QUALITY AND TOTAL COST OF CARE “Today our healthcare system is burdened by enormous expense without great return. We are now at

the point that our country’s prosperity is financially at risk if we don’t change the way we deliver

healthcare. With our Quality and Total Cost of Care offering, we have developed a model of

innovative care that focuses on continuously improving value. We work side by side with our

healthcare partners to empower patients and physicians. Our mission is to provide our healthcare

partners with people, processes and technology that will allow them to deliver the best quality care at

sustainably lower costs.” Dr. Walter Ettinger, Senior Vice President Accretive Health, Professor of

Medicine, University of Massachusetts Medical School and Retired President UMass-Memorial

Medical Center.

Accretive Health’s Quality and Total Cost of Care is a continuous care assessment and patient population

management solution that helps physicians provide patient-focused, integrated care. We know that, in

order to solve the fundamental problems of quality and cost in our healthcare system, we must offer

solutions that improve value across the care continuum by matching care with the needs of the patient,

proactively and efficiently.

Our mission is to partner with healthcare providers to help them become accountable care

organizations that can improve the health of a population and reduce the costs of care . Our solution

assists healthcare providers in creating improved quality of care, enhanced accessibility to care for those

most vulnerable and greater efficiencies to make quality care more affordable and sustainable.

Better quality is the challenge. Today, U.S. healthcare costs are the highest in the world, yet consistent

quality can be comparatively low. Too often care is fragmented and focuses on treating episodes of

acute illness. Patients with chronic illness get lost in a maze of providers without coordination of their

care. The outcome of this approach results in overuse and dupli cation of services and a focus on curing

the illness rather than prevention.

Quality and Total Cost of Care is the solution. Through our Quality and Total Cost of Care solution, Accretive Health is working to transition healthcare to a value-based system of total quality care. We are forming partnerships with providers to establish accountable care organizations that achieve the aim of better experiences for patients at lower overall costs.

Solutions for patients: Creates a patient-centric relationship through an integrated approach aimed at helping healthcare providers keep patients healthy and coordinating their care both inside and outside the walls of the clinic, hospital or other place of care.

Solutions for physicians: Enables physicians to focus on the most vulnerable patients by identifying those who are most at risk for worsening health, providing coordinated care, and preventing illness with a commitment to delivering the right care at the right place in a timely manner.

Solutions for hospitals and healthcare systems: Helps drive greater efficiency by focusing on the areas of need that account for 60 percent of the patient population’s healthcare costs.

Our solution is built on an integrated set of principles:

Improving quality of patient care/outcomes, while reducing unnecessary costs Helping healthcare providers engage patients in wellness and shared decision making Physician-led care, with appropriate incentives to promote health and wellness Data-driven, fact-based solutions, not presumptions

Learn more about our transformative Quality and Total Cost of Care solution:

Core Solution

People

Processes

Technology

Measurable Results

Case Study

Core Solution

Accretive Health is committed to correcting the imbalance between quality and cost by partnering with

providers, physicians, hospitals and payers to create an improved care experience for those patients

most at risk. We equip physicians with the information and analytical tools necessary to make the right

clinical decisions in the appropriate settings and at the appropriate time for their patients. By educating

patients and administering care early in the disease process, providers can decrease costs and improve

outcomes over the life of a patient.

We apply our operational and clinical expertise to execute a patient-centered physician engagement strategy that emphasizes a collaborative team- based approach fulfilled through our people, processes and proprietary technology. Our value-based model promotes highly focused and intense treatment options that physicians can apply to those patients most vulnerable. We keep physicians informed with meaningful analytics, facilitating much greater insight into the context of how a patient’s disease impacts all areas of health. Our data also allows the provider to focus greater efforts on managing these patients within and across the delivery system, as well as at home.

Primary care physicians are supported with care managers, social workers, pharmacists and other team members to allow them to extend their influence outside of the examining room. This integrated care approach creates a patient-centric relationship that delivers value by keeping the patient healthy and providing the right care at the right place in a timely fashion. By providing the information and tools necessary to make the best clinical decisions, our model ensures that primary care physicians enjoy a

more meaningful experience practicing medicine while realizing the economic benefit of more efficient care delivery.

People

Through Quality and Total Cost of Care, patient care is delivered in a team-based approach. Clinical care coordinators and outreach coordinators are embedded within the primary care physician’s practice, and this core team works with your clinical staff to implement the initiatives that drive clinical and economic value. Social workers and clinical pharmacists are included on the team, as needed. In addition, experts in day-to-day clinical operations work with physicians and their staff to maximize effectiveness and efficiency of the team.

Our goal is to help physicians and hospital networks deliver total care of a population at the right level

and the right time. We are there with you every step of the way to help you provide high quality care,

patient satisfaction and cost reduction.

Processes

With Quality and Total Cost of Care, we help healthcare providers focus on those patients most likely to need future medical care and increase access for those patients to the right physicians as early as the need is determined.

Total system value proposition

Our solution is a total system value proposition financed by the savings achieved through our model. We provide the capital, resources and infrastructure necessary to make the transition to accountable care. As your operating partner, we share with you, your physicians, and participating payers in the verified cost savings associated with delivering higher value care.

Patient prioritization

Proprietary algorithms help predict the small percentage of patients, within a population panel, who have chronic diseases and conditions, and who require integrated, proactive care to increase both the effectiveness and efficiency of their treatments. This knowledge helps your physicians dedicate the right amount of focus on the patients who will require the majority of care and drive the majority of unnecessary costs.

Optimal care plans

Primary care physicians, in collaboration with other team members, use our extensive database and knowledge of available medical resources to create individualized care plans for all patients. Through comprehensive delivery and access planning, care coordination and admission management, we partner

with physicians to optimize capacity for priority population care, and our teams monitor and support adherence to the optimal care plans developed by the physician and patient.

Patient engagement support

We provide physicians with the line of sight, education and support required to improve outcomes for patients most in need, while transforming their revenue, cost and service visibility across the entire care continuum. Coaching and education programs include performance management, population-based opportunity reviews, delivery training, and benefit/eligibility training and provider service issues.

Analytics and reporting

Analytics and reporting mechanisms are embedded throughout our platform to ensure that all processes are driving value. This includes a wide array of benchmarking data that helps determine best quality outcomes across a myriad of evaluation points.

Technology

Quality and Total Cost of Care offers a world- class technology platform that enables providers to take

accountability for population health. Our proprietary applications provide the visibility and day -to-day

tools your primary care physicians need to provide the right level of care at the right time.

Our proprietary AccretiveQ software suite consists of two broad domains: “Analytics” and “Workflow .”

They provide visibility into, and better control of, the full spectrum of services, quality of care and

associated costs for all patients. With these tools, care management staff can focus extra effort on high

priority patients while still being able to monitor all patients effectively.

Analytics

The analytics domain provides physicians with on-line analytical processing capabilities so that they can

more easily and accurately monitor patient results by grouping patients with similar healthcare

attributes, demographics and other factors. The analytics domain is also used to monitor the progress of

individual physicians, physician practices or clinics toward adopting processes designed to enhance

clinical outcomes with lower total cost of care for the defined patient populations.

Workflow

Our workflow domain uses a combination of proprietary algorithms and industry standard applications

to identify patients who are most likely to have an adverse health event. The domain then automatically

assigns the patient to an appropriate care coordinator, assists in developing the patient’s care plan, and

serves as a tool for scheduling the appropriate care interventions. The workflow solution also monitors

variation in care plan activities and the success rate of applying the care p lan’s parameters.

Measurable Results

Through our holistic approach consisting of people, processes and technology, you can improve the

patient’s experience and improve the health of a defined patient population while ultimately reducing

the total cost of care. We work together with the health system, physicians and third-party payers to

reduce healthcare costs, while improving quality of care. When measurable economic benefits are

realized through our Quality and Total Cost of Care solution, the provider, its physicians, participating

payers and Accretive Health share equitably in the cost savings created.

Quality Total Cost of Care delivers measurable results that include:

Improvements in patient satisfaction and engagement

Improvements in measures of population health

Reduction in unnecessary emergency room use

Reduction in inpatient admissions and readmissions

Improvements in primary care physician satisfaction