Employee Plan Performance Employee Plan Performance Medicare Advantage Inpatient Admissions Medicare Advantage Skilled Nursing Facility Days Health Plan Revenue Medical Loss Ratio Year 1* Year 2* Year 1** Year 2** Year 1** Year 2** The Five Principles of a High Performing Value-Based Care Enterprise Access to scaled processes and purchasing power Ability to engage providers A strategic roadmap Proven clinical and administrative capabilities THE TASK IS VAST, BUT THERE IS A DEFINED PATH TO SUCCESS WINNING THE HEARTS AND MINDS OF PHYSICIANS IS CRUCIAL WE MUST PREPARE FOR INEVITABLE CHALLENGES ALONG THE WAY WITH CHANGE IN MIND, WE KNOW THE DIRECTION WE MUST GO C-level commitment to an independent value-based business Year 1* Year 2* Compensation models that reward primary care physicians and specialists for clinical efficiency Tangible support in “one way of practicing medicine” vs. payer-based silos True workflow integration to drive efficiency and to support decisions at the point of care “It’s creating engagement in places we didn’t have engagement before. It’s exciting to see the network come together, the clinical model of care piloted in different plans, and the creation of value contracts with payers to help us financially make this a go.” — Physician Leader 20% reduction in medical admissions 36% reduction in all-cause readmission rate 5% generic Rx dispensing rate 10% increase in in-system inpatient utilization 27% reduction in medical admissions 24% reduction in avoidable admissions 7% increase to generic dispensing rate “We have an opportunity to remove 30% of unnecessary spending and radically change quality of life.” — Dr. Arnold Milstein, Stanford CERC CHIEF EXECUTIVE OFFICERS CHIEF MEDICAL OFFICERS CHIEF FINANCIAL OFFICERS SENIOR INDUSTRY LEADERS FUNCTIONAL AREA VICE PRESIDENTS ATTENDEES The route taken is as important as the destination. Along the way there are essential ingredients to maximize value creation and capture. “Today the eyes of all people are truly upon us…as a city upon a hill, constructed and inhabited by people aware of their great trust and their great responsibilities.” — John F. Kennedy evolenthealth.com ©2015 Evolent Health LLC EH-1410039-0320 With thanks to our partners for joining our 2014 summit, and for leading the way in this new era. TOTAL COMBINED EXPERIENCE: 1,200 YEARS If you are interested in Evolent’s premier executive learning forums, let us know at [email protected]. Setting a Bold and Balanced Direction INSIGHTS FROM EVOLENT HEALTH’S 2014 FALL SUMMIT Evolent Health gathered 50+ executives from 22 health systems to share insights from their transformation efforts in a dynamic health care era. “We face a big technology challenge—it’s a huge problem to connect lots of independent physicians who use different EHR systems. We need a solution that will operate in our closed network, and a revenue stream to make this investment.” “When Medicare beneficiaries are discharged from hospitals, 50% are readmitted within one year. The acute care hospital episode is not an episode at all. It’s a unique and seminal predictor of declining clinical condition and increasing cost.” “Our price is now given by the market. Our business is changing from cost-based pricing to price-based costing.” — CFO, Health Plan — COO, Large Physician Group — Executive Chairman, Full-Service Health Care Organization Financial Challenges Clinical Challenges Technological Challenges PARTNER HEALTH SYSTEM A PARTNER HEALTH SYSTEM B PARTNER HEALTH SYSTEM C CAPTURE OF REGIONAL PREMIUM VALUE CREATION LOW HIGH HIGH EFFICIENT COST STRUCTURE BROAD NETWORK/ACCESS HIGHLY ENGAGED PHYSICIANS INTEGRATED POPULATION HEALTH INFRASTRUCTURE RADICALLY DIFFERENT INCENTIVES Year 1* pre-Evolent partnership projected—without Evolent solution actual Year 2* in PMPM Year 1 pre-Evolent partnership Year 2 in PMPM projected—without Evolent solution actual *January–September 13 20 *January-September 2013/2014 **As of 2014