Patient Responsibility Performance

Gap Analysis Results

Illustrative Template

Patient Responsibility Performance

Gap Analysis

Date

Initial Results Discussion Performance analysis prepared by

In partnership with

Proprietary and ConďŹ dential

1

Gap Analysis Results

Project Recap Gap Analysis Overview ● The analysis layers proprietary and patented modeling technologies that generate confidence-rated patient financial engagement/performance strategies in the context of ___________ its current Change Healthcare product suite, processes, and vendor relations/other assets. ● Data inputs include historical data file extract/sample, payment and adjustment history, costs, SLAs, SOPs, CC/FAP policies, soft credit data, community-based data, socio-demographics, and behavioral economics. ● The analysis benchmarks performance, calculates economic patient vitals, computes performance KPIs, generates segmentation analysis, determines data integrity levels; insurance discovery and patient payment opportunity; and examines CC/FAP metrics.

Analytic Scope ● Identify and quantify performance gaps related to patient responsibility collections. ● Scrub true self-pay open AR for missed eligible coverage. ● Design data-guided and customized workflow strategies to monetize the opportunities identified.

Proprietary and Confidential

2

Gap Analysis Results

Data Gathering Process/Timeline ● Change Healthcare requested placement and transaction data for accounts with discharge dates > xx/xx/20xx. ● Change Healthcare imported and reviewed all of this data. ● Change Healthcare defined the scope of the gap analysis to include ________ .

Proprietary and Confidential

3

Gap Analysis Results

Sampling Method ● Change Healthcare ○ Rolled charge data up to the encounter level. ○ Used current balance information and mapped transaction data from ______ to work back to the patient balance at time of early out placement for patient accounts. ● Change Healthcare received data for 194,384 records totaling $123,157,317 in patient balance at the time of early out placement (_____ – ____ 20xx) broken out as follows: ○ System 1: 64,579 accounts totaling $49,547,865. ○ System 2: 23,467 accounts totaling $11,762,112. ○ System 3: 106,338 accounts totaling $61,847,340. ● Change Healthcare randomly selected a representative sample of 32,500 records totaling $20,542,450 for the gap analysis broken out as follows: ○ System 1:: 10,800 accounts totaling $8,220,620. ○ System 2: 4,000 accounts totaling $2,024,180. ○ System 3: 17,700 accounts totaling $10,297,699. ○ The sample selected represented ~xx days of average placements for xx/xx/xxxx – xx/xx/xxxx.

Proprietary and Confidential

4

Gap Analysis Results

Performance Baselines & Method Account Vol. (Mthly)

Liquidation Rates

● Avg. accounts | 65,896 ● Avg. placements | $41,655,621 ● Avg. balance | $632

● Liquidation Rate/0-120 | 20.2% ● Liquidation Rate/Total | 23.7%

Segmentation/Benchmarking ● Change Healthcare scored and segmented accounts into patient-specific composites based on economic, demographic and behavioral characteristics correlated to performance; ● It then compared actual performance by record to benchmark performance (normalized for category, segment, and age) in order to identify and quantify areas of improvement opportunity; and ● Annualized performance at variable achievement intervals.

Proprietary and Confidential

5

Gap Analysis Results

Est. Initial Results - $25,681,372 Annual Opportunity @ 75th Percentile SPAI-EO: $22,532,904

AFA

SP-EO: $3,148,468

$TBD

Segment

Opportunity

Segment

Opportunity

1

7,202,451

1

1,630,684

2

551,292

4

55,609

4

2,095,524

10

800,727

10

6,261,096

13

161,595

11

319,424

16

55,960

12

77,177

19

226,196

13

1,197,213

22

124,011

19

2,388,429

25

71,657

20

51,034

22

571,765

28

566,004

35

816,898

42

434,595

42

22,030

●

●

●

ARxChange’s Adaptive Financial Assistance (AFA) tailors patient financial care to each individual's economic circumstances.

Rooted in the field of “compassionomics,” AFA mathematically tunes discounts to each individual’s circumstances given their affordability characteristics, and at levels that achieve the highest possible payment for hospitals.

AFA focuses on financially at-risk distressed and hardship patients with low-to-moderate Economic Patient Vitals and where conventional CC/FAP are insufficient or unresponsive.

Proprietary and Confidential

Key Performance Observations ●

Analysis at the individual patient performance segment level reveals $4,605,884 in additional annual opportunity at the 50th percentile; and $25,681,372 at the 75th percentile.

●

Of note, 47% of the potential gain at the 75th percentile occurs in high-quality segments, which lends itself to a higher confidence regarding its achievability.

●

This analysis can be used to build data-guided strategies for _______ earlier in the process, including POS collections, setting up payment plans, patient tailored counseling/engagement, forecasting, BI, etc.

●

At present, ○

Analysis does not include insurance discovery opportunity, which is expected to be additive to the above and will be completed upon receipt of missing files;

○

The estimated lift is limited only to ________ 0-120-day performance; and

○

It does not include any potential associated with the application of Adaptive Financial Assistance discounting.

6

Gap Analysis Results

Business Intelligence System (White-Labeled) Performance Dashboard Illustration

Proprietary and ConďŹ dential

7

Gap Analysis Results

Next Steps Actioning the Analysis Actions

01

Review Results and ROI Scenario Modeling

02

Design and Deploy Data-Driven Workflow Strategies

Line Item ● ● ● ●

Read-out of analysis Discuss ROI sensitivity/scenarios Prioritize use-cases based on ROI and operational capacity Identify critical transition activities

● ● ●

Engage outsource vendors to finalize workflow and treatment strategy designs Deployment and implementation support Continuous performance improvement and monitoring (including Business Intelligence Dashboard system)

Proprietary and Confidential

8