Four of the five steps are either invisible or a clear value-add for the health plan member. Why not get started restoring the American Dream?

1. Highly confidential. Do not share without permission.Highly confidential. Do not share without permission.
1
Empowering Community-Owned Health Plans
The Lowest Hanging Fruit: Rationalizing Rx

2. 2
A MOVEMENT TO CORRECT THE STARK IMBALANCE
THERE’S MORE THAN ENOUGH MONEY TO FUND WORLD CLASS HEALTH CARE AND WHAT DRIVES 80% OF HEALTH OUTCOMES
What Drives Outcomes?
10%
Physical
Environment
40%
Social and
Economic Factors
30%
Health Behaviors
20%
Clinical Care
Where Do We Spend Money?
88%
Medical/Rx
[Note: prices 2.5x other countries
with worse outcomes]
4% Health Behaviors
8% Other
Collateral Damage
Fraud
Wasted Spending
Price-gouging hospitals
Profiteering PBMs
Inappropriate treatment

3. 3
Today: Clinicians only receive $0.27 of every $1 ($0.08 for MDs)

4. Highly confidential. Do not share without permission.Highly confidential. Do not share without permission.
HEALTH ROSETTA FRAMEWORK
Sourced from real-life successes of employers everywhere. Collectively, it sustainably
reduces health care spending by 30% or more.
Transparent,AlignedAdvisors
Transparent Open Networks
Independent, Active Plan Administration & Oversight
High-Performance Plan Design, Docs. & Risk Management
Major Specialties & Outlier Patients
Transparent Pharmacy Benefits
IndividualStewardship
EnablingTechnologies
Health Rosetta Market Network
Value-Based Primary Care
4
5-10%
5-10%
~5%
POTENTIAL SAVINGS
10-20%
10-20%

5. 5
ESTABLISHING A NEW HEALTH PLAN
THE OLD WAY
Benefits
Time

6. 6
Learn how to be liberated
from the status quo
Result: Overall savings 20-55% | 4 of 5 Steps invisible or clear
positive to members
L
Step 1

7. 7
ESTABLISHING A NEW HEALTH PLAN
Benefits
THE OLD WAY
L
Time
Learn how to be liberated from the status quo

8. 8
Optimize plan infrastructure
(e.g., advisor relationship, plan docs,
independent admin)
Result: Directly save 5-10% but impacts all spending
Invisible to members
O
Step 2

9. 9
ESTABLISHING A NEW HEALTH PLAN
THE OLD WAY
L
O
Benefits
Time
Optimize plan infrastructure

10. 10
Carve out PBM
Result: Save 5-10% | Invisible to members
C
Step 3

11. 11
ESTABLISHING A NEW HEALTH PLAN
THE OLD WAY
L
O
C
Benefits
Time
Carve out PBM

12. 12
Add Value Based Primary Care
(e.g., DPC with Rx woven in)
Result: Directly save 5-10% but impacts all spending
Positive, visible change for members
A
Step 4

13. 13
ESTABLISHING A NEW HEALTH PLAN
THE OLD WAY
L
O
C
A
Benefits
Time
Add Value-Based Primary Care

14. 14
Leave behind value-extracting
networks & add Centers of
Excellence
Result: Save 20-30% | Most significant change, most impact
L
Step 5

15. 15
ESTABLISHING A NEW HEALTH PLAN
Benefits
Time
L
O
Leave behind value-extracting
PPO networks
C
A
L
INCREMENTAL REALIZED BENEFITS

16. Relocalizing health
Like a $500B Recurring Stimulus

17. 17
THE HEALTH ROSETTA DIVIDEND
OUR KEY SOCIAL IMPACT METRIC FOR REDEPLOYING PREVIOUSLY SQUANDERED HEALTHCARE COSTS
2019 2020 & BEYOND
Hotelier pays for employees & their kids college education (crime plummets,
grad rates spike)
School district has $2B more available for education
Service center’s profit-sharing increases ~$1000/employee
Manufacturer/recycler: Forklift driver retires with executive-like payout
“Shop local” comes to healthcare recirculating $$ in local economies ($3-5k
per person per year)
~$400 million saved across Health Rosetta advisors < 1 year
We will repurpose $billions into
local people/economies
If the Health Rosetta was in a pill, it
would be the blockbuster drug of
the century in terms of improved
health outcomes.

18. Learn more with free book downloads
healthrosetta.org/friends