This document summarizes the services provided by Accountable Care Solutions Group (ACSG) to support Accountable Care Organizations (ACOs). ACSG utilizes the American Health Data Institute (AHDI) to provide data analytics, population health management, and cost/quality reporting. ACSG's patented population management processes can help ACOs manage healthcare costs and quality. ACSG can also support ACO infrastructure, operations, financial reporting, and deployment of employer-based population health programs.

1. Patented Population Management
Creating Value Based Healthcare
Presented by:
Jack Hill, Partner
© 2011 Accountable Care Solutions Group, LLC
JUNE, 2011
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2. Contents
• Key Family of Companies and who we are; Why KBA, AHDI & ACSG?
• Value Based Healthcare for Tomorrow…Turning Data into Intelligence
and the future delivery of integrated healthcare
• ACO Development with Patented Population Management
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3. Key Family of Companies
 Key Benefit Administrators - KBA
 Provides administrative infrastructure for population management
 Risk management specialists
 Highly integrated administrative infrastructure necessary to support healthcare budget
management
 American Health Data Institute - AHDI
 A data warehouse and targeted utilization management partner that combines all the
necessary elements for controlling healthcare costs from both the demand and supply
side of the healthcare equation
 A Premier Partner of TriZetto – The largest claims software vendor in the U.S.
 TriZetto represents 353 Payers (62% of all BCBS Organizations), 173 Million Lives
Under Contract (36% of Managed Medicare), and 144 Million Lives in Production
(Processing 38% of Managed Medicaid)
 Accountable Care Solutions Group, LLC - ACSG
 A distribution and consulting firm for managed care strategies and development,
uninsured mitigation programs, and the Patented Population Management processes
applicable to any payer segment 2

4. Key Family of Companies
• Size and Stability – The Key Family was founded in 1979 as a full-service group benefits
administration firm specializing in self-funded medical plans. Since that time, the Key Family has
grown to become one of the country’s largest independently owned third party administrators,
supporting a wide variety of group benefit plans. With its two major locations in Indianapolis,
Indiana, and Fort Mill, South Carolina, the Key Family is a commonly held group of benefits-related
organizations with over 400 employees, over 3,000 corporate customers, and over 500,000
members under management.
• Integrated Systems - All of our systems, nurse coaches, case management and disease
management are all connected. This allows our systems, in combination with AHDI, to deliver
meaningful information so that our clients can make critical decisions relative to their integrated
system or healthcare plan.
• Reporting – AHDI utilizes the payers’ medical and Rx claims data to develop standard reports. In
combination with these statistics, an expansive industry data set, and sophisticated analytical tools,
AHDI performs multiple analysis necessary to evaluate costs, quality and efficiency. Ordinary
claims data is transformed into powerful, actionable intelligence.
• Resources - As part of our package, you will have access to a Medical Director and ERISA
Attorney to assist you with plan design, HIPAA compliance, COBRA issues and Healthcare Reform.
• Planning - It is not just about what happens during an “ACO readiness assessment” or the
inaugural launch of an integrated healthcare solution; it’s truly about supporting the demands of
your local payer community and ensuring that value is delivered.
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5. AHDI: Calculation of Value Based Healthcare
• Effectively control healthcare costs while improving health quality, the
following data must be analyzed:
– Population health statistics
– Provider data: quality, cost and compliance
• To ensure standardization, implement the application of the same
statistical measures across all payers
• The American Health Data Institute (AHDI) has been measuring
population health and provider data in order to provide actionable
intelligence to payers
• AHDI has been the central technology engine among a variety of payers
in any given geography
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6. AHDI: Provider Practice & Cost Deviation
• Provider practice and cost deviations
– Practice patterns which result in low total costs for the types of illnesses comparable to other
physicians of the same specialty (cost efficiency index)
– Delivery of high levels of post-primary preventive care services for chronically ill patients
– Patterns of clinical and billing practices that avoid service up-coding, services that are not
appropriate for the diagnosis, invalid diagnostic coding and services performed more frequently
than typically appropriate.
• It has been statistically validated that Endorsed Providers are on
average 40% less expensive than providers who do not pass the three,
clinically based tests
• There are on average 15% Non-Endorsed Providers in areas where
there are enough episodes to statistically measure
• It has been actuarially validated that Non-Endorsed Providers on
average will add 10% excess cost to an employers health plan costs
6 5

7. AHDI: Results
• AHDI’s Chronic Disease Management Program has documented the
following results:
– Multiple payers in two different large geographic areas of the country saved
between 6.4% and 7.3% of medical claims cost each year by using the AHDI
model for managing chronic conditions
– After 5 years these multiple payers
saved between 11-17% of medical
claims cost by using the AHDI model
for managing chronic conditions
7 6

8. AHDI: Results
Self Funded Employer Groups – Case Studies for 200-1,000 Employee Lives
Company 1 Textile Manufacturer - Healthcare Index 1.22 Company 2 Trucking Company - Healthcare Index 1.21
$6,000,000 Company 1 Trend Company 2 Trend
$6,000,000
$5,000,000
$5,000,000
Total Medical Costs
Total Medical Costs
$4,000,000
$4,000,000
$3,000,000 $3,000,000
$2,000,000 $2,000,000
32%
$1,000,000 Savings
$1,000,000 17%
Savings
$- $-
2005 2006 2007 2008 2009 2010 2005 2006 2007 2008 2009 2010
Company 3 City Government - Healthcare Index 1.25
Company 3 Trend
$7,600,000
$6,600,000
Total Medical Costs
$5,600,000
$4,600,000 12%
Savings
$3,600,000
$2,600,000
$1,600,000 8 7
2008 2009 2009

9. The Role of ACSG within an Integrated
Healthcare Management System
The services work together to provide an end result where the whole is greater
than the sum of its parts.
* Employer * Step Down
On-site Data
Benefit UM
Warehousing
Testing Consulting Management
Gain Data Drill Ongoing
Employer
Sharing Down Educational
Capabilities Stop Loss Resources
Formulas
Small
* Health
Clinically
=
Physician Geographic Employer
Benchmarks Financial
Risk
Profiling
Targets Assessments
*
Predictive
*
Episodic
* Recognition
Wellness
Integrated Network
of High Cost
Modeling Analysis Patients Programs Delivery of Quality Healthcare
* Chronic * Treatment Member Personal
Controlled Healthcare Costs
Disease
Criteria
Compliance
Incentive Health Healthier Members
Management Program Records
Structural * * Employee * Employer
Professional
Organization
Telephonic Healthcare Healthcare
Phys
Hosp/etc Nurse Coaching Indexing Indexing
* Gain Sharing Hospital/ Medical ACO
Distribution Physician Referral Medical
Methodologies
Discounts Control Director 8
*Items incorporated in United States Patent #7,711,577

10. What Could ACSG Bring to Your Community?
Clinically
Integrated
Network
CMS Employer 1 Employer 2
Blue Cross &
TPA 2
Blue Shield Plan
Data Extract to AHDI
Individual & Aggregate Employer
ACO Reporting
Reporting Package
Gain Sharing
ACO Distribution – Hospitals &
Employer Distribution
Physicians
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11. The Role of Your ACO with our Patented
Integrated Healthcare Management System
A proven system of
population management that
can assist medical providers
in their management of new
payment reforms under
Medicare, Medicaid,
commercial health plan risk
contracts, and proprietary
employer health plan
management.
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12. Population Management Patent – So What?
• Patent awarded in 2010.
• Identifies patients from a covered population likely to
generate expensive healthcare, determines whether
they have received healthcare services, sets up a
regimen of care, identifies qualified providers with best
practices, and prompts patients to obtain needed care.
• Broadly defined definitions on processes that
encompass most managed care delivery systems (e.g.,
PHOs, HMOs, IPAs, etc.), including ACOs.
• Health Economic Zones can be states, zip codes,
counties, cities, etc.
• US Patent Office did not uncover any “Prior Art”
concerning processes being used by any other
organization.
• Patented processes have been utilized with
quantifiable results.
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13. What is ACSG’s Value? So What?
Support of ACO Infrastructure
• ACSG through ADHI can support all key elements, such as data warehouse and data
sources, the use of disease registries to provide physicians and their care teams with
meaningful information inclusive of reports for tracking financial and clinical performance.
• Through nurse navigator coaching and beneficiary compliance with minimum levels of
care;
– Interventions can quickly generate savings and ROI
– Support of long-term interventions aimed at better managing chronic disease
• Can support One-sided & Two-sided Models through financial reporting and management.
– Can measure all the claims-based clinical quality measures under CMS/ACO regulations
– Risk Management model with access to “integrated” reinsurance for Two-sided models.
• Can support bundled payments, partial and full capitation models.
• Can support eligibility management for various attribution and commercial membership
models.
• Can assist in establishing three-year cost and utilization reporting in addition to trend
analysis.
– Cost and utilization trend reports, mix of services analysis, provider reimbursement analysis,
utilization management analysis, and disease management and other medical intervention analysis
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14. What is ACSG’s Value? So What?
Support of ACO Infrastructure
• Operational services:
– Access to data to identify and attribute beneficiaries;
– Use of our contract rates with ACO participating provider;
– Use of our contract rates with providers “outside” the ACO;
– Claims adjudication;
– Data analysis services performed by our actuarial and analytical staff;
– Use of our utilization management services such as nurse navigators, nurse help-line and contracts
with PBMs; and
– Calculation of bonus amounts according to agreed-upon formulas.
• Can supply ACO with deployment of a proprietary employer based program(s) for
population management:
– Utilizing our proven results;
– Utilizing our patented processes;
– Utilizing our gain sharing methodologies;
– For small and large employers; and
– Establishing ACO’s benchmarks for future CMS Medicare launch.
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15. Jack Hill
Executive Vice President & Partner
Phone: 630.878.7539
Email: jack.hill@accountablecaresg.com