1

CASE STUDY

PeakMed Direct Primary Care Results For A Large Employer

Location: Colorado Industry: Financial Services Size: 500+ Employees / 1,000+ Members THE CHALLENGE During the plan year prior to implementing PeakMed Direct Primary Care, a self-insured employer with over 1,000 eligible members was spending in excess of $5,796 per member per year. Despite increasing enrollment and membership, utilization was decreasing by >5%, outpatient services accounted for 19% of total plan spend, and diagnostic testing increased 24%. Urgent Care usage was increasing, there were over 700 visits to convenience care clinics, and in excess of $11,000 was spent on non-life threatening ER visits. During this same period, primary care visits declined by 20% while specialist visits increase by 39%. THE SOLUTION The broker for this large employer recommended PeakMed Direct Primary Care as a solution for increased utilization of primary care and decreased specialty visits, labs and medication expenses. PeakMed is now in its third successful year with this employer. Primary Care utilization is up, resulting in a 54% decrease in catastrophic claims, 50% decrease in non-life threatening ER visits, 12% decrease in pharmacy spend (even though number of prescriptions increased 46%), and a 24% decrease in total plan spend.

2

QUALITY, FULL SERVICE CARE IS NOT POSSIBLE IN TODAY’S FEE-FOR-SERVICE:

The facts are clear. The CDC National Center for Health Statistics states that the average (fee-for-service) primary care physician has 2,300 patients in their panel. The Journal of Family Medicine writes that the average fee-for-service primary care physician’s panel size (2,300) is too large for delivering consistently high quality care because it would take 20 hours per day to provide appropriate preventive, chronic, and acute care to that many patients. PeakMed physicians limit their patient panels to 750 members and, using the same methodology, can provide all the appropriate preventative, chronic and acute care for their patients in a little over 6 hours per day. Not surprisingly, PeakMed DPC’s service experience and health outcomes are far superior to fee-for-service primary care. RESULTS: COST SAVINGS

176.8

94.3

62.7

Industry Norm PeakMed Year 1 PeakMed Year 2

Urgent Care UtilizationVisits per 1,000 Members

228

195.5

137.5

Industry Norm PeakMed Year 1 PeakMed Year 2

Emergency Room UtilizationVisits per 1,000 Members

PeakMed drove ER Utilization in the first

year to 14% below Industry Norms ER Utilization

decreased an additional 30%

in Year 2

After 2 years, ER Utilization with PeakMedis 40% below industry norms

After 2 years, Urgent Care Utilization with PeakMedis 65% below industry norms

PeakMed drove UC Utilization in the first

year to 47% below Industry Norms UC Utilization

decreased an additional 34%

in Year 2

Primary Care Spend: 3-to-7%

Emergency Room

Urgent Care

Rx

Lab Testing

Specialty Care

Fee-For-Service HealthCare Spend

Downstream CostsIn-Patient, Out-Patient, Specialty Rx, Behavioral Health, Imaging, High Claims

7%-15%Compounding Inflation

Each Year!

WOULD YOU INVEST IN PRIMARY CARE IF IT SAVED YOU 15-25%?

Actual PeakMed Client Savings – After Two Years with PeakMed showing 24% total savings after a 10% increased investment in Primary Care

$6,202

$6,636

$5,417

$5,040

2015 2016 2017

PeakMed DPC Impact on Plan SpendPlan Spend with 7% Inflation

SAVINGS

Actual Plan Spend with PeakMed DPC

Plan Spend Pre-PeakMed

$5,796

First Year withPeakMed

Second Yearwith PeakMed

Actual PeakMed Client Results, 1,000+ employees in Financial Services, Colorado. Spend shown is Per Member Per Year

24% decrease in Total Plan Spend

in 2 years

POPULATION HEALTH MEASURES