Future of Nursing 2020 2030 Angela Patterson DNP

Future of Nursing 2020 -2030 Angela Patterson, DNP, FNP-BC, NEA-BC, FAANP Chief Nurse Practitioner Officer Minute. Clinic Date: November 20, 2019 © 2019 CVS Health and/or one of its affiliates. Confidential and proprietary.

Trends Driving Change in the Health Care Landscape Empowered Health Care Consumer Migration from Sick Care to Self Care Changing Perspectives on Aging Evolution of Personalized Care Evolving Payment Models

Integrated Capabilities Minute. Clinic® Video Visits CVS Pharmacy Infusion Services Care Management Specialty Pharmacy Digital Health and Pharmacy Benefits

Integrated Capabilities and 10, 000+ Nurses Minute. Clinic® NPs and LVNs Video Visits NPs Care Management RNs and LPNs Specialty Pharmacy RNs and LPNs CVS Pharmacy Infusion Services RNs and LPNs Digital Health and Pharmacy Benefits

Minute. Clinic: Improving Access to High. Quality, Lower-Cost Care with High Satisfaction 1, 100+ clinics in 33 states and D. C. ACCESS ~3, 100 providers (NPs/PAs) using Evidence-based guidelines QUALITY Significant savings over higher levels of care (UC and ER) 94% overall patient satisfaction NP (Nurse practitioner). PA (Physician assistant). UC (Urgent care). ER (Emergency room). PCP (Primary care provider). Source: CVS Health Enterprise Analytics, 2017. CVS Health uses and shares data as allowed by applicable law, and by our agreements and our information firewall. 44965 Walk-in care seven days per week including evenings 30 -50% of patients report no PCP VALUE SATISFACTION Accreditation by The Joint Commission Electronic data transfer to plans and providers 83. 2 net promoter score

Health Care and Nursing Priorities Be Local Make it Simple Improve Health Lead the Change Address Social Determinants of Health Commitment to Quality Empower our Nurses 6 © 2019 CVS Health and/or one of its affiliates. Confidential and proprietary.

Be Local: CVS Health interacts with one in three Americans annually In the community ~70% of U. S. population lives within three miles of a CVS Pharmacy In the home 700 K visits annually In the palm of their hand 72 M patients enrolled in text messaging program *Number of in-home visits include visits by Coram, Aetna and vendor nurses or other care team members to homes or other community settings

Be Local = Impact on Social Determinants of Health Project Health Affordable Housing Access to Affordable Quality Care Addressing Housing Insecurity Since 2006, delivered more than $127 M in free health care services to nearly 1. 7 M Americans Investing more than $50 M by the end of 2019 in affordable housing for underserved and at-risk populations

Minute. Clinic: Impacting communities Helping communities through Access to care Population health Our convenient locations and high quality care Broad range of preventive, acute, chronic and wellness services Lower cost of care Low cost services and accessibility supporting ER avoidance initiatives HEDIS/Star Performance PCMH support Evidence-based services and member outreach to close gaps in care Clinical data exchange and recommending that all patients have established PCP 9

We’re reinventing local health care delivery with our community assets ONE EXAMPLE: Original Minute. Clinic® services Legacy ® Minute. Clinic services in 2019 Minute. Clinic® can manage ~ 80% of the scope of typical primary care practice Traditional primary care Currently over 1, 100 Minute. Clinic® locations Urgent care High Acuity Acute Low Acuity Acute Preventive Low Complexity Chronic High Complexity Chronic New services include: • Sleep apnea screening • Retina evaluations • Phlebotomy

4 Transforming the consumer health experience starts with Health. HUB® Complex chronic Risk stratification Common chronic Healthy Enables Personalized engagement • Be local • Make it simple • Improve health Impactful interventions • Coordinate care • Integrate member context • Influence meaningful moments In consumers’ daily lives

Minute. Clinic Patient Journeys Sandy – 59 yrs Patrick – 43 yrs Edgar – 45 yrs “My one-stop shop” “My blood pressure is high, now what? ” “Help me find a doctor and get back on track” Initial Visit 4 visits to manage mix of chronic & acute conditions (HBP, knee pain, prediabetes, acute sinusitis, pneumonia) 2 additional visits to manage his hypertension, including with the on-site dietician Provider recommended patient find a PCP Started on blood pressure meds, BP is normal, and no side effects Patient feels better and is seeing glucose levels decrease “Thankful Minute. Clinic supported me through my medical journey” Patient feels “significantly” better since starting treatment Follow up appointment scheduled with endocrinologist Outcome Return Visits Edgar hadn’t seen a PCP in 2+ years, needed chronic Rx refills, wanted a BP check, diabetes screening and monitoring and needed a referral to a new PCP. Sandy needed a vaccine and ended up returning for a mix of acute & chronic services. Patrick’s BP was high at his last doctor visit, so a visit for a BP check resulted in series of visits for HBP monitoring and support services. Returned 3 x for ongoing chronic & acute conditions (diabetes, upper respiratory infection)

Minute. Clinic Virtual Care We are committed to Virtual Care as a means of increasing access to high-quality, low cost and convenient care Goals • Expand the reach of Minute. Clinic to provide convenient access and improve the health of the populations we serve • Make services more readily available • Improve care coordination • Provider workforce initiative What is Video Visit? How does it work? • Modality introduced as a “real-time” audio-video enabled consult via mobile app, mobile web or your computer with a health care provider, available 24/7/365 • Request a visit: • Patients engage in a video visit for minor illnesses and injuries, skin conditions and women’s services • $59, available in AL, AR, AZ, CA, CO, CT, DE, FL, HI, IA, ID, IL, IN, KY, LA, MD, ME, MI, MN, MO, MS, ND, NE, NH, NJ, NM, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WV, WY and D. C • Adding medical insurance in 2020 – Sign in or create a CVS Pharmacy account via mobile app or computer – Enter information, pay a $59 visit fee and get connected with a health care provider • Video chat with a provider: – Provider will review the patient history and assess the condition to determine the right treatment plan • Receive a treatment plan: – After the video visit, the patient receives a treatment plan – If a prescription is needed, it is sent to the patient’s pharmacy of choice

Minute. Clinic and Age Friendly Health Systems (AFHS) • Minute. Clinic, together with the Case Western Reserve University Frances Payne Bolton School of Nursing and the Institute for Healthcare Improvement, received an AFHS Ambulatory Care Continuum Planning Grant from the John A. Hartford Foundation. • Goal: to build a social movement so all care to older adults is age-friendly care: –Guided by the 4 M’s an essential set of evidence-based practices –Causes no harm –Consistent with What Matters to the older adult and their family

Commitment to Quality: Joint Commission Accreditation • In 2006, Minute. Clinic was the first Retail Health Care company to receive Joint Commission Accreditation. • We have achieved re-accreditation in Full Joint Commission Surveys every three years • We maintain Joint Commission readiness by consistently practicing with Clinical Quality measures and maintaining a safe Environment of Care.

Commitment to Culture: ANCC Pathway to Excellence® © 2019 CVS Health and/or one of its affiliates. Confidential and proprietary.

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