RowdMap, Inc. joined the Rothman Institute at the Medical Group Management Association (MGMA) 2015 National Conference on using government benchmark data to identify and capture hidden value for physicians entering value-based risk arrangements. Joshua Rosenthal, PhD, Chief Scientific Officer and Co-Founder at RowdMap, Inc., joined Mike West, Chief Executive Officer at the Rothman Institute to jointly speak on how doctors can use newly released government data to identify and capture hidden value to succeed in value based risk arrangements. The presentation entitled, “Capturing Your Hidden Value: Using Newly Released Government Benchmark Data to Select Value Programs and Negotiate Risk Arrangements,” was delivered at the Medical Group Management Association (MGMA) 2015 National Conference.

1. All contents are proprietary to RowdMap, Inc. and are being provided on a confidential basis.
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2. 2
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What RowdMap Does
Risk-Readiness SM and You
Rothman Institute
as Best Practice

3. 3
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What RowdMap Does
Risk-Readiness SM and You
Rothman Institute
as Best Practice

4. 4
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WHAT WE DO
It’s Time for Risk
CMS: 50% of FFS will
be gone by 2018
CMS Means
Business!
These are just the first pieces
to move and transforming
payment across the system!
Current payment models aren’t changing provider
behavior.
Providers need help.
Effectsof Health Care Payment Models on
Physician Practice in the United States, May 2015.

5. 5
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without the prior written consent of the Company, is prohibited.
Featured Nationally US CTO on
RowdMap:
“Visionary
Genius”
WHO WE ARE
Founders & Team

6. 6
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without the prior written consent of the Company, is prohibited.
Melanie Rosenthal – Chief Executive Officer
Co-Founder & CEO @ Sprigley [acquired by Eliza Corporation, 2008]; VP of Product Ops @ Eliza
[Majority Equity Investment Parthenon Capital, 2011]; Health Dialog, Yale, Human Genome Project, Tufte, Solstice Capital
Burak Sezen – Chief Information Officer
Co-Founder & CTO @ Sprigley [acquired by Eliza Corporation, 2008]; Platform Architect @ Eliza [Majority Equity
Investment Parthenon Capital, 2011], Health Dialog, Pricewaterhouse Coopers; Ernst & Young; Standards Committees
Joshua Rosenthal, PhD – Chief Scientific Officer
Co-Founder & CSO @ Sprigley [acquired by Eliza Corporation, 2008]; VP of Product Ops @ Eliza
[Majority Equity Investment Parthenon Capital, 2011], Fulbright, Sorbonne (Applied Institute for Advanced Studies),
HHS/CMS/ONC/NCHVS Public Adviser (Technology & Innovation, Market & Policy, Data Access) and HCTTF
Speaker/Guest Lecturer/Guest @ Harvard, Johns Hopkins, MIT , SXSW, HDI, RWJ, AF4Q, NPR (with US CTO and HHS CTO)
Henriette Coetzer, MD – Chief Clinical Risk Officer
Clinical Transformation, NHS (National Health Service, United Kingdom); Global Medical Director, Towers Watson; Senior Medical
Director and Clinical Analytics, BUPA and Health Dialog; Product Development, Healthways; Practicing Physician; Patent Holder
Kimberly Spalding, CPA – Chief Financial Officer
Co-Founder Tech Republic [acquired by CNET, 2001]; Co-founder & CFO Narrowcast
[acquired by QuinStreet, 2011]; Ernst &Young’s Entrepreneurial Services
Bryant Hutson & Ashley Distler – Senior Client Strategists
Cornell, Xavier; Cincinnati Children’s Hospital, Optimity Advisors, Presence Health; Skydiver, Travel Connoisseur
WHO WE ARE
Founders & Team
Industry Leading
Advisory Board

7. WHO WE ARE
Where It’s Worked
7
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RowdMap Success Stories
• Increaseda plan’s membership through smart growth by 40,000
in 12 months; and another plan’s by 40% in the same time
• Reduced membership attrition for a SNP plan in a competitivemetro by 20%
• Launched high-end conciergeplan that broke member price sensitivity and
generatedsignificant profit, doubling original membership goal
• Launched a purpose-built plan for a curatedprovider network
• Increaseda plan’s Star scores by a full point through provider-centric growth
• Designed product strategy and corresponding benefits for a major metro area
that lead to plan’s first profitable product portfolio in three years
• Aligned a plan’s sales and networkteam strategyaround providers
• Tripled a plan’s original goal of contracting with targetedproviders
(and in some cases, out of exclusivity arrangements)
• Shifted a plan’s majority of membershipfrom PPO to HMO, doubling original goal
• Moved a plan’s membershipin targetproviders from 2% to 30%
in target providers in 12 months
• Articulatedclear data-drivenMA strategy for board-levelpresentations
that resultedin additional investments
• Developed comprehensive strategyfor governmentaffairs that created
an advantageous environment for plan and members
Where we’ve done it…

8. 8
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What You Get with RowdMap
Technology and Professional Service
Enterprise
Platform
License
License covers
entire
enterprise
across all
functional units
and all
(reasonable)
users and
usage
RowdMap U
Online
Learning
Center
One of a kind
web-based
resource with tips,
tricks, tutorials
and functionally-
oriented
resources to help
users understand,
and interpret the
information
Benchmarks
Drill Downs
and Profiles
Payer Profiles,
Provider Profiles,
Market and
Geographic
Profiles Including
Social
Determinants
and Health
Behaviors
On-site
Analytic
Workshops
RowdMap
prepares an
analysis across
functional
areas and
presents data,
interpretation
and
recommendati
ons
Auto-
Generated
Reporting
Self-serve
dashboards and
reporting with
tagging and
sharing that
export as PDF or
PPT
Enrichment
Client Data
RowdMap
accepts and
integrates your
data and
incorporates it
within the
RowdMap
platform
Risk
Readiness
Your Provider
Profiles,
Available Risk
Arrangements,
Risk Arrangement
Matching,
Payer/Provider
Risk Profiles
Year in the
Life Custom
Analyses &
Support
Provider Performance
Profiles and Risk-
Readiness
Analysis
New Payment Model
Opportunity Analysis
Reimbursement
Opportunity and
Payer Profile Analysis
Policy and
Regulatory Analysis

9. 9
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As payment models change, the system is looking intently to find
better ways of managing risk. (Who is Risk-Ready SM ?)
The new world of risk
WHAT WE DO
Risk-Readiness SM
And… is your profile coherent,
cohesive and consistent?
In a world intently focused on managing risk, variation is the enemy.
To outsiders (payers), variation is hard to predict and hard to interpret
To insiders (within your practice), variation is disruptive and
difficult to implement standards against.
We are going to show you what your practice looks like from a risk
management perspective (your Risk-Readiness SM profile).
Do you look like a good risk partner?
The right: market position, mix of procedures & drugs, referral partners, practice
profile and docs

10. 10
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without the prior written consent of the Company, is prohibited.
Plan from prevalence & physician supply
Population Report Card
Population Health Report
Population Supply and Demand Report
Population Over-coding / Under-coding Report
Match your practicepatternsto the right arrangements
Risk-ReadinessSM Profile
Risk-ReadinessSM Landscape
Risk-ReadinessSM Value Chain Referral and Leakage Analysis
Risk-ReadinessSM Arrangement Match-Maker
Risk-ReadinessSM Medical Economics Report
Negotiateusing government benchmarks
Payer Report Card
Payer Profit Driver Report
Payer Product Impact Report
Payer - Provider Negotiation Report
Payer - Provider Network Adequacy and Optimization Report

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What RowdMap Does
Risk-Readiness SM and You
Rothman Institute
as Best Practice

12. 12
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without the prior written consent of the Company, is prohibited.
Risk-Readiness℠ looks at a
different category of spending
ACOs, MSSP, Capitation, VBPO: Goal Is to Get Rid
of the 30 Cents of Every Dollar of No-Value Care
Clinically Appropriate,
but Unnecessary Care
(30% of spend)
Claims Spend for a Health Plan /
Government Program
Necessary Utilization
(70%)
“Bigger than higher prices, administrative expenses, and fraud, however,
was the amount spent on unnecessary health-care services.
Now a far more detailed study confirmed that such waste was pervasive.”
In just a single year, up to 42% of patients receive “No Value” Care.
Dr. Atul Gawande,Professor, Department of Health Policy and Managementat the
Harvard School of Public Health & the Department of Surgery at Harvard Medical School.
“It’s generally agreed that
About 30 percent of what we spend on
health care is unnecessary.
If we eliminate the unneeded care, there
are more than enough resources in
our system to cover everybody.”
-Dr. Elliott Fisher,
Dartmouth Institute for Health Policy

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without the prior written consent of the Company, is prohibited.
At the core of Risk-Readiness SM is
Unwarranted Variation:
Every provider has a unique practice pattern
that informs Risk-Readiness SM
Low and Now Value Care Defined by Decades of
Publicly Available Research
Apply the Dartmouth Atlas for Unwarranted
Variation methodologies to the newly
released CMS data. This research has been
repeatedly validated over the last 30 years
and we now have a national data set to
apply the methodologies at a large scale.
Grey area outside of obvious fraud but based on choice of two
options for care that yield same outcomes, but one at marked
higher costs. Definitions across PCP care, specialties.
Provider with High Intensity
Practice Pattern
Maximizing Fee for Service
Provider with Low Intensity
Practice Pattern Maximizing Pay for Value

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without the prior written consent of the Company, is prohibited.
Magnitude of Problem Means Darwinian Approach
30% of the U.S. health care spend goes to no value care
and unnecessary spending driven by FFS Incentives
Over $66B in Florida
$850 Billion Unnecessary Spend* in 2014
30% of U.S. health care spend that goes to
clinically appropriate, but unnecessary
care. Newly released data and historic
models can identify the cost-savings
opportunities in a geography based on the
collective intensity of care delivered by
doctors in that area.
* Unnecessary Spend =
(Dartmouth Avg cost) * (Population) *
(Network Opportunity Index)
Concern Is One Model Won’t Work for All;
New Models Win that Mitigate this 30 Cents
RAND/AMA study confirms providers face challenges, especially
on data, and may not be able to achieve success.
CMS A/B testing payers and providers across a wide variety of
programs and ratcheting economics to find winners.
Over $9B in
Orange County, CA

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without the prior written consent of the Company, is prohibited.
Medicare DocGraph
Referral file
(Patient flows between
PCPS, specialists, hospitals
and post acute centers)
Dartmouth Atlas of Health Care &
Choosing Wisely
(Decades of research and data on
unwarranted variation by condition
and geography to keep things
apples-to-apples for comparisons)
CMS FFS Data Sets, CDC Data Sets
(MEDPAR, Part B, Part D, BRFSS)
(Individual providers, groups,
hospitals and post acute centers)
Provider Pattern Intensity Profiles and
Risk Readiness for every provider,
hospital, post acute center in the US.
All preloaded with no IT.
New Government Benchmark Data
Particularly powerful when pulled together
Affordable Care Act data to determine
Risk-Readiness SM of Providers / Networks
CMS Historic Releases of Largest Provider Data;
Virtually Every Provider, Group, Hospital, Etc.

16. Here’s why these benchmarks are so powerful
16
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without the prior written consent of the Company, is prohibited.
Government benchmark data serves as the common language
necessary to build relationships with providers to
improve the member experience and profitability
The benchmarks are available today with no IT involvement
The data already have a level of analysis on top,
so you can see if a provider is over/under benchmarks
It’s from CMS; it’s a standard;
it’s already used to day to drive reimbursement
CMS Benchmarks Work across all Geographies,
Populations, P&Ls (Care, Caid, Commercial, etc.)

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without the prior written consent of the Company, is prohibited.
HospitalMarketshare
by Major Clinical Categories
ProviderGroupMarketshare
by Major Clinical Categories
PhysicianMarketshare
by Major Clinical Categories
MSSP Candidate
Circulatory
Respiratory
Unnecessary Spend in Miami
By condition across hospitals,
groups and physicians
Know Your Market and How Much / Little
No-Value Care You Create in It
Large purple boxes are most difficult targets. Large light boxes
are great candidates. Small purple have work to do. Small light
should focus on growth.
Next Gen ACO
Candidate

18. 18
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without the prior written consent of the Company, is prohibited.
Know Your Market and How Much / Little
No-Value Care You Create in It
Diabetes Prevalence PCP Density
Income
Obesity
Depression
Demand vs. Supply
Sick and underserved
Westchester, NY
RowdMap’s Population Health Report helps you allocate care management
resources around condition-specific population needs by zip.
For example, reassess expansion and PCPS contracting strategies by zip
code or locate retail clinics, RVs and health fairs based on chronic needs.
Population Health Report

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without the prior written consent of the Company, is prohibited.
Know Exactly What Drives Success in Each Type of
ACO or Value Based Arrangement in Your Market
Largest Counties in CA
Regional
Benchmarks
Risk
Scores
Total
Cost
PMPM
Reimbursement
Overall
Star
Chronic
Star
Health
Rank
Network
Opportunity
Profit
Opportunity
MA
Profit
Opportunity
Exchange
Medicare
Eligibles /
MA Enrolled
Exchange
Subsidy Eligibles /
Exchange Enrolled
Medicaid
Beneficiary Eligibles /
Beneficiaries
Population Report Card
RowdMap’s Population Health Report helps you calibrate
Expectations for profitability by incorporating population
health and provider performance into strategy.
For example, some geographies lend themselves to volume and
profitability around specific products and lines of service.

20. 20
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without the prior written consent of the Company, is prohibited.
Know Your Practice Pattern, Its Drivers, and
How You Compare to Your Competition
Orange County, CA
Regional Benchmarks
Identify and highlight highly efficient, Risk-Ready practices.
For example, focus resources and growth opportunities in these
practices and share best practices with other physicians.
Group Risk-Readiness SM Report

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without the prior written consent of the Company, is prohibited.
Know Your Practice Pattern, Its Drivers, and
How You Compare to Your Competition
PCPs
Identify low cost, highly efficient physicians and make them your
stars. For example, feature them in risk arrangements.
Physician Risk-Readiness SM Report
Regional Benchmarks
Jefferson Co, KY

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without the prior written consent of the Company, is prohibited.
Know Your Practice Pattern, Its Drivers, and
How You Compare to Your Competition
California
EOL Hosp Days: Which hospitals fewer end-of-life days than their peers?
Chronic Admits: Which hospitals see their most chronic population repeatedly/ with the most frequency?
Cardiac Imaging: Which hospitals are more likely to over-utilize cardiac imaging compared to their peers?
Regional Benchmarks
Highlight and focus on relationships with low cost and efficiency in end of
life and chronic care. For example, target for referral management or use
them as levers for risk contracting with payers and government programs.
Hospital Risk-Readiness SM Report

23. 23
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without the prior written consent of the Company, is prohibited.
Know Your Practice Pattern, Its Drivers, and
How You Compare to Your Competition
Identify high and low performing post-acute facilities.
Consider planning post-discharge interventions and protocols with
the highest performing facilities.
Post Acute Center Risk-Readiness SM Report Westchester County, NY

24. 24
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without the prior written consent of the Company, is prohibited.
Decreased
Cost
Average
Increased
Cost
LessEfficient
1
2
3
4
5
MoreEfficient
Miami Dade, Florida
Risk-ReadinessSM
Benchmark
Impact on
Spend
Know Exactly How Much Value You Create for
Whoever Owns the Risk in Any Arrangement
$ PMPY per Specialty & Efficiency Score
Providers ‘hidden value’ can be quantified into dollars from how much
no-value care they mitigate. These dollars are translated into different
ACO, MSSP, Capitation arrangements differently. Make sure you pick
the right program / arrangement in order to maximize your value and
get credit for your work.

25. 25
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without the prior written consent of the Company, is prohibited.
Know Exactly How Much Value You Create for
Whoever Owns the Risk in Any Arrangement
Primary Care
Docs
Specialist
Post Acute
Facility
Thickness of lines indicates
the number of referrals.
Note: Some markets are
oversupplied. This market is
controlled by one provider.
Less efficient
More efficient
Identify PCPs that refer to higher intensity specialists.
Consider new contracting arrangements and provider education to
improve overall care efficiency.
Risk-Readiness SM Value Chain Referral and Leakage Report

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without the prior written consent of the Company, is prohibited.
26
Negotiate from Health Plan’s Expected Pro Forma,
Strengths, Weakness and Provider Contribution
Payer Profiles and Report Cards
If opting for a virtual ACO or other capitated arrangement with a payer
partner, determine which payers have acute needs and where and how
you help them. For a payer with low reimbursement, poor population
health scores, poor overall clinical metrics and a small population,
negotiate less from your medical performance and
more from your coding and panel size.
Blue = Volume
Every Payer in
your market

27. All contents are proprietary to RowdMap, Inc. and are being provided on a confidential basis.
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without the prior written consent of the Company, is prohibited.
27
Unless a utilization review or actuarial analysis can connect points on
the no/low-value care path and address the entire bundles they miss
the largest pocket of value, even when case mix adjusted
This doctor has
lower utilization
and unit costs
But this doctor is making money for
whoever owns the risk
Providers Who Mitigate No/Low-Value Care
Often Do Not Get Credit

28. All contents are proprietary to RowdMap, Inc. and are being provided on a confidential basis.
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without the prior written consent of the Company, is prohibited.
28
Unless a utilization review or actuarial analysis can connect points on
the no/low-value care path and address the entire bundles they miss
the largest pocket of value, even when case mix adjusted
Providers Who Mitigate No/Low-Value Care
Often Do Not Get Credit
This doc is making money for whoever owns the
risk across value based arrangements
She might not be the highest
producing and may cost more…
…but she’s disproportionately
reducing unwarranted costs
and unnecessary negative
impact and patient experience

29. 29
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without the prior written consent of the Company, is prohibited.
New Public Data Shows Risk-Readiness SM and
Drivers for Groups, Individual Physicians
Practice patterns for unnecessary spending and no-value care
benchmarked nationally and regionally inform government
programs and payer-based risk arrangements
Great profile for
aggressive risk
Tread carefully on
path to risk
Match appropriate risk arrangements based on
provider practice patterns and
Population characteristics within a geography

30. 30
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without the prior written consent of the Company, is prohibited.
CMS: 50% of FFS will
be gone by 2018
What if you knew which
providers would
drive your success?
What if you knew which
providers would sink you?
Here’s who will win and who will lose

31. 31
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What RowdMap Does
Risk-Readiness SM and You
Rothman Institute
as Best Practice
Mike West,
CEO

32. 32
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without the prior written consent of the Company, is prohibited.
Philadelphia, PA
Orthopedic Surgeons Only
Group Risk-Readiness SM Report
Rothman Institute
Best Practice at Risk-Readiness SM
Rothman Institute
The most Risk-Ready orthopedic group in Philadelphia. Practicing
care in a way designed to maximize value based risk arrangements.
Large patient panel and the best performing, and Best Practice at
mitigating unnecessary spending from no / low value care.
Performing above national and regional benchmarks
in every category.

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without the prior written consent of the Company, is prohibited.
Philadelphia, PA
Orthopedic Surgeons Only
Group Risk-Readiness SM Report
Rothman Institute
Best Practice at Risk-Readiness SM
Questions for Mike West, CEO, Rothman Institute
1 – What have you done to achieve this Risk-Readiness SM ?
2 – What does this data allow you to do and what are your plans?