Direct healthcare and premise health

© 2018 Premise Health. All material contained in this
presentation is extremely confidential and is not for distribution.
Direct Healthcare
and Premise Health

22© 2018 Premise Health. All material contained in this
Where is
Healthcare
Today?

(1) Source: http://www.cdc.gov/chronicdisease/about/prevention.htm
(2) Source: http://bhpr.hrsa.gov/healthworkforce/supplydemand/usworkforce/primarycare/
(3) Source: https://www.cdc.gov/nchs/fastats/emergency-department.htm
(4) Source: https://www.beckershospitalreview.com/healthcare-information-technology.html
Today’s Healthcare Challenges
Physician Shortage
By 2020, the demand will
outweigh the supply by
20,400 physicians2
More chronic conditions
86%
50%
Chronic conditions account
for 86% of total healthcare
spend in the US1
50% of Americans have at
least one or more chronic
health conditions1
Emergency Room
There are approximately
137 million emergency room
visits in the US every year.3
Rising Medical Costs Dysfunctional Payment System
Incentivizing quantity over
quality of services
High Deductible Cost
Due to cost, patients may decide
to avoid treatment for common
conditions, increasing the likelihood
of developing complications that will
then require an emergency room visit.4

Employers Impacted by Rising Healthcare Costs
2012 2020P
$2.8
$4.2
5.2%
Compound Annual
Growth Rate
30.8
2015 2030P
83.4
6.9%
Compound Annual
Growth Rate
Source – Merritt, Hawkins & Associates
National Healthcare Expenditures
($ in trillions)
Growth in National Healthcare Costs
Number of people with 3+ chronic diseases
(millions of lives)
Prevalence of Chronic Conditions
Average annual employer contributions to
premiums for single and family coverage
Financial Impact on Employers
Single
Coverage
Family
Coverage
$3,785
$8,824
Single
Coverage
Family
Coverage
$5,477
$13,049
2007 2017

Employee Experience
Enhancing the employee experience with health and well-being programs is a
top priority of employers
Improve employee
engagement in
health care decisions
89%
Improve employee
satisfaction with the
health care program
81%
Improve our employee
value proposition
78%
Have a direct impact
on long-term costs
74%
Source – 2017 Willis Towers Watson Emerging Trends in Health Care Survey.

What is Direct
Healthcare?

• Onsite and nearsite facilities are state-of-the-art and are tailored to meet specific client needs
• Easy to use virtual health interface can be accessed from any mobile device, tablet, or computer
Direct Healthcare – Access Points
Nearsite
Onsite, nearsite, and virtual health access points offer superior alternatives to
traditional providers
Onsite Virtual

Employers Seeking a Highly Differentiated Primary Care Model
High-Touch Member Relationship
Convenient Access
Alignment with Self-Funded Employers
Integrated Care Coordination
Data Driven Specialists Referral
Integrated Population Health Analytics
Access to Medical History
Chronic Condition Management
Well-Care
Integrated Occupational Health
Integrated Wellness Programs
Urgent Care Services
Primary Provider
Employer Sponsored
Direct Health
Traditional Health
System Primary Care
Retail Based
Primary Care
MD / MP MD / MP MP
(1) Source: U.S. Census Bureau, County Business Patterns and Economic Census Data
(2) Source: RAND Corporation
(3) Source: IBISWorld, Occupational Health and Workplace Safety Services, May 2015

Mercer Survey Results
29%
of large employers
provided an
onsite / nearsite
clinic
72%
of respondents said
managing health
risks / chronic care
was their top objective
63%
said that using the
clinic reduced lost
work days

The Health Center is a Leverage Point for the Client
Why Do Large Employers Embrace Direct Healthcare?
The Health Center is a Convenient Benefit for the Client
• Deliver better access to high quality care
• Higher program engagement and retention rates
• Employer of Choice offering
• Located where employees spend 70% of their waking hours
• Same day and walk-in appointments
• Providers dedicated to specific population
• Cost effective
2017 2019 E
25%
50%
100%
Greater Adoption of Onsite /
Nearsite Centers
Percentage of 1,000+ Employee Firms Offering
Onsite / Nearsite Centers

Why Premise
Health?

Vision/Mission/Values
To be the premier direct healthcare access company in
the world.
Our Vision
Dedicated. Proactive. Primary. Comprehensive. Aligned.
To help people get, stay and be well.
Our Mission
ORGANIZATIONS
275+
WELLNESS
CENTERS
600+
PROVIDER TEAM
MEMBERS
3,500+
NET PROMOTER
SCORE
88
PERCENTILE
HEDIS
95TH
CLAIMS BASED
SAVINGS
27%Providing high-quality and efficient care, focusing on
health improvement and an exceptional member and
client experience.
Courageous. Engaged. Innovative. Accountable.
Quality-Focused. Respectful. Ethical.
Our Values

Our Relevant Experience
Sample Clients, by Premise Health Operating Region
Northeast East Southeast Central South West

One Integrated Choice
Manage
Members
Manage
Premise
Providers
Manage
Downstream
Care
Members
Clients
Member Health Management
Platform
Direct Primary Access
Lifestyle
Medicine
Occupational Therapy Dental Vision Wellness Coaching Biometric Screening Nutrition Services Integrative
Medicine
Physical Therapy
Occupational
Health
Behavioral HealthPharmacyPrimary Care LaboratoryFitness RadiologyWomen’s Health
Access
Onsite Nearsite
VirtualMobile

Focus on Innovation
Virtual Reality
AI
Genomics
CURRENT
NEAR-TERM
LONG-TERM
Integration
Access
Model
Health Center
Design
Value-Based
Model
Digital
Tools
Wearables/
Shareables
Blockchain
Centers of
Excellence
Social
Determinants
Appropriate Risk
on Total Spend
Performance
Network

Our Value
Integrated
Service Model
Effective
Transition Approach
Covered by clients who utilize
multiple lines of service
55%
Members
Switching from existing
vendor to Premise Health
Leading
Operational Efficiency
Client
Retention Rate98%
Premise Health Center wait times
are 90% better than PCPs nationally
200+
20 minutes
12 minutes
Premise Health Average
Top Performing Community Providers
Primary Care National Average
2 minutes

Non Member Member
$568
$415
Compelling Financial Value Proposition for Clients
Premise Health generates tangible benefits for clients by consistently delivering clinical outcomes
that improve member health, driving significant cost savings.
• On average, Premise delivers 27% cost savings based on eligible members utilizing Premise’s services
• Onsite and nearsite centers also improve productivity and serve as a valuable talent recruiting and retention tool
Significant Financial Benefits Delivered(1)
(1) Results represent third party case study with 85,000+ eligible members; representative book of business analysis shown in rates per 1,000 members, with varied
results based on industry and geography.
27% Savings
Risk-Adjusted
PMPMPrimary Care Visits
21% Increase
Non Member Member
2,571
3,112
Inpatient Admissions
37% Reduction
Non Member Member
59
37
Specialist Visits
15% Reduction
Non Member Member
2,367
2,022
Outpatient Services
27% Reduction
Non Member Member
3,154
2,292

Premise Primary Care and Premise Pharmacy Cost Savings
Comparison for Members
No Premise Pharmacy or
Premise Primary Care
Premise Primary Care but
No Premise Pharmacy
Premise Pharmacy but
No Premise Primary Care
and Premise Pharmacy
$689 $628 $541 $416
9% savings 21% savings 40% savings
*Based on Risk Adjusted PMPM For Members in Each Segment Compared to Members Not Attributed to Premise Primary Care or Pharmacy
34%
23%
Greater cost savings for
Members than PC Alone
Greater savings for
Members than RX Alone
and Premise Pharmacy

Design a Solution to Better Health
1 Identify value proposition
Member Experience
Clinical Quality
Financial Value
Other: Access, Productivity, Culture
Choose product line(s)
PharmacyPrimary
Care
Occupational
Health
Behavioral
Health
2
DentalFitness Vision
Physical
Therapy
Other
Choose provider model(s)4
MD NP PA RN
5
Identify eligible population(s)
Employees Only
Employees + Dependents
Single Market
Multi-Market
6
Select base fee structure
Eligibility Capitation Fixed Fee Cost Plus
8
Choose access model(s)
Onsite Nearsite Virtual
3
Mobile
Execute10
Design physical space7
Modern
Spa-Like
Utilitarian
Evidence Based Design
Articulate desired member experience4
Convenience
Concierge
Zen-Like
Engaged
Determine aligned incentives9
Plan design Performance guarantees

Resources

Clinical Quality Performance
Hypertension
Members whose
last BP < 140 / 902
Diabetes
Members whose
last BP < 140 / 901
BMI
Screening3
1 HEDIS metric “Comprehensive Diabetes Care - Blood Pressure Control (<140/90)”
2 HEDIS metric “Controlling High Blood Pressure – Total”
3 HEDIS metric “Adult BMI Assessment”
Premise Health Median 2017 HEDIS PPO 90th percentile
82
69
69 69
95
86

Community Integration
− 50% of U.S.
actively sharing
member info on
Epic network
− 56% of
ambulatory
physicians are
Epic users
− 64% of academic
medical centers
on Epic
− Ambulatory Electronic Medical
Record (EMR) for 17 years straight
− Practice Management System
− Member Portal
− Health Information Exchange
(HIE)
− Self-Service Kiosk
− Electronic Health Record (EHR)
Population Health vendor
Platform for Sucess
is the #1
Market Leader
Best in KLAS
2015 – 2017
© 2017 Epic Systems Corporation. Used with permission.

• Secure online and mobile portal
• One place to access and manage healthcare anytime, anywhere
• Real-time scheduling
• Lab results
• Provider messaging
• Medication management
• Video visits
• Health forms
• Bill payment

• Schedule appointments
• Send secure messages
• Conduct video visits
• E-Visits
• Text notifications
• After visit summaries
• View lab results
• Medication management
• Bill payment
• Health forms
One place to access and manage healthcare anytime, anywhere
regardless of solutions already provided by Premise Health
Secure mobile portal
Mobile

• Members securely access medical record online and mobile
- Register using an access code provided by Premise Health
- Set a password and enter basic demographic information
- Reset passwords through the app without the need for support
from Premise Health
• Virtual support will be available via our trained support
team if a member needs assistance
- TouchID on mobile (iOS only) to login to the app
• Once registered, members can set notification preferences
- SMS, email, and phone
- Preferences are integrated into the provider workflow for future
interactions
• Providers can perform bulk outreach for care gap closure
Login and Notifications

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