OPPORTUNITIES VIA PROVIDER TRANSPARENCY. Thomas Grumley, Health Care Bluebook

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1 OPPORTUNITIES VIA PROVIDER TRANSPARENCY Thomas Grumley, Health Care Bluebook

2 PROTECTING PATIENTS BY EXPOSING THE TRUTH & EMPOWERING CHOICE

3 Price Blindness

4 Knee MRI (no contrast) $2,466 $440

5 Deductible Amounts Have Increased: Up 50% Since 2009

6 80% of Non- Chronically Ill Individuals Never Reach Their Deductible

7 The Majority of YOUR Employees Pay 100% of Their Healthcare Costs from Their Own Pocket

8 69% of Americans Have Less Than $1,000 In Savings

9 #1 Reason For Personal Bankruptcy: Healthcare Expenses

10 Healthcare Bluebook Cures Price Blindness $2,466 $440

11 OBJECTIVE: UNCOVER THE DIRT

12 Economic Opportunity Analysis + + QUANTIFY Savings Opportunities VISUALIZE Price Variability Across Markets STRATEGIZE The Right Program and Incentives

13 QUANTIFY General Diagnostics Women s Health SHOPSMART SERVICES High Volume Non-Emergent Elective High Price Variance Bone & Joint CT Imaging X-Ray Imaging MRI Imaging Ultrasound IP/OP Surgery Procedures

14 ShopSmart Services account for 22% of Total Medical Spend ShopSmart Category Total Procedures Total Spend Opportunities to Save Potential Savings Savings Percent General Diagnostics 2,740 $6,956,275 1,777 $3,447, % OP Surgery and Procedures 465 $3,711, $1,808, % Women's Health 4,046 $3,671,774 2,770 $1,094, % Bone & Joint 416 $7,118, $2,515, % MRI Imaging 1,818 $3,434,988 1,193 $2,020, % CT Imaging 1,362 $2,664, $1,884, % US Imaging 3,996 $1,755,999 2,407 $886, % X-ray Imaging 8,564 $1,375,219 5,576 $895, % Labs (Top 30) 47,584 $2,363,156 34,746 $1,470, % Total 70,991 $33,051,296 50,041 $16,022, % 48% of the spend on ShopSmart services could be saved using lower-cost in-network providers.

15 Represents 11% savings

16 Anatomy of a Claim: Knee Arthroscopy Seattle, WA

17 General Diagnostics ShopSmart Total Procedures Total Spend Fair Price Opportunities to Save Potential Savings Savings Percent Colonoscopy (no biopsy) 422 $1,169,983 $1, $484, % Colonoscopy (with biopsy) 624 $2,029,612 $2, $833, % Cystoscopy 133 $188,279 $ $124, % Heart Perfusion Imaging 147 $434,662 $1, $261, % Sleep Study 286 $710,626 $1, $401, % Transthoracic Echocardiogram (TTE) 605 $664,838 $ $430, % Transthoracic Echocardiogram (TTE) (with doppler) 76 $130,069 $ $83, % Upper Gastrointestinal Endoscopy (no biopsy) 82 $255,139 $1, $122, % Upper Gastrointestinal Endoscopy (with biopsy) 365 $1,373,065 $2, $703, % Total 2,740 $6,956,275 1,777 $3,447,014 50%

18 Colonoscopy (With Biopsy) All Markets

19 Colonoscopy (With Biopsy) By Market

20 OP Surgery & Procedures ShopSmart Total Procedures Total Spend Fair Price Opportunities to Save Potential Savings Savings Percent Cataract Surgery 159 $879,932 $3, $405, % Cholecystectomy (laparoscopic) 68 $899,938 $7, $402, % Ear Tube Placement (Tympanostomy) 52 $285,014 $3, $140, % Hernia Repair (inguinal, umbilical, or ventral) 57 $510,545 $4, $258, % Lithotripsy 29 $339,934 $8, $151, % Nasal Septum Repair 22 $262,301 $4, $165, % Removal of Adenoids 16 $126,727 $4, $64, % Tonsillectomy 62 $407,068 $3, $219, % Total 465 $3,711, $1,808,006 49%

21 Cataract Surgery All Markets

22 Bone & Joint ShopSmart Total Procedures Total Spend Fair Price Opportunities to Save Potential Savings Savings Percent Anterior Cruciate Ligament Knee Surgery (ACL) 26 $442,134 $13, $158, % Back Surgery (Laminectomy) 40 $764,111 $14, $270, % Carpal Tunnel Surgery 53 $224,634 $3, $60, % Knee Arthroscopy 114 $951,805 $5, $422, % Rotator Cuff Repair (arthroscopic) 21 $334,501 $9, $148, % Shoulder Arthroscopy 60 $910,565 $9, $406, % Total Hip Replacement 39 $1,268,343 $27, $394, % Total Knee Replacement 63 $2,222,322 $28, $655, % Total 416 $7,118, $2,515,928 35%

23 Knee Arthroscopy All Markets

24 Knee Arthroscopy By Market

25 Spine MRI (no contrast) All Markets

26 Spine MRI (no contrast) By Market

27 WOULD YOU PAY $67.99 FOR A BURGER?

28 Healthcare Price Variance Report Green Bay, WI Procedure Low Price High Price Variance Abdominal Ultrasound $248 $ % Cataract Surgery $2,230 $16, % Chest CT (no contrast) $447 $2, % Colonoscopy (screening) $1,006 $7, % Ear Tube Placement (Tympanostomy) $2,255 $11, % Heart Perfusion Imaging $1,124 $5, % Knee Arthroscopy $3,554 $22, % Shoulder MRI (no contrast) $414 $3, % Sleep Study $1,023 $4, % Upper Gastrointestinal Endoscopy (no biopsy) $920 $7, % Average Variance 607% Equivalent Variance in a Gallon of Gas $2.20 $ % * All healthcare procedure costs are derived from claims amounts after network discounts were applied

29 DON T RELY ON LUCK BLUEBOOK IT!

30 PRACTICAL

31 BLUEBOOK QUALITY RATINGS

32 The Quality Problem Gall Bladder Removal 49 th Percentile CARDIAC SURGERY 99 th Percentile Bone Marrow Transplant 8 th Percentile

33 The Quality Problem CARDIAC SURGERY (MAJOR) BONE MARROW TRANSPLANT Ranked 2 out of 1,163 Hospitals Nationwide Ranked 210 out of 225 Hospitals Nationwide

34 OUR STRATEGIC DIFFERENCE 26% 67% 100% 80% 1 Simple tt 60% 2 Practical PHYSICIAN 58% 33% 40% 3 Outcomes-Driven BASE YEAR 1 20% FACILITIES 0%

35 SIMPLICITY. WHAT WORKS 1 What do I need? 2 What should it cost? 3 Where should I go? PROPRIETARY AND CONFIDENTIAL

36 It was eye-opening; to see the vast difference between providers for the same service and the same care was astonishing! - Bluebook Consumer Testimonial

37 PRICE BLINDNESS HURTS EVERYONE The cost of health illiteracy is up to $520 BILLION annually 4 out of 5 American s are ill-equipped to navigate our health system The Keckley Report January 16, 2017

38 ? WHAT CAN YOU DO NEXT?

39 Bluebook It! Text: MyBluebook To: Thomas

OUTPATIENT Surgery Estimates APPENDECTOMY-laparoscopic: $17, Open-none in 2018 in OPS setting OBS PTS (laparoscopic) $27,973.

OUTPATIENT Surgery Estimates APPENDECTOMY-laparoscopic: $17, Open-none in 2018 in OPS setting OBS PTS (laparoscopic) $27,973. OUTPATIENT Surgery Estimates 2019 APPENDECTOMY-laparoscopic: $17,852.53 Open-none in 2018 in OPS setting OBS PTS (laparoscopic) $27,973.96 BILATERAL TUBAL LIGATION Laparoscopic using clips: $17,193.28