WellSpan Health Leadership Forum Leading our organizational improvement journey

1. WellSpan Health Leadership ForumLeading our organizational improvement journey July 17, 2014

2. Today’s agenda • WellSpan and the Central PA Region • Getting to Know: Bruce Solomon • FY 2015 Operating Strategies • The Improvement Imperative • Quality, patient experience and performance improvement • How Enhanced Performance Contributes to a Financially Strong Health System • Mastering the Matrix • Final Thoughts

3. WellSpan and the Central Pennsylvania Region:What has happened this past year? Dr. Kevin Mosser

4. An action-packed time for the industry and WellSpan • Affordable Care Act moves forward; more than 7 million enroll in public exchanges • CEO retirement, transition • Senior leadership reorganization • Integrationwith Ephrata Community Hospital • Many unplanned, but important priorities (physician compensation, practice integration)

5. The regional marketplace has Continued to evolve and consolidate Geisinger P.S. Hershey Medical Center Good Samaritan Pinnacle Health Reading Hospital Holy Spirit Hospital Carlisle Regional Medical Center WellSpan Ephrata CommunityHospital Heart of Lancaster Regional Medical Center (HMA) Lancaster RegionalMedical Center (HMA) Lancaster General Health Memorial Hospital WellSpan York Hospital Chambersburg Hospital WellSpan Gettysburg Hospital Waynesboro Hospital Hanover Hospital

6. Amid the activity, we executed on a new system of care in Lancaster County… • New Ephrata Community Health Foundation • Integrated leadership teams and administrative functions • Aligned brands • New Maternal-Fetal Medicine Practice • MyWellSpan in Lancaster County • Integrated research efforts • Coming Up: • Integrated staff email, IT, timekeeping, employee payroll and benefits • New PCP office in Manheim • Expanded Plain Community Program & DME • Integration of NLCMG, Home Care, Urgent Care & Wellness Programs

7. …built new bridges with regional partners… • GSHS & WSH Due Diligence since January • Definitive Agreement possible soon

8. …built new bridges with regional partners… • Vascular Services, in addition to Orthopedics, Gastroenterology and Radiation Oncology • Level II NICU at Chambersburg Hospital and Pediatric Service at Waynesboro, in addition to Telestroke and Maternal-Fetal Medicine

9. …and continued to collaborate with organizations beyond Central Pennsylvania • Began to explore hospital throughput initiative • Continue to evaluate others: • Group purchasing • Shared laboratory services • Jointly sponsored ASO for health plans • Common medical management platform • Common approach to engaging the community in end-of-lifedecision-making

10. We’re now helping more friends and neighbors manage their health • 500+ covered lives in several local companies • Anticipate approximately 2,500 covered lives by the end of 2015 • Exploring similar relationships with other payers Brewery Products Inc.

11. …and reach their goals through patient-centered medical homes WellSpan Medical Group – Level 3 Recognition Adams Cumberland Family Medicine, Apple Hill Internal Medicine, Biglerville Family Medicine, Brockie Internal Medicine, Dover Internal Medicine, East Berlin Family Medicine, Gettysburg Adult Medicine, Hayshire Family Medicine, Herrs Ridge Family Medicine, Pine Grove Adult Medicine, Stony Brook Family Medicine, Thomas Hart Family Practice, Thurmont Family Medicine, York Hospital Community Health Center, and Yorktowne Family Medicine = 15 practices WellSpan Medical Group – Level 2 Recognition Gotham Internal Medicine

12. We continued to remodel our organization for the future, which required some tough decisions • System-wide approach to courier services • Single process, outsourced to company with specific expertise • Private-duty services in the home • Eliminated VNA’s Community Services Program • Transitioned current patients to respected local provider • Greater focus on skilled nursing services • Access to primary care for the uninsured • Celebrated the success of HealthConnect • Discontinued service based on current and future environment

13. In general, we found many bright spots in 2014 • Culture of Improvement: • Value Analysis Teams • Patient Safety • MyWellSpan: More patients • New Markets: Lancaster County & Northwest York • National Recognition for Population Health: • PCMH, Care Mgt. Teams, AllSpire • New Business Model • TOGETHER, WE HAVE: • Advanced the Strategic Plan • Executed on the Annual Operating Plan • Been Resilient • Focused on Achievement

14. So what? Are we safer and more clinically reliable? Are we easier to use? Are we better prepared for the future?

15. Are we safer? More clinically reliable? • Yes. • Survey on Patient Safety Scores • WellSpan Gettysburg Hospital and WellSpan Surgery & Rehabilitation Hospital in top quartile • WellSpan Medical Group and WellSpan York Hospital statistically significant improvement • Crew Resource Management • 100% compliance with four cardinal elements • Discharge Instructions • SCIP But, there is much to do. Mortality Rates Inconsistency in our Treatment of Sepsis Medication Reconciliation Suboptimal Across the System

16. Are we easier to use? Yes. MyWellSpan Portal – 24/7 • Online appointments • Same-day access to lab results • Secure messaging with providers • Proxy access for parents of children under age 18 Expanded Hours – Walk-in Care Call Center – Improved Telephone Metrics and Staff Training But, there is much to do. Pace of improvement behind the rest of the country, which adversely affects our overall performance • Inconsistent patient experiences across the system • Provider communicationand coordination • Handoffs

17. Are we better prepared for The future? Yes. WellSpan Medical Group Clinically Integrated Physician Organization (WPN) Well-developed Continuum of Care Strong Financial Performance Building capacity for Population Health and New Business Model Strong Brand But, there is much to do. Lack of a Single Patient Information System, Multiple Platforms Significant Waste via Lack of Standardization Ongoing Development of the Patient-centered Medical Neighborhood Continued Development of Premium-based Contracts with Third-party Payer Organizations

18. As leaders, we must remain focused on creating a system for the future. That requires change… Develop services to serve patients in a new environment Re-design to reduce variation Accelerate Performance Improvement

19. …and a sense of urgency, without panic. “Help others see the need for change and they will be convinced of the importance of acting immediately.” -Dr. John Kotter, Best-selling Author, Business and Management Thought Leader

20. Questions?

21. Getting to Know Bruce Solomon

22. Question #1: What does Bruce like best about working at WellSpan?

23. What does Bruce like best about working at WellSpan? • The food at the WellSpan Surgery & Rehabilitation Hospital • Our organizational culture • The balmy winter climate of south central PA • The wit and brilliance of the WellSpan CEO

24. Answer:Our organizational culture

25. Question #2: In what city was Bruce born?

26. In what city was Bruce born? • Macungie, Pennsylvania • Walla Walla, Washington • Brooklyn, New York • Cambridge, Massachusetts

27. Answer:Brooklyn, New York

28. Question #3:Which of the following jobs did Bruce once hold?

29. Which of the following jobs did Bruce once hold? • Regional Coordinator of the ACLU • Executive Director of a health care system for the homeless • Short order cook • State Senator

30. Answer:Executive Director of a health care system for the homeless

31. Question #4:With which of the following hobbies does Bruce spend most of his non-work time?

32. With which of the following hobbies does Bruce spend most of his non-work time? • Reading • Golf • Fencing • Yoga

33. Answer:Yoga

34. Question #5:Which of the following describes the profession of Bruce’s wife, Dr. Joan Lebow?

35. Which of the following describes the profession of Bruce’s wife, Dr. Joan Lebow? • Internist • Cardiologist • Professor of anthropology • TV psychologist

36. Answer:Internist

37. Question #6:How many children do Bruce and his wife have?

38. How many children do Bruce and his wife have? • Three • One • Five • Six

39. Answer:Three

40. Question #7:From which institution of higher education does Bruce hold an advanced degree?

41. From which institution of higher education does Bruce hold an advanced degree? • University of Pennsylvania • Cornell University • University of Minnesota • Tulane University

42. Answer:Tulane University

43. BREAKMaking Connections… Introduce yourself to 1-2 other leaders in the room who you haven’t previously met and share: Your name Your leadership role Any special vacation plans for this summer

44. The Next 12 Months: Advancing the WellSpan 2020 Strategic PlanFY 15 Operating PlanMaria RoyceSr. Vice President, Planning & Community Development

45. Today’s Presentation • Our Mission: Working as One • WellSpan 2020 Strategic Plan • WellSpan Operating Plan • Final thoughts on FY14 • Introducing FY15

46. Planning… A Roadmap for Working as One Objectives Strategy 1 Objectives Objectives Strategy 2 Objectives Values Mission Vision Objectives Strategy 3 Objectives Strategy 4 Objectives Objectives Strategic Plan (10 years) Operating Plan – Blue Book (annual) Objectives Strategy 5 Objectives Objectives Strategy 6 Objectives Objectives Strategy 7 Objectives Objectives Strategy 8 Objectives Strategy 9 Objectives Objectives

47. WellSpan Mission Working as one to improve health through exceptional care for all, lifelong wellness and healthy communities.

48. WellSpan Mission Measurably improving the overall health of an individual or population is the reason we exist… We are moving beyond “just sick care" No one can do it alone…WellSpan’s success in the future will depend on integration, teamwork, collaboration, and partnerships The health of the individual…supporting patients in optimizing their health and achieving personal wellness through prevention and healthy lifestyles What our community expects from our illness and injury care Working as one to improve health through exceptional care for all, lifelong wellness andhealthy communities. The most difficult aspect of our work, tackling the root cause of most illness and disease Our non-profit, charitable purpose

49. Our mission is penetrating the organization, and we are recognizing opportunities for improving how we function as a team • 88% (nearly 9 out of 10) WellSpan employees are familiar with the mission of “Working as One” • 95% agree that they understand the importance of Working as One • 79% (nearly 8 out of 10) employees agree that their supervisors encourage their group to Work as One • 77% agree that their work group understands how to function as a coordinated team • 73% feel their work group is moving in the right direction to support this mission

50. WellSpan Values Care for All Patient and Family Centered Working as One Respect Integrity Continuous Learning Stewardship