Pay-for-Performance Health Risk Management - Driven Onsite Clinic

1. Pay-for-Performance Health Risk Management - Driven Onsite Clinic HR Specialty Products & Services Catalogue Executive Summary A No Frills Distillation of Vendor’s Marketing Collateral Thomas A Ference President & CEO Human Resources Mining & Distribution Co Locating, Validating and Accelerating HR  Innovation Office: 219-662-0201 Cell: 630-240-2583 Fax: 219-661-0236 e-mail: tference@hrmdco.com Website: www.hrmdco.com

2. Typical onsite clinic vendor focuses solely on providing healthcare services and not managing employee health risk • Full time vendor-provided onsite health coach/clinician • Primary, acute and episodic services for (at your option) occ-health, non-occ-health plus  LM, DM, Rx and Fitness Center • Automated evidence-based and decision support system originally begun 15+ years ago for the Department of Defense and now supported by over 30 full-time research clinicians • Reduces 50% error rate found in physicians’ memory-based diagnoses and recommended treatments • Integrated PHR/EMR for improved patient/clinician experience, measuring improved health management , evidence based care • Health professionals skilled in motivation, education, personal goal setting, and behavior change coaching Pay-for-Performance Onsite Clinics

3. Clinic funded by dollars now being spent in the healthcare plan • Fixed fees vs. cost-plus so as not bias service delivery • Immediate medical savings by re-directing most primary care to convenient, lower cost setting. Also reduces lost work time • Removes $500K of excess medical cost/1000ees/year • Meaningful fees put at risk based upon improvement in health risk factors (e.g. smoking, obesity, etc.) as determined by the employer or a reduction in claims • Real time executive dashboard reporting on ROI and all clinic utilization. Shows what services would have cost on the outside • Need 350 employees plus their dependents per location or can deploy “circuit rider “ approach • ROI = 1.5 Year 1 to 4.0 Year 3 Pay-for-Performance Onsite Clinics

4. Value of Population Health Risk Model Specialty referral rate  20% ER/UC utilization  20% Hospitalization rate  5%-10% Rx spend  5%-7%

5. Risk Mitigation at the Onsite Clinic Year 1 Results Outside Range Making Progress Within Range Body Mass Index Blood Pressure Serum Glucose LDL Cholesterol Smoking Risk Mitigation (Year 1) At outset 17% of the population had high cholesterol … MN Average 36.9% (NHANES) 34% 12 months later, 40% of those with high cholesterol had lowered it but were still at risk … US Average 30.7% (NHANES) And 22% had gotten their high cholesterol under control… US Average 26% (ADA) 25% 24% US Average 16.6% (NHANES) 17% MN Average 19.7% (NHANES) 50% 48% 11% 25% 35% 40% 25% 12% 22% 35% 18% BMI> 30 > 100 mg/dl > 130 mg/dl Present > 140/90 mmhg

6. Capture Measureable Savings 9% Annual Trend Expected -3% Actual Trend Post Implementation

7. This product/service is contained in the HR Specialty Products & Services Catalogue™ • Operational level details about this particular service provider can be obtained in conference with the vendor • The HR Mining &Distribution Co. is an independent and contracted representative of the vendor • Upon your request, we will arrange for an introduction that can range from a simple, quick conference call to a services overview / system demo • Tom Ference 219-662-0201 (Chicagoland area) or tference@hrmdco.com • Thank you for your potential interest in this fresh thinking Next Steps