Health care IT Wholesalers Contract Sales Devices Generics Branded Pharma | Biotech Contract Research Organiza?ons Diagnos?cs Life science tools Pa?ent Ins?tu?onal providers Hospitals HMOs ACOs Ambulatory MD office Urgent care Convenient | retail care Homebased providers Nursing| rehab DME Hospice Ancillary services Labs Imaging Payors © 2013 Winton Gibbons Officebased 23% Prescrip?on drugs 21% Outpa?ent 9% Dental 7% ER 4% Home health 3% Other 2% Medicare 15% Private 9% Medicaid 5% Uninsured 1% Other 1% Hospital 31% Percent of $1.4 trillion HC Costs and Payors in Hospitals (adds to total hospital %) 1%, $270 5%, $630 25%, $1,091 50%, $1,228 100%, $1,263 0% 20% 40% 60% 80% 100% Cumula9ve cost billions $86 $41 $14 $8 $4 1% 5% 25% 50% 100% Cost per pa9ent thousands Annually, top 1% of pa?ents cost on average $86 thousand, cumula?vely $270 billion. The bo^om 50% only cost on average $4 thousand, cumula?vely $35 billion Hospitals account got about ⅓ of total health care spending, and about ⅔ of hospital spending is government funded Data source: AHRQ, NCHS 17% 21% 24% 29% 35% 42% 48% 51% 57% 72% 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Physician EMR Implementa9on 7% 13% 32% 22% 38% 26% 7% 3% 12% 21% 26% 13% 11% 13% 6% 4% 7% 6% 5% 4% 26% 32% 32% 34% 124 2544 4564 65+ Other Liver disease Alzheimer's Stroke Lower respiratory Homicide Suicide Heart disease Accidents Cancer Causes of Death by age