This document describes a population health management system that medical providers can access to manage healthcare for self-insured employers. It allows providers to take on insurance-like roles without assuming insurance risk. The system utilizes over a decade of data on over 1 million members to analyze healthcare costs and outcomes. Medical providers are incentivized through gain-sharing agreements where they receive a portion of savings if healthcare budgets are kept lower than projected. The system aims to reduce costs through coordinated care, recruiting high quality/low cost providers, and promoting wellness. It has achieved healthcare cost reductions of up to 32% for some employers that have used the system.

1. A Proven Commercial Population Health Management System for Medical Providers
Direct-to-Employer
Gain Sharing Model

2. There has never been a better time in this nation’s history for Medical Providers to take control of the healthcare system
than now. Healthcare Reform has produced a number of challenges to the way that Medical Providers get paid and the
number one question is how you adapt while still remaining profitable. One of the key opportunities available today is to
maximize reimbursements with self-funded employers in your community without any down side risk. These systems are
available as a proprietary strategy of your organization, not just another financial reimbursement contract with Medicare,
Medicaid, or a commercial insurance carrier.
Goals and objectives must lead toward the management of positive outcomes and value while diminishing healthcare
expenses. Sustainability is contingent on managing the risks of population segments that are predicted to increase
healthcare expenditures if left unattended. These items must be accomplished while embracing a patient centric
approach.
Medical providers can now have access to a proven population management
system that has been in place for over 12 years with extraordinary results
applied to over 1 million members under management. ACSG/Key Family
has established a comprehensive system of patented and proven processes
that can track quality and cost of care with proven and targeted interventions.
Through the American Health Data Institute’s (AHDI) population management
process hundreds of health plans have seen their healthcare trend reduced
year over year and in many instances total aggregate costs have been reduced
substantially.
EMPLOYERS ARE CHALLENGED
With the advent of ACA there are increased uncertainties and escalating costs for employers that offer a group health
plan. Key market forces indicate that:
• Employers are looking to establish direct
relationships with medical providers to improve
quality and reduce costs
• Rate increases in group health plans are higher
than they have been in 5 years
• Employers are becoming more frustrated with the
lack of information when rate increases are being
presented
• Refugees from the fully-insured marketplace are
looking at self-funding alternatives
• Employees are becoming increasingly less
satisfied with their benefit plans
• 57% of health plans are self-funded today, an
increase of nearly 30% in the past ten years
• There is very little risk management in the
marketplace to manage and understand the key
elements affecting healthcare plans
A Proven Commercial Population Health Management System for Medical Providers
We know that given
the right tools Medical
Providers can have
the greatest impact on
controlling costs and
increasing quality, even
more than any insurance
company or HMO.
Direct-to-Employer Gain Sharing Model

3. A PROVEN POPULATION HEALTH MODEL
Accountable Care Solutions Group (ACSG/Key Family) has developed a “turn-key” and customizable infrastructure
that medical providers can deploy within their communities to access self-funded employer purchasers on a direct basis
with a value proposition of quality and cost savings that no other system can attest. With more than 30 years of health
plan management experience and over 3,300 corporate clients covering over 1 million members, ACSG/Key Family has
developed a system that medical providers can “private label” to attract employers into their medical provider delivery
system. The infrastructure supports all of the components for managing and administering self-funded plans with
preferential stop loss and pricing advantages.
A PROVEN ANALYTICAL FRAMEWORK
The American Health Data Institute (AHDI) utilizes sophisticated data warehousing techniques and analytical tools. The
data in the AHDI warehouse includes over three million lives, all but two states are represented related to geographic and
regional data and there are over 20 terabytes of computer storage, capacity and memory. To provide a perspective on the
volume of data, a warehouse, which can store eighteen terabytes, could hold the entire printed collection of the Library
of Congress. The back end database engine is a Microsoft SQL Server 2000/2008. The data in the AHDI warehouse
is transformed into powerful, actionable intelligence utilizing very sophisticated software to analyze the variance, cost
drivers, cost trends and other significant clinical and financial factors influencing healthcare costs. Using the AHDI
intelligent data to manage chronic diseases will drive the favorable variances necessary to optimize a gain
sharing distribution.
Identify
the sickest
of the sick
Set up a
regimen of
care for the
chronically ill
Monitor
compliance with
sophisticated
data analytics
FFS
reimbursement
and gain share
Coach patients
into quality
narrow network
providers
Increase service
and completion
rates for the
chronically ill

4. PROVEN RESULTS
Thousands of employer groups are realizing improved plan performance and lower healthcare expense as the result
of our patented and proven care systems for population health management. Medical Provider groups that desire to
sponsor a program to get direct access to the self-funded marketplace can access this proven system, and by actively
participating, can “turbo-charge” the results we are already achieving.
ACSG/KEY FAMILY SMALL MID-SIZE GROUP
HEALTHCARE COSTS (10-150 EES)
CostsPerEmployeePerYearEmployee HRA and
Biometric Data
Physician Group, Narrow
Network
and Non-Network Claims
Data
Membership and Eligibility
Data
ETGs and ERG
Episode Treatment and
Episode Risk Groups
Gaps in Care
Regimens of Care/
Care Standards for the
Chronically Ill
Reporting
EZViewTM
and Health
Risk Management (HRM)
Reports
$9,000
$8,500
$8,000
$7,500
$7,000
$6,500
$6,000
$5,500
Small to Mid-Size Fully Insured Employer Groups
Source: United Benefit Advisor Survey 2008, 2009, 2010, 2011
Healthcare Trend at 8% per year
Key Healthy PartnersTM
$7,236
$6,224
$7,536
$5,785
$6,722
$8,110
$5,908
$7,260
$8,688
$6,228
$7,841
2008 2009 2010 2011

5. LEVERAGING RESULTS TO MAXIMIZE GAIN SHARING
The gain sharing system encompasses the following key elements:
1. BENEFIT BUDGET
• Employers and healthcare providers determine health benefit budgets
• Healthcare providers arrange for discounted healthcare services
• Employers and healthcare providers share in the savings to the healthcare budget through financial
performance rewards
2. ENGINEERING AND COORDINATION OF CARE
• Medical director engineers the coordination of patient care pathways through top performing medical
providers
3. BEST OF BREED PHYSICIANS AND HOSPITALS RECRUITED
• Best of breed medical providers are identified by the medical director and are heavily incentivized by the gain
sharing due to favorable variances to the employers’ healthcare budget
• High quality, cost effective medical providers
4. DEVELOP A CULTURE OF WELLNESS
• Member Health Incentive Programs
• Member Healthcare Coaching—Ongoing healthcare education
PROVIDER GAIN
SHARE DISTRIBUTION
YEAR MEMBERS
HEALTH
BUDGET ACTUAL
FAVORABLE
VARIANCE
MEDICAL PROVIDERS
(50% OF FAVORABLE VARIANCE)
1 1278 $7,326,774 $5,822,568 $1,504,206 $752,103
2 1354 $8,476,040 $6,524,926 $1,951,114 $975,557
3 1368 $9,337,640 $6,792,120 $2,585,520 $1,292,760
Based upon actual claims results
TotalMedicalCosts
COMPANY 1
TEXTILE MANUFACTURER
Healthcare Index 1.22
$6M
$5M
$4M
$3M
$2M
$1M
2004 2005 2006 2007 2008 2009
32% SAVINGS
COMPANY 2
TRUCKING COMPANY
Healthcare Index 1.21
$6M
$5M
$4M
$3M
$2M
$1M
2004 2005 2006 2007 2008 2009
17% SAVINGS
COMPANY 3
CITY GOVERNMENT
Healthcare Index 1.25
$8M
$7M
$6M
$5M
$4M
$3M
$2M
$1M
2007 2008 2009
12% SAVINGS
Trend Company

6. WHAT IS THE VALUE PROPOSITION
FOR MEDICAL PROVIDERS?
• Diversify payer mix by disintermediation of third party payers in order to drive additional margin
• No need to establish your own insurance company
• National and regional PPO network wrap
• Actuarial pricing of medical provider network reimbursement contracts
• No insurance risk to assume
• Four to six months start-up
• Minimal cost requirements, e.g., infrastructure already in place
• Proven sales and marketing distribution process
• Proven population management system
• Optimal revenues through gain sharing, reducing outmigration, increasing top line revenues, and addition of
new administrative revenues
• Complete transparency
WHO IS A GOOD CANDIDATE FOR THIS PROGRAM?
• A provider organization structured as a loosely affiliated network, IPA, PHO, or a clinically integrated group
(e.g., clinical integration is not required).
• Geographic markets with a service area comprising 100,000 or more individuals
• Market segment that can generate 2,500 members or more over an 18 month period
%ofCost
% of Service
140%
120%
100%
80%
60%
40%
20%
0%
S/P Medicare Medicaid Commercial
8% 40% 20% 32%
REIMBURSEMENT
RATE GAIN SHARING
CONTRIBUTE TO MARGIN
HOSPITAL PAYER MIX DISTRIBUTION
Direct-to-Employer Mix
Direct-to-Employer
Under 100% Cost
Special Payments
Provider Tax
% Cost

7. ACSG/KEY FAMILY - POINTS OF DIFFERENTIATION:
STOP LOSS REINSURANCE
• Managing General Underwriter (MGU)—Highly rated stop-loss partners with “favored-nation” relationships
and pricing
NETWORK DEVELOPMENT AND PPO WRAP NETWORKS
• 20 + years’ experience
• Access to over 70 wrap PPO networks
• Network agnostic—we do not own or manage provider networks - we are a vested partner with the medical
provider community
TPA ADMINISTRATIVE SERVICES
• National administrator for multiple insurance product carriers, including:
◦◦ Consumers Mutual Insurance Company of Michigan (CMI-CMS CO-OP), Assurant (Fortis, John Alden
Time Life), Companion Life, Fidelity Security Life, HM Insurance Group, ING and TransAmerica
• Administrative Systems—Claims, Customer Service, Fulfillment, Compliance, Data Reporting
• Core Competency in complex health care administration
• Over 30 years of self-funded and insured medical plan management experience
• Integrated Healthcare Risk Management (HRM) solutions
• A proven track record of reducing claims costs
• Exceed all industry benchmarks for financial, procedural and processing accuracy
• Administrator and population health data warehouse for several fortune 1000 companies
POPULATION HEALTH MANAGEMENT
• Patented Population Health Management process in place for over 12 years
• Data Warehouse containing 20 terabytes of claims, biometric, Rx, health risk assessment and encounter data
• Real-time access to data analytics:
◦◦ Population risk stratification and predictive analysis
◦◦ Gaps in care analysis
◦◦ Clinically based physician profiling
• Integrated Chronic Disease Nurse Coaching
• Over 40 payers extract data to our warehouse, including insurance carriers and
Third Party Administrators (TPA)

8. MARKETING AND SALES
• Private-label programs with branding opportunities
• Access to major national and regional agency relationships
• Proven sales and marketing distribution system
GAIN SHARING MODELS
• Methods for calculating employer favorable variance
• Calculations for defining distribution model based upon key metrics
• Practice improvement data
• Completely transparent
ACSG/KEY FAMILY PROVIDES THE FOLLOWING
SERVICES IN DEPLOYMENT OF THE PROGRAM
• Facilitate Gain Sharing Arrangement
• Planning, Negotiation
• Network Development and Wrap Networks
• Administrative Systems—Claims, Customer Service, Fulfillment, Compliance, Data Reporting
• Employer Group Education
• Integration of Claims Data and Certain Medical Records
◦◦ Population Health Management, Wellness Programs, Nurse Coaching
• Educate and Communicate with Medical Providers
• Administration of Plan Designs
• Sales, Marketing/Branding, and Distribution
• Financial Distribution of Gain Share Disbursements Reporting
FOR MORE INFORMATION ON NEXT STEPS, PLEASE CONTACT:
Bret Petrick, CLU, ChFC, CSFS
Distribution Partner
408.358.0084 | bretACSG@outlook.com
Jack Hill
Partner
630.878.7539 | jack.hill@accountablecaresg.com
www.accountablecaresg.com