Hospital-At-Home Extending the Continuum....

1. Hospital-At-HomeExtending the Continuum.... Vince Kuraitis JD, MBA Better Health Technologies, LLC www.bhtinfo.com (208) 395-1197

2. A huge potential disruption.... • ...that hardly anyone in the U.S. is talking about...yet...is... • Hospital-At-Home (HAH)

3. Hospital at home is defined as a service that provides active treatment by health care professionals, in the patient's home, of a condition that otherwise would require acute hospital in-patient care, always for a limited period.

4. $34 B Market for Healthcare Unbound Technologies $US (billions) ADL/elder $0.35 $0.37 $0.47 $0.59 $0.73 $0.98 $1.2 $1.6 $2.0 $2.4 $3.0 $3.7 Chronic $0.10 $0.13 $0.22 $0.38 $0.65 $1.2 $3.8 $12.1 $23.1 $26.3 $25.7 $26.7 Acute $0.00 $0.00 $0.00 $0.00 $0.01 $0.02 $0.65 $2.0 $3.6 $3.5 $3.0 $3.2 Total $0.45 $0.50 $0.69 $0.97 $1.4 $2.1 $5.7 $15.7 $28.7 $32.3 $31.7 $33.6 (Numbers have been rounded)

5. While there is some overlap.... Disease/condition management is mostly about avoiding hospital care (and other high-cost care) HAH is mostly about substituting for hospital care

6. Hospital-at-Home -- Background • Concept emerged in the 1960s • Significant research/literature base • Almost all outside of U.S. • Cochrane review • Johns Hopkins as only U.S. project • HAH definition varies • NOT based on leveraging technology • But, HAH can be turbocharged with technology • Early example of a company with a HAH business/care model – Care Level Management

7. Elaborate Proof of a Hypothesis..... The Willie Sutton Theory of Hospital-At-Home Projected 2014 U.S. Annual Hospital Costs = $1 Trillion Projected 2015 Healthcare Unbound market of $34 B = 3.4%

8. Outside the U.S. ....

9.  Cost reduction opportunity Hospital safety/error issues Concerns over hospital acquired infections Patient preference for home Benefit structures & incentives Advancing tech allows for safe care in home  Potential burden on caregivers Risk of HAH being viewed as a reincarnation of managed care Physician concerns and inconvenience? HAH Driving/Restraining Forces

10. Long-term....A (Not So) Rhetorical Question • If we can spend $1 Trillion a year in the U.S. to care for people in buildings where • There is a high risk of infection • 98,000 people die annually due to medical errors • The cost of care is higher than anywhere else • People don’t want to be Why would we spend only 3.4% as much ($34 B) to care for people in their homes and communities?

11. Call to Action The U.S. needs to join & advance the world dialogue about hospital-at-home

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13. Pre-IPO Companies HealthPost Cardiobeat HomMed EZWeb Sensitron Life Navigator Medical Peace Stress Less DiabetesManager.com CogniMed Caresoft Benchmark Oncology SOS Wireless Click4Care eCare Technologies The Healan Group FitSense Technology Established organizations Samsung Electronics, Seoul Intel Digital Health Group Medtronic Philips Corporate Strategy Group, Amsterdam Siemens Medical Solutions Joslin Diabetes Center Sears Methodist Retirement System National Rural Electric Cooperative Association Disease Management Association of America Blue Cross Blue Shield of Massachusetts PCS Health Systems Varian Medical Systems VRI Washoe Health System S2 Systems CorpHealth Physician IPA Centocor BHT Clients

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