Lhc Presentation

LHC and KCI 11/4/2009360˚Value Proposition

On-CallClinicalExperts

Care Continuum

Support

Integrated Nationwide

Service

The Most Evidence-Based

Outcomes

Innovative Therapy Systems

V.A.C.® GranuFoam™ Technology

360° of Healing360° of Healing

Carey BeckerDistrict Sales ManagerNew Orleans

Agenda

1. Business Review2. Clinical Account Management

Program3. VAC Champion Definition and

Training4. KCI Express/Ready Care5. What do you want from KCI?

KCI at-a-glance

Global medical device organization with 6,000 employees worldwide

V.A.C.® Therapy- 3rd generation Negative Pressure Wound Therapy (NPWT) Device

Numerous clinical studies, including14 Randomized Control Trials (RCT’s)*

Joint Commission Accredited Organization

Over 3 million wounds treated worldwide*

* Based on KCI Data on File, November 2008

V.A.C.® Therapy: Level A & B RCT Study Comparison Analysis

1. Chaby et al, Dressings for Acute and Chronic Wounds: A Systematic Review, Arch Dermatol; 143(10):1297-1304 (2007)

Numbers of Clinical Evidence by Therapy

V.A.C.® Therapy: A Growing Body of Clinical Evidence

0

100

200

300

400

500

600

700

1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

Articles (580)

Peer Reviewed Articles (479)

Abstracts (587)

Book References (62)

Related Articles (327)

Non-English Language Articles (133)

Peer Reviewed Non-English Articles (31)

V.A.C.® Therapy Publication Numbers as of January 12, 2009

V.A.C.® Therapy: Total Utilization

QTR/YEAR Q1 08 Q2 08 Q3 08 Q4 08 Q1 09 Q2 09 Q3 09

Orders - LHC V655 44 34 31 30 44 48 33

% of Total 16.7% 12.9% 11.7% 11.4% 16.7% 18.2% 12.5%

Orders - LHC Corp 282 292 293 315 270 230 174

% of Total 15.2% 15.7% 15.8% 17.0% 14.5% 12.4% 9.4%

LHC - Aggregate Business Review

-25

25

75

125

175

225

275

325

Q1 / 08 Q2 / 08 Q3 / 08 Q4 / 08 Q1 / 09 Q2 / 09 Q3 / 09

Rental VAC Orders - Qtrly

Orders - LHC V655 Orders - LHC Corp

V.A.C.® Therapy: Current Utilization by Wound Type

* Total wound treated with VAC therapy between July 2008 - September 2009. * Total wound treated with VAC therapy between July 2008 - September 2009.


Trauma Open

Wounds3.76%

Surgical Dehiscences

68.80%

Skin Grafts0.38%

Pressure Ulcers (II/III/IV)

13.53%

Other6.39% No Description

Provided4.89%Flaps

0.38%

Diabetic Ulcers1.88%

Wound Type Category - # Orders - % of TotalLHC V655

Trauma Open Wounds4.85%

Surgical Dehiscences

64.16%

Skin Grafts0.32%

Pressure Ulcers (II/III/IV)

13.71%

Partial-Thickness

Burns0.05%

Other5.97%

No Description Provided

4.85%Flaps0.16%

Diabetic Ulcers5.92%

Wound Type Category - # Orders - % of TotalLHC Corp

V.A.C.® Therapy: Historical Utilization by Wound Group

QTR/YEAR Q1 08 Q2 08 Q3 08 Q4 08 Q1 09 Q2 09 Q3 09

Open Wound 9 11 6 8 17 9 9

Other 6 7 10 7 11 12 3

Surgical Wound 21 14 9 10 10 20 13

Ulcer 8 2 6 5 6 7 8Total: 44 34 31 30 44 48 33


Wound Grp Examples:

Open Wound - Opn Wnd Abdomen, Knee, Hip. Surgical Wound - all diagnosis code 94*. Ulcer - all diagnosis code 707*.

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5

10

15

20

25

Q1 / 08 Q2 / 08 Q3 / 08 Q4 / 08 Q1 / 09 Q2 / 09 Q3 / 09

Rental VAC Orders By Wound Grp - QtrlyLHC V655

Open Wound Other Surgical Wound Ulcer

QTR/YEAR Q1 08 Q2 08 Q3 08 Q4 08 Q1 09 Q2 09 Q3 09

Burn 1Open Wound 57 89 78 80 65 72 59Other 62 58 57 53 60 33 20Surgical Wound 101 89 99 105 76 77 72Ulcer 61 56 59 78 69 48 23

Total: 282 292 293 316 270 230 174Wound Grp Examples:


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20

40

60

80

100

120

Q1 / 08 Q2 / 08 Q3 / 08 Q4 / 08 Q1 / 09 Q2 / 09 Q3 / 09

Rental VAC Orders By Wound Grp - QtrlyLHC Corp

Burn Open Wound Other Surgical Wound Ulcer

V.A.C.® Therapy: Average Length of Therapy (ALOT)

QTR/YEAR Q1 08 Q2 08 Q3 08 Q4 08 Q1 09 Q2 09 Q3 09

Orders - LHC V655 44 34 31 30 44 48 33

ALOT - LHC V655 41.0 40.7 39.0 39.7 45.4 35.2 25.8

Orders - LHC Corp 282 292 293 315 270 230 174

ALOT - LHC Corp 42.9 40.2 43.4 43.2 39.9 37.6 28.2

National Benchmark (ALOT) 39.8 38.6 38.4 39.6 41.2 39.5 39.0


* ALOT (Avg Length Of Therapy) is the number of days between date of placement and stop bill date, plus 1.

* Nat'l benchmark ALOT is derived from KCI order data.

0

5

10

15

20

25

30

35

40

45

50

Q1 / 08 Q2 / 08 Q3 / 08 Q4 / 08 Q1 / 09 Q2 / 09 Q3 / 09

ALOT (Days) Vs Orders - Qtrly

ALOT - LHC V655 ALOT - LHC Corp National Benchmark (ALOT)

V.A.C.® Therapy: ALOT in 30 Day Intervals

ALOT

Intervals Orders % OrdersALOT

Intervals Orders % Orders

1-30 149 56% 1-30 1008 54%

31-60 78 29% 31-60 493 27%

61-90 18 7% 61-90 183 10%

91-120 10 4% 91-120 98 5%

121-150 3 1% 121-150 34 2%

151-180 2 1% 151-180 16 1%

181+ 5 2% 181+ 26 1%

Total 265 100% Total 1858 100%






56%

29%

7%4%

1% 1% 2%

55%

28%

9%

4%2% 1% 1%

0%

10%

20%

30%

40%

50%

60%

1-30 31-60 61-90 91-120 121-150 151-180 181+

ALOT In 30 Day IntervalsLHC V655

Facility Nat'l

54%

27%

10%

5%2% 1% 1%

55%

28%

9%4%

2% 1% 1%

0%

10%

20%

30%

40%

50%

60%

1-30 31-60 61-90 91-120 121-150 151-180 181+

ALOT In 30 Day IntervalsLHC Corp

Facility Nat'l

V.A.C.® Therapy: ALOT by Wound Group

Wound Grp Orders ALOT Wound Grp Examples:

Open Wound 69 29.7

Other 56 37.1

Surgical Wound 97 32.5

Ulcer 42 67.7

Total 264 38.4




69

56

97

42

3037

33

68

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40

60

80

100

120

Open Wound Other Surgical Wound Ulcer

ALOT by Wound GroupLHC V655

Orders ALOT

Wound Grp Orders ALOT Wound Grp Examples:Burn 1 2.0

Open Wound 500 32.7

Other 343 34.2

Surgical Wound 619 38.5

Ulcer 394 57.4

Total 1857 40.1



1

500

343

619

394

233 34 38 57

0

100

200

300

400

500

600

700

Burn Open Wound Other Surgical Wound Ulcer

ALOT by Wound GroupLHC Corp

Orders ALOT

V.A.C.® Therapy: Prescriber Specialties

GIRLING HOME HEALTH CARE #K36640


* Total wound treated with VAC therapy between July 2008 - September 2009. * Total wound treated with VAC therapy between July 2008 - September 2009.

Vascular Surgeons3.03%

Trauma Surgeons0.38%

Podiatry1.89%

Plastic Surgeons

1.89%

Physical Med & Rehab2.27%

Other13.26%

Orthopedic Surgeons

3.79%

Oncology0.38%

No Description Provided32.95%

Internal Medicine5.68%

Infectious Disease1.52%

General Surgeons31.44%

Family Practice0.76%

Cardiologists0.76%

Prescriber Specialties - # Orders - % of TotalLHC V655

Vascular Surgeons3.07%

Trauma Surgeons0.05%

Thoracic Surgeons0.16%

Podiatry4.36%

Plastic Surgeons

3.13%Physical Med

& Rehab0.97%

Other8.35%Orthopedic

Surgeons5.87%

No Description Provided29.04%

Internal Medicine6.14%

Infectious Disease1.24%

Geriatrics0.16%

General Surgeons31.90%

Family Practice4.90%

Cardiologists0.65%

Prescriber Specialties - # Orders - % of TotalLHC Corp

V.A.C.® Therapy: Top Prescriber Detail

2008 2009 2008 2009

Physician Last Name

Physician First Name

No of Orders

No of Orders Total

Physician Last Name

Physician First Name

No of Orders

No of Orders Total

BERRY SCOTT 1 9 10 PATTERSON CHAD 7 10 17

ROOKS JAMES 3 3 6 BROWN DONALD 7 9 16

BENZING JEFFREY 1 4 5 NABERS HUGH 6 9 15

CLEVELAND KENNETH 2 2 4 BERRY SCOTT 1 10 11

HEATH GINA 2 2 4 CARTER PAUL 4 5 9

HOLDEN MATTHEW 1 3 4 BEAVER RICHARD 3 5 8

PARKER AUSTIN 2 2 4 JENSEN PAMELA 4 4 8

BOLTON JOHN 1 2 3 BRITT STEPHEN 2 4 6

DO MICHAEL 1 2 3 COOK BYRON 4 2 6

STECKLER DAVID 3 3 OTHER OTHER 4 2 6

THERIOT DEBRA 3 3 PADULA JOSEPH 5 1 6

ADKINS JONATHAN 2 2 APPLE JEFFREY 1 4 5

ALEXANDER PEGGY 1 1 2 DELEONIBUS JOHN 4 1 5

ALFONSO LACIE 1 1 2 ELLIS ADAM 4 1 5

BABYCOS CHRIS 1 1 2 LAUT DANIEL 4 1 5


LHC V655 LHC Corp

V.A.C.® Therapy: Utilization by Payer

QTR/YEAR Q1 08 Q2 08 Q3 08 Q4 08 Q1 09 Q2 09 Q3 09

Managed Care 18 12 10 11 17 23 13

Medicare 24 18 19 18 25 25 19

Workmans Compensation 2 1

Medicaid 2 2 1 1 2 1

Total: 44 34 31 30 44 48 33


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5

10

15

20

25

30

Q1 / 08 Q2 / 08 Q3 / 08 Q4 / 08 Q1 / 09 Q2 / 09 Q3 / 09

Orders By Payer - QtrlyLHC V655

Managed Care Medicare Workmans Compensation Medicaid

QTR/YEAR Q1 08 Q2 08 Q3 08 Q4 08 Q1 09 Q2 09 Q3 09

Managed Care 109 113 109 127 104 67 68

Medicare 137 156 156 156 140 140 93

Workmans Compensation 6 2 5 2 5 6 2

Medicaid 29 20 23 29 20 17 11

Private Pay 1 1 1 1

Total: 282 292 293 315 270 230 174

0

20

40

60

80

100

120

140

160

180

Q1 / 08 Q2 / 08 Q3 / 08 Q4 / 08 Q1 / 09 Q2 / 09 Q3 / 09

Orders By Payer - QtrlyLHC Corp

Managed Care Medicare Workmans Compensation Medicaid Private Pay

V.A.C.® Therapy: ALOT by Payer

QTR/YEAR Q1 08 Q2 08 Q3 08 Q4 08 Q1 09 Q2 09 Q3 09

Managed Care 52.6 46.3 34.9 38.2 52.2 37.3 24.5

Medicare 29.1 28.4 42.7 35.6 43.0 33.4 26.9

Workmans Compensation 37.0 29.0

Medicaid 78.5 120.5 20.0 130.0 17.5 23.0

Total: 41.0 40.7 39.0 39.7 45.4 35.2 25.8


0

20

40

60

80

100

120

140

Q1 / 08 Q2 / 08 Q3 / 08 Q4 / 08 Q1 / 09 Q2 / 09 Q3 / 09

ALOT (Days) By Payer - QtrlyLHC V655

Managed Care Medicare Workmans Compensation Medicaid

QTR/YEAR Q1 08 Q2 08 Q3 08 Q4 08 Q1 09 Q2 09 Q3 09

Managed Care 41.2 39.0 48.8 40.4 31.2 41.8 32.6

Medicare 38.8 42.8 37.2 44.3 46.9 35.9 25.0

Workmans Compensation 80.8 90.0 87.4 13.5 37.6 29.3 33.5

Medicaid 54.9 20.0 49.7 52.2 38.6 37.7 28.3

Private Pay 228.0 76.0 14.0 11.0

Total: 42.9 40.2 43.4 43.2 39.9 37.6 28.2

0

50

100

150

200

250

Q1 / 08 Q2 / 08 Q3 / 08 Q4 / 08 Q1 / 09 Q2 / 09 Q3 / 09

ALOT (Days) By Payer - QtrlyLHC Corp

Managed Care Medicare Workmans Compensation Medicaid Private Pay

Studies show each day a provider waits to use V.A.C.® Therapy, an additional day is added to the total home care length of stay.1,2

Industry Expertise

V.A.C.®

Therapy Team

Account Executive (AE)

Clinical Account Manager (CAM)

Case Management

Order Processing/ Obtaining Insurance

Authorization

Manufacturing

Customer Service

Service Delivery

Research & Development

Professional Education

Safety& Quality Control

Industry Expertise Research & Development

Continuous R&D efforts

Product Upgrades & New Technologies

Clinical Services

Field-based Clinical Account Managers (RN’s)

Corporate Case Managers

Clinical Progress Management Program- wound assessment program

Professional Education

Local & national educational programs

CEU & CME Accredited Education Programs

WRN- Multi-Tiered Clinician Training Program

Customer Service

24/7 customer support (clinical, order fulfillment, billing questions)

Product Issue Response Team (P.I.R.T.) for customers

Service Delivery

Over 100 service centers nationwide

Joint Commission-Certified Service Centers

Mobile van service & delivery units (available 2009)

Manufacturing/Quality Control

KCI owned manufacturing facilities

Strictly monitored quality control and product cleanliness guidelines

Industry Expertise

Value of V.A.C.® Therapy & KCI

√ Research & Development

√ Clinical Evidence

√ Infrastructure

√ Relationships

√ Service

Caution: Federal law restricts this device to sale/rental by or on the order of a physician.

Trademarks

All trademarks designated herein are proprietary to KCI Licensing, Inc., its affiliates and/or licensors. Those KCI trademarks designated with the “®” or “™” symbol are either registered or pending registration in at least one country where this product/work is commercialized, but not necessarily in all such countries.

On-CallClinicalExperts

Care Continuum

Support

Integrated Nationwide

Service

The Most Evidence-Based

Outcomes

Innovative Therapy Systems

V.A.C.® GranuFoam™ Technology

360° of 360° of HealingHealing

KCI’s 360° of HealingKCI’s 360° of HealingOur Clinical Account Management Program (C.A.M.P.) is a detailed patient management program to assist with achieving cost effective, positive wound care outcomes. Our highly trained clinical experts collaborate with your medical staff to help them manage V.A.C.®

Therapy patients throughout the wound healing process.

KCI’s C.A.M.P Value Proposition:KCI’s C.A.M.P Value Proposition:

KCI’s C.A.M.P. Helps Achieve Patient OutcomesKCI’s C.A.M.P. Helps Achieve Patient Outcomes

V.A.C. ® Wound Patients Assess Wound Progress and Improvement Opportunities

Improved Clinical Outcomes and Economic Effectiveness

Standardize/StreamlineWound Care Practices

Increased Provider/Member Satisfaction

ResourceEfficiency

Improved V.A.C. ® Therapy Patient Outcomes

24

DSL#09-06-383 (7/09)

Review Patient Clinical Summary

Report and schedule visits

Yes

No

Is patient approaching long

term therapy (current days >90)?

Review clinical progress with

Clinical Provider

Complete Bedside consultation with Clinical Provider

Assess patient progress and

complete Clinical Progress Report

Assess patient progress and

complete Clinical Provider Care

Plan

Is the patient improving ?

Complete appropriate payor Clinical Progress

Report

Complete collaboration process and

Clinical Provider Care Plan

Yes

No

KCI Clinical Wound Experts Provide:KCI Clinical Wound Experts Provide:

Comprehensive collaboration with clinical providersComprehensive collaboration with clinical providers

V.A.C.V.A.C.® ® Therapy wound evaluation & consultation Therapy wound evaluation & consultation

V.A.C.V.A.C.® ® Therapy wound management care planTherapy wound management care plan

Patient clinical outcomes reportsPatient clinical outcomes reports

Support with V.A.C.Support with V.A.C.®®discharge planningdischarge planning

In-depth wound care training In-depth wound care training

KCI’s Wound Experts Collaborate With Care GiversKCI’s Wound Experts Collaborate With Care Givers V.A.C.V.A.C.® ® Therapy, Wound Progression And Therapy, Wound Progression And

Documentation.Documentation.

Clinical Progress Report ExampleClinical Progress Report Example

28

KCI’s Wound Experts Provide Consultation On The KCI’s Wound Experts Provide Consultation On The Development Of A Comprehensive Care Plan To Assist With Development Of A Comprehensive Care Plan To Assist With

Management of V.A.C.Management of V.A.C.® ® Therapy Patients Throughout The Therapy Patients Throughout The Wound Healing Process. Wound Healing Process.

KCI Clinical Wound Experts Will Provide In-depth Wound Care KCI Clinical Wound Experts Will Provide In-depth Wound Care Training Which Includes A Series Of Programs Such As Pressure Training Which Includes A Series Of Programs Such As Pressure Ulcers, Dehisced Surgical Wounds, Orthopedic Wounds And Ulcers, Dehisced Surgical Wounds, Orthopedic Wounds And

Diabetic Foot Wounds. Diabetic Foot Wounds.

KCI Clinical Wound Experts Are Also Available To Provide KCI Clinical Wound Experts Are Also Available To Provide Bedside Consultation On Appropriate Use of V.A.C.Bedside Consultation On Appropriate Use of V.A.C.® ® Therapy. Therapy.

Our Clinical Account Manager Program offers an exclusive patient management program whereby our highly trained clinical staff collaborate with physicians and nurses to assess and manage patients through the wound healing process.

KCI’s C.A.M.P. Assist HHA’s With Achieving Clinical and KCI’s C.A.M.P. Assist HHA’s With Achieving Clinical and Financial OutcomesFinancial Outcomes

KCI Wound V.A.C. ® Champions

Identify Regional VAC Champions- NP/PA, WOCN, extensive wound care experience with ability and desire to TRAIN peers

Clinical Account Managers will train identified VAC champions to do the following

a. New Hire Trainingb. Bedside application with HHA Nursesc. Identify and train patient family/friend/home caregiver

to change VAC dressing1x weekd. Identify potential KCI Wound V.A.C.® patients and ask

Rx’ing Doctor for Wound V.A.C.

Additional Clinical Account Manager Support

ANCC KCI Wound V.A.C.® Certification CEU Classes Wound Rounding Referral Exchanges Case Conference Support Wound Assessment Skills Fairs Continuing Education

KCI Express/KCI Ready Care

Facility has On-Line capability to order supplies via the internet

Facility will house KCI Wound V.A.C. ® for use, to include enough supplies until the first home visit with Home Care Nurse

Patient can have KCI Wound V.A.C. ® applied in the hospital upon discharge by LHC nurse, or in the home

Contract and Training to be conducted by KCI

KCI Express/KCI Ready Care

Advantages of KCI Express/Ready Care2. On line ordering of supplies3. On line submission of insurance verification form4. Trained by KCI 5. Decreased lead time for delivery of Wound V.A.C.6. Decrease in time for insurance approval7. New V.A.C. delivered to facility to replace V.A.C. in use

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