MHA Update and Strategic Outlook MRRN Meeting March

MHA Update and Strategic Outlook MRRN Meeting March 18, 2015 Brian Peters CEO-Designate 1

Full Disclosure - About MHA • • Established in 1919; Nonprofit (501 C 6) Approximately 100 employees Locations: Okemos campus; Downtown Lansing (CAC) Mission: We advocate for hospitals and the patients they serve. • Primary Membership: hospitals / health systems • Subsidiaries: MHA Service Corporation (for-profit) and MHA Health Foundation (501 c 3) • Health. PAC (perennial Top 10 independent Political Action Committee)

Physician Leadership at MHA Gary L. Roth, D. O. , FACOS, FCCM, FACS Medical Director Michigan Health & Hospital Association Keystone Center 3

Physician – Hospital Collaboration • Medicaid Expansion • Auto No-Fault • GME • Medical Liability • Patient Safety & Quality • Physician Leadership Education • Economic Impact of Healthcare Report

The Outlook: Major Themes • More integrated • More at-risk • More transparent • More importance attached to advocacy/public policy “ 56 -20 -1” 5

More Integrated • 1980: 236 Hospitals; 49, 369 total beds – Nearly all independent • 2015: 133 Hospitals; 24, 617 total beds – 20 systems = over 100 hospitals – 8 out-of-state systems (4 for-profit) – 36 Critical Access Hospitals (1, 300 in U. S. ) • 65% of practicing Michigan physicians are either employed or “near-employed” by hospitals • MHC – GLHIE merger 6

More At-Risk ØRise of high-deductible plans Ø 577, 000 enrolled in MI (5 th highest in nation) ØPrivate exchanges Ø 70, 000 in Michigan – and growing ØNarrow networks ØValue-Based Contracting ØReference pricing; shift from “cost-based pricing” to “pricebased costing” ØCMS payment penalties ØMedicare enrollment = dramatic increase (Baby Boomers) ØMedicaid Expansion = 500, 000 new lives in Michigan ØPatient loyalty to “brand” vs. consideration of price 7

More Transparent MHA Keystone: Care Transitions MHA Keystone: CA-UTI MHA Keystone: ER MHA Keystone: Gift of Life MHA Keystone: ICU MHA Keystone: OB MHA Keystone: Safe Care MHA Keystone: Sepsis MHA Keystone: Surgery MHA Keystone Hospital Engagement Network (HEN) On the CUSP: Stop BSI On the CUSP: Stop CA-UTI MHA Patient Safety Organization (PSO) http: //www. mhakeystonecenter. org/compare. htm

Questions / Discussion BRIAN PETERS | CEO-Designate Michigan Health & Hospital Association 517 -886 -8223 Phone | 517 -323 -1132 Fax bpeters@mha. org www. mha. org 9