Joslin Diabetes Center Annual Meeting Debriefing for Center AdministratorsNovember 19, 2008

Affiliated Programs - 22nd Year – 2007 Highlights

20 Contracts 30 Sites 170,000 patient visits in 2007 30,000 new patients visits in 2007

11% increase over 2006 13 states 2 International sites 77 Physicians 21 Nurse Practitioners 111 Educators 2 New Partners for Diabetes Specialty Program at

Long-Term Care and Skilled Nursing Facilities (with SUNY & The Hospital of Central Connecticut Affiliate Partners)

Notes: Blue circles indicate multiple sites associated with one contract.

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11 6

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1. The Hospital of Central Connecticut - New Britain, CT

2. Lawrence and Memorial Hospital - Mystic, CT

Lawrence and Memorial Hospital - New London, CT

Lawrence and Memorial-Old Saybrook, CT

3. Southern NH Medical Center - Nashua, NH (2 sites)

4. SUNY Upstate Medical Univ. - Syracuse, NY

5. Western PA Hospital - Pittsburgh, PA

Forbes Regional Medical Ctr. - Monroeville, PA

Alle-Kiski Medical Center - Natrona Heights, PA

6. Univ. of MD Medical System - Baltimore, MD

Maryland General Hospital - Baltimore, MD

Baltimore Washington Medical Center - Glen Burnie, MD

7. Doctor’s Community Hospital - Lanham, MD

8. St. Mary’s Medical Center - Evansville, IN

9. Floyd Mem. Hospital & Health Service - New Albany, IN

10. St. Vincent Hospital - Cleveland, OH

11. Southview Hospital - Dayton, OH

12. St. Mary’s Medical Center - Huntington, WV

13. Swedish Medical Center - Seattle, WA

14 UC-Irvine Medical Center - Irvine, CA

15. Frisbie Medical Center - Rochester, NH

16. Providence Medical Center - Novi, MI

Providence Hospital - Southfield, MI

17. Mercy Medical Center - Cedar Rapids, IA

18. Gulf Diabetes Specialist Center, Kingdom of Bahrain

19. Chaleur Regional Medical Center, Bathurst, NB, Canada

20. Diabetes Specialty Services at Newington Health Care

21. Dubai Health Authority, Dubai

Key

Affiliates in 12 states29 Total Sites

26 Domestic Sites3 International Sites

21 Contracts

7

12

Joslin Diabetes Center Affiliated Programs

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March 2008

3

2008 Affiliate Domestic Expansion Focus

Network Growth with our existing Affiliate partners

2008 Presentations & Contracts in Negotiation: IllinoisCaliforniaTexasFloridaOhioNew Jersey

December 31, 2008 22 Domestic Contracts 4 International Contracts 32 Domestic Sites 6 International Sites 2 SNF Diabetes Specialty Programs

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INTERNATIONAL SITES Bathurst, NB, CanadaManama, BahrainDubai, UAEChennai, India

Network of Centers-Projected December 2008

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Joslin Diabetes Center Affiliated Programs

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17

15

12

16

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214

Single siteMultiple sitesUpgrade to multiple sitesUpgrade to additional sitesContracts in negotiation

2008 Affiliate Domestic Expansion Focus

Skilled Nursing Homes and Long Term Care Growth of partnerships between our Affiliates and SNF &

LTC prospective partners

Metro Marketing Campaign Comprehensive Materials being finalized for targeted

campaign to decisionmakers in Major Metropolitan Markets (20 Cities)

Targeted series of cover letters and informational papers discussing Joslin benefits and services

Consulting Services Increased requests for Joslin Boston to conduct consulting

engagements for existing ADA recognized programs throughout the U.S.

- Consulting engagements provide a vehicle for introduction of Joslin team-based approach to prospective Affiliate partners

Topics Identified by Center Administrators for Further Followup

Joslin Boston to send survey questions to Center Administrators to followup on areas of interest:Center Administrators identified that they want

- Analysis of front desk staffing ratios in support of physicians and educators

- Further review of how educators are using their time

- JARS working group

Topics Identified by Center Administrators for Further Followup (continued)

Update Manuals and materials where appropriate

More engagement with other Center Administrators to share best practicesMore conference calls topically focused on areas

pertinent to Center Administrators- Business & Operational Planning

- Productivity Review

- Coding & Compliance review

- Billing review and analysis

Topics Identified by Center Administrators for Further Followup (continued)

Multicultural SurveysHow can Center Administrators have a better

understanding of cultural competencies and how their patients are impacted?

Affiliates want to collaborate with Joslin Boston on research

Marketing Support from Boston- Center Administrators want marketing templates and support from

Joslin Boston so that there is uniformity of message and themes across the network

- Joslin Boston advertisements should include affiliate network partners

Topics Identified by Center Administrators for Further Followup (continued)

Joslin Boston discussing new conference call schedule post annual meeting to increase collaboration:Center Administrator focused callsEducator focused callsPhysician focused callsDiscussing doing a series of 6 calls for each groupAffiliates to share areas where they want further

collaboration for topics

Topics Identified by Center Administrators for Further Followup (continued)

Affiliates want “Why Wait” Lite programDrs. Jackson and Krishnamurthy to take the lead on

developing program content

Structure annual meeting agenda differently next yearHave dinner/reception on Sunday night instead of

Monday nightHave physicians attend for just one dayHave parallel track for sessions whereby more time

is focused with Center Administrators together and physicians together

More JARS and sharing of results

Have JARS Working Group for engaged affiliate partners

Share below results for 2007: $~9 million annual net revenue per FTE

endocrinologist 8% incremental annual net revenue $3,000+ per patient 40% increase in patient population 53% increase in incremental patient population

Produce instructions for JARS reports similar to Monthly Report instructions

ADA Poster Abstract Demonstration JARS (Joslin Affiliates Reporting System) ROI