qliance Direct Primary Care Medical Home: Improving Care and Reducing Costs Presented to: CLG Employer Resources Erika Bliss, MD – President & CEO of Qliance August 9, 2012

2. Current Healthcare Costs: Fiscal Cancer • 17% of GDP, projected to be >19% by 2017 • 62% of bankruptcies in 2010 were due to medical expenses • Primary care is severely underfunded (only represents 3% of medical expenditures) • Burdensome fee-for-service insurance billing system undermines potential of primary care Total annual healthcare costs = $2.6T ($8047 per person per year) Qliance Confidential & Proprietary

3. The Effect of Inadequate Primary Care ($$$) Emergency Care ($$$) Hospital Care An ineffective primary care system pushes patients to expensive down-stream care. The result is an increaseinhealth care costsfor employers and employees. PrimaryCare ($$$) Specialist Care ($$$) End of Life Care Qliance Confidential & Proprietary

4. ($) Hospital Care ($) Emergency Care Effective Primary Care Changes the Dynamic… • Primary care can address 80-90% of medical issues • Primary care can catch little problems(hyperglycemia) before they become big problems (diabetes) • Robust primary care reduces need for expensive downstream care • But, good primary care requires doctors to spend time with their patients PrimaryCare ($) Specialist Care ($) End of Life Care Qliance Confidential & Proprietary

5. The Solution: • Operate outside of traditional insurance • reserve insurance for undesirable, costly events • pay direct for primary care which is desirable and low-cost • eliminate high administrative overhead for primary care practices • Charge a monthly fee • low-cost: $64 per month • eliminates negative incentives of the fee-for-service system • incentivizes doctors to focus on holistic care • no co-pays or additional charges for visits and services • Provide great access • limit patient panel size • offer 30-60 minute appointments • multi-modal access, including office, phone, and e-visits • extended office hours and weekend hours • 24x7 physician coverage Qliance Confidential & Proprietary

6. The Qliance Mission • Re-establish the direct relationship between doctor and patient, allowing time to develop trust and foster a partnership that promotes and sustains health. • Dedicate ourselves to providing care that is personal, high-quality, accessible, and most of all, humane. “If you give them enough time, your patients will tell you what is wrong with them. Time to listen to a patient is what is missing in today’s system.” -Garrison Bliss, MD, Qliance Founder Qliance Confidential & Proprietary

7. Preventive Care Qliance: All-Inclusive Primary Care Urgent Care Wellness Care Specialist & Hospital Care Coordination Chronic Disease Management Enhance primary care to increase quality & control costs Behavior & Lifestyle Management Qliance Confidential & Proprietary

8. Qliance Patients Use Less Downstream Care * Based on best available internal data, may not capture all non-primary care claims. ** Based on regional benchmarks from Ingenix and other sources. *** Based on average costs in WA State. ****No additional cost for additional primary care visits in the Qliance model. Source: Qliance Medical Group non-Medicare patients, 2010 (n=3,088)

9. How DoesQlianceImprove Member Health? • Gives members the care and resources they need the way they want it. They want: • To feel better • To not feel rushed, with: • Enough time with their doctor to understand what’s wrong and what they need to do next • Enough time with their doctor to understand their choices • Appointments when they need them • Convenience (onsite lab, common DME, X-rays, etc.) • Help over the phone or by email instead of coming in • Expert advice on the best specialists or hospitals to get the best care

10. How Does QlianceReduce the Overall Cost of Care? • By shifting focus to primary care that includes at no extra cost to the member: • Longer appointments • Basic x-rays and labs onsite • First fill drug dispensary • Routine DME • Establishing trusting relationship with patients so we can positively influence their decisions and behaviors • Being available when patients need us so they don’t have to go to urgent care or emergency rooms • Reducing self-referral to specialists • Coordinating specialist, ancillary, and hospital care, making sure they get the right care at the right time

11. Plan Integration Examples

12. Our Clinics Opening soon in Bellevue! Qliance Confidential & Proprietary