WHC Physician-Hospital Organization, Inc.

1. WHC Physician-Hospital Organization, Inc. 2012 Annual Meeting October 17, 2012

2. Agenda • Welcome, Opening Remarks from WHC-PHO Chair Marc E. Boisvert, M.D. • Overview of WHC-PHO Eric R. Wagner • Election of Class I Directors Marc E. Boisvert, M.D. • Welcome, from Chief Operating Officer and Chief Medical Officer MedStar Washington Hospital Center Janis M. Orlowski, M.D. • Comments • Appointment of Class II Directors • WHC-PHO Accomplishments 2012 Carolyn M. Mason • Report from WHC-PHO President Eric R. Wagner • WHC-PHO Strategic Planning Initiative 2012 • Discussion and Questions Marc E. Boisvert, M.D. • Other Business Marc E. Boisvert, M.D. • Adjourn Marc E. Boisvert, M.D. RECEPTION immediately following

3. WHC-PHO 2012 Annual Meeting • Welcome from Chair, WHC-PHO Board of Directors Marc E. Boisvert, M.D.

4. WHC-PHO 2012 Annual Meeting • Overview: WHC Physician-Hospital Organization, Inc. Eric R. Wagner, President

5. WHC Physician-Hospital Organization, Inc. • WHC Physician-Hospital Organization, Inc. "WHC-PHO" is a membership organization incorporated in 1994 to bring together, under a single structure, MedStar Washington Hospital Center including its employed physicians, and its affiliated private practice physicians in order to collaboratively and jointly contract with payers • WHC-PHO’s most significant current program is MedStar Washington Hospital Center’s global-risk program for certain centers-of-excellence, i.e., cardiac surgery, invasive cardiology, and transplant services. This program causes some payers to direct a volume of such cases to MWHC and its physicians • WHC-PHO also serves as a contracting network for MedStar’s insurance products including: • MedStar Family Choice Maryland and D.C. Medicaid products • MedStar Medicare Choice, MedStar’s Medicare Advantage program • MedStar Select, the new MedStar employee health option • WHC-PHO offers its membership certain value-added services including a group purchasing organization (for private practices), educational venues for practice staff including managed care payer in-services, and an electronic managed care handbook, an informational quarterly electronic newsletter

6. WHC Physician-Hospital Organization, Inc. • WHC-PHO operates under a 14-person Board of Directors with seven directors representing MedStar Washington Hospital Center and seven representing the physicians • Membership is designated as Class I and Class II • Traditionally, Class I included only private practice physicians while Class II included all employed physicians as well as representatives of the hospital • During 2012, WHC-PHO Board of Directors revised the by-laws in order to combine all physicians (private practice and employed) under Class I representation • Class II still includes representatives of MedStar Washington Hospital Center including three physicians • Each year WHC-PHO holds elections to select Class I directors • WHC-PHO holds an Annual Meeting during October. Meeting includes: • Election of Class I directors • Appointment of Class II directors by President, MWHC • Business meeting including prior year accomplishments and future year goals • A meet-and-greet reception

7. WHC-PHO 2012 Annual Meeting • Election of Class I Directors Chair, WHC-PHO Board of Directors, Marc E. Boisvert, M.D.

8. WHC-PHO 2012 Annual Meeting • Welcome, and Appointment of Class II Directors Chief Operating Officer and Chief Medical Officer, MedStar Washington Hospital Center, Janis M. Orlowski, M.D.

9. WHC-PHO 2012 Management Report FY 2012 - Year In-review: WHC-PHO, Executive Director, Carolyn M. Mason - Centers-of-Excellence Program: The global-risk program remains strong and continues to bring cardiac and transplant cases to Medstar Washington Hospital Center • Three cardiovascular contracts, with 923 cases • Seven transplant contracts, with 15 transplants and 40 new candidates - Value-added Services: Group Purchasing Organization, In Focus newsletter, Practice Staff Educational Forums and on-line Managed Care Handbook, and Managed Care Educational Forum – Round Table - Revisions to By-laws - Strategic Planning Initiative and Approved Plan - FY 2012 Financial Statement

10. WHC-PHO FY 2012 Financial Statement

11. WHC-PHO 2012 Annual Meeting 2012 WHC-PHO Strategic Planning Initiative Committee: Marc E. Boisvert, M.D.   Carmella A. Cole, M.D.   Cosette O. Jamieson, M.D. Bradley S. Kappalman  Debora Kuchka-Craig Emmanuel T. Mbualungu, M.D.  Edward I. Morris, M.D.  Janis M. Orlowski, M.D.  Eric R. Wagner

12. What’s Next for WHC-PHO?

13. Options for WHC-PHO

14. Can a PHO be a Viable Alignment Model?* • In order to be a viable alignment model, a PHO must: be “clinically integrated”, meaning doctors and hospitals collaborate to provide better care at lower cost, not to leverage higher fees from payers, so that the PHO can offer a compelling value proposition to payers *Certain references in this presentation are extracted from Great Boards, Winter 2009, Vol. IX, No. 4, “Clinically Integrated Physician-Hospital Organizations’.

15. 2012 Strategic Planning Initiative Network and Infrastructure to Support Clinical Integration and Risk-based Programs is lacking: • Full service network and strong culture of engaged primary and specialty care physicians • Web-based Information technology • Clinical practice guidelines and best practices • Provider education, feedback, & monitoring • Strong medical management program to identify and support high cost, at-risk patients • Links to other providers, for example, pharmacy providers

16. Challenges WHC-PHO Membership Trend

17. WHC-PHO Current Membership

18. 2012 Strategic Planning Initiative FY 2012 MWHC Admissions

19. Board Endorsed Strategies Global Agreements - Continue to administer and support global risk-based centers-of-excellence programs - Support additional global risk-based centers-of-excellence programs if additional opportunities present - Support bundled Medicare programs if MedStar pursues Non-Risk-based Contracting - Support the MedStar insurance products to WHC-PHO including: MedStar Select, MedStar’s new employee health option with medical management program MedStar Family Choice – Maryland and DC Medicaid Plans MedStar Medicare Choice, MedStar’s new Medicare Advantage Plan Value-added Services - Offer value-added services to help member-physicians achieve excellence in practice including being good stewards of resources - Continue educational and practice support and enhance level of engagement with WHC-PHO private practice administrative staff including educational forums, managed care handbook, newsletters Monitor Health Care Reform and Implications for WHC-PHO

20. WHC-PHO 2012 Annual Meeting Discussion and Questions

21. WHC-PHO 2012 Annual Meeting Thank You for Coming! Reception begins now