Approaches to Financing & Aligning Incentives:

Lessons Learned

eHI Capitol Hill Update

May 11 2005

Bridges To Excellence, Inc.Francois de Brantes, Officer and Director

Bridges To Excellence, Proprietary & Confidential Page 2

Original design proven right

Meaningful incentives – 5% to 10% of physician revenue ~ $10K to $15K per physician…cash is especially important for PCPs

Independent review of performance (i.e. NCQA), and panel-wide sampling

Standard and recognized measures that are attainable

Consumer engagement when holding physicians accountable for outcomes

Predictable costs & benefits, and timely rewards

Bridges To Excellence, Proprietary & Confidential Page 3

Original hypothesis also proven right

$1,250

$1,300

$1,350

$1,400

$1,450

$1,500

$1,550

$1,600

$1,650

Diabetes Costs Only

Non-recognized Physicians Recognized Physicians

$170

$180

$190

$200

$210

$220

All PCP cases

Non-Recognized Recognized

Diabetes Care Link Physician Office Link

Average episode costs of care for recognized and non-recognized physicians

Bridges To Excellence, Proprietary & Confidential Page 4

Some barriers and findings were unexpected Small practices need lots of help in

reengineering and there are not many resources available

Single disease focus limits program uptake among PCPs

Recognized docs are happy to get more patients, even w/ a chronic condition

You need a pull (bonus) and a push (steerage) to maximize results

Organized groups required smaller per physician bonuses to get engaged