2014 Accomplishments

Brochure

Health Care Management Services, Inc.

2

MissionVHA Georgia, Inc. and Phoenix Health Care Management Services, Inc. exist to bring excellent value to our members and owners by providing synergistic services, information exchanges and collaborative initiatives that help our health care organizations meet the growing challenges of service to their communities.

~ VHA Georgia exists to consistently deliver expert guidance and solutions that drive exceptional performance through collaborative power for the members we serve.

~ Phoenix exists to create innovative services and solutions, best achieved collaboratively, that deliver superior economic and operational results to health care providers.

Vision ~ VHA Georgia will be the pre-eminent, indispensable organization of community-owned health care systems that collaborate to achieve industry leading performance.

~ Phoenix will be the pre-eminent, indispensable enterprise delivering superior economic results.

ValuesThe principles guiding services that our staff provides to our members are:

Excellence – To exceed our members’ and customers’ highest expectations through the continuous pursuit of excellence.

Results – To deliver outcomes that are indispensable and integral to our members’ and customers’ success.

Integrity – To always deliver on our commitments and build all relationships on honesty, trust and respect.

Service – To listen, create, execute and surpass member and customer needs.

Teamwork – To collaborate internally and externally to succeed at everything we do.

Innovation – To be visionary, creative and dynamic, strengthened by the collective wisdom of our members and customers.

3

Helping Members Navigate Health Care ComplexitiesThroughout 2014, members of VHA Georgia and Phoenix actively pursued efforts aimed at improving quality of care and reducing costs as part of their strategic work and operational practices. We are pleased to have been a part of those efforts by bringing members together to gain efficiencies of scale—be it knowledge, purchasing volumes or shared services. Through a variety of programs and services built on bottom line improvement, clinical and quality improvement, and the power of collaboration, members were able to learn, share, experiment and improve in a trusting environment whereby participation resulted in better patient care and hospital performance.

VHA Georgia offered several improvement and learning councils and initiatives aimed at improving operational and clinical processes that positively engaged physicians, staff and patients, enhanced clinical quality and safety metrics, and generated costs savings, cost avoidance and/or revenue enhancements. Highlights included the development of a new Health Transformation Advisory Group, continued quality focus through the VHA HEN, and a renewed focus on cost management. Additionally, VHA Georgia members benefited from major educational events, comparative benchmarking reports and performance improvement solutions including advanced analytics and expertise through VHA Inc. Improvements made as a result of this work included a positive financial impact for VHA Georgia members of over $58.8 million.

Phoenix Health Care Management Services offered additional opportunities for bottom line improvements. Through our Phoenix Committed Insurance Program (PCIP), over 231,000 insurance policies were purchased in 2014. Georgia ADS offered a secure way to pool financing in addition to the group purchase of stop-loss insurance. HSI Financial Services continued to improve and contribute to our members’ success by collecting $11.1 million for its clients in 2014. Finally, Georgia Medical Resource Pool (GMRP) continued to meet staffing needs and requests by providing 37,914 hours of contingent staffing to its customers. Combined, Phoenix participants documented value of just over $36 million through participation in these companies, as well as our regional contract portfolio.

In addition to regional activities, VHA Georgia members also reported a documented value of $29.2 million through national supply chain and service offerings. All told, we are pleased to report over $124.1 million in bottom line improvements for 2014. As health care complexities continue to arise and evolve, VHA Georgia and Phoenix exist to serve and will proudly continue to provide solutions, expertise and a trusting environment to assist all members in their journeys to provide high quality, affordable, local health care to the communities they serve.

Philip R. Wolfe, FACHEPresident and CEOGwinnett Health System, Inc.Chair, VHA Georgia, Inc.

Richard T. Howerton, III, FACHEPresident and CEOVHA Georgia, Inc. and Phoenix Health Care Management Services, Inc.

Total Savings$124.1 Million

J. Perry Mustian, FACHEPresident and CEOArchbold Medical Center, Inc.Chair, Phoenix Health Care Management Services, Inc.

4

Discovering New Ways to Improve Quality of Care Advisory Services, Analytics, Collaboration & Expertise

While VHA Georgia serves as a local presence to provide services specific to the needs of its members, a relationship with VHA Inc. allows us to leverage national opportunities that provide further economies of scale. VHA national programs combine the best of national strength and local presence to provide meaningful solutions for its members.

World Class SolutionsAnalytics

With VHA’s industry-leading suite of business intelligence solutions, VHA LYNX™ helps you increase savings and improve supply chain and operational performance.

Consulting

Members have access to more than 250 experts in a wide range of health care performance consulting specialties, including supply chain, clinical and financial.

Contracting

Benefit from the best group purchasing organization in the country – Novation. With the largest purchasing volume in the industry, Novation has just under $50 billion in annual purchases and in partnership with VHA Inc., gives you access to the lowest prices, highest quality and broadest portfolio of supplies, pharmaceuticals, capital equipment and purchased services.

Expertise

We invest in people who are skilled advisors to hospital staff and executives alike, and who excel in all health care environments along the continuum of care.

Performance Improvement

VHA IMPERATIV® combines vital information with expert advisory services, proprietary knowledge resources and collaborative networking.

Revenue Cycle Management

Through relationships with industry leaders, VHA offers revenue management and technology services that will help you vastly improve payment cycles and reimbursement models.

Through a variety of programs, group buy opportunities and regional supply networks, VHA Georgia members documented $29.2 million in savings in 2014 as a result of the various opportunities listed below:

Capital Group Buys – $2,051,723

Cash Distributions – $13,884,665

Performance Services – $4,027,221

Purchased Services – $2,002,869

Standardized Programs – $3,822,182

Supply Networks – $3,437,410

$29.2 Million

5

VHA Hospital Engagement Network (HEN)VHA’s Hospital Engagement Network (HEN) is part of the federal Partnership for Patients (PfP) initiative and is the third largest in the country.

In 2014, the VHA HEN had just under 200 participating hospitals that continued to improve in 10 areas of focus including adverse drug events, early elective deliveries, falls, hospital acquired infections and readmissions. Of the total number of participating hospitals, 10 were part of the VHA Georgia HEN, all of which met or exceeded the goals set forth by the initiative. One of the VHA Georgia HEN members, Grady General Hospital, was recognized several times for their success with the program. The award-winning team is pictured below.

VHA Leading Practice Blueprint®The blueprint, a proprietary VHA methodology, highlights leading practices at individual hospitals through detailed, easy-to-understand visual depictions and supporting narrative on proven processes. Helping to drive cultural change and improve patient care, blueprints transform leading practices into something easily shared and replicated across VHA’s membership. Current blueprints cover topics such as care coordination, clinical management/quality, patient safety, patient experience, supply management, green health and population health management.

VHA Georgia members blueprinted in 2014 include:

~ Athens Regional Health System for reducing surgical site infections in cardiac surgery

~ John D. Archbold Memorial Hospital for successfully preventing Ventilator Associated Pneumonia (VAP)

~ Northeast Georgia Health System for their success in managing their health populations and for preparing patients for the responsibility of owning their own health care

~ WellStar Health System for their success with implementing evidence-based orders for blood utilization as it relates to the safety and quality of care of blood management and also for eliminating preventable harm

VHA Georgia’s HEN Named Collaborative of the Year As part of VHA Inc’s Hospital Engagement Network (HEN) and the federal Partnership for Patients (PfP) initiative, the VHA Georgia HEN surpassed established goals which were to improve in 10 of 11 areas of focus ranging from falls and surgical site infections to readmissions. They were also tasked with reducing hospital-acquired conditions by 40 percent and readmissions by 20 percent.

VHA Georgia HEN members contributed to this success by demonstrating an outstanding commitment to the Partnership for Patients initiative by reporting data at the highest level across all areas of focus and as such, received Gold and Platinum Awards. All VHA Georgia HEN members were also highlighted in VHA’s HEN Quarterly Honor Roll for outstanding performance.

Athens Regional Health System and Grady General Hospital were featured as VHA HEN success stories by the Centers for Medicare and Medicaid Services (CMS), and three VHA Georgia HEN members were blueprinted as leading practices and were also selected as mentor organizations. They included Athens Regional Health System, John D. Archbold Memorial Hospital and Northeast Georgia Health System. As a further honor, Dr. James L. Moore, Senior Vice President and Chief Medical Officer of Athens Regional Health System and Karen Watts, MSN, RN, NEA-BC, Vice President of Patient Care Services of Northeast Georgia Health System were also asked to serve as advisors.

Congratulations to the VHA Georgia HEN for documenting $13, 221,021 in cost avoidance/savings for 2014 and $14,339,671 over the entire 3-year HEN engagement! As a result of their efforts and leadership, they are VHA Georgia’s Collaborative of the Year!

Crystal Ramm, RN, MSNAdministrator/Director of NursingGrady General Hospital

“Archbold’s system-wide collaboration with VHA has helped our hospitals implement and improve processes for the patients we serve in many ways. At Grady General Hospital, our VHA partnership allowed us to receive on-site visits from both nurses and physicians. As a result of VHA’s education and on-site peer-to-peer guidance, we have been able to engage not only our frontline staff, but also our physicians in many of the health system’s quality improvement projects—an essential component necessary to achieve a high level of success. The support from VHA provided through networking and best practices was a true asset to our success.”

Pictured L to R: Vicky Jenkins, RN, BSN; Crystal Ramm, RN, MSN; and Julie Dumas, RN, BSN – Grady General Hospital HEN Team Leads

6

VHA Georgia brings members together to exchange ideas, learn best practices, benchmark performance and leverage economies of scale. In doing so, members are able to succeed more effectively and efficiently than they otherwise would independently. These collective efforts demonstrate VHA Georgia’s power of collaboration.

Blood Management CollaborativeLaunched in 2012 under the direction of leading practice organization WellStar Health System, 100 percent of the membership participated at one time or another in the collaborative, with many organizations using the knowledge learned to implement blood management programs at their own facilities. This included the restructuring of blood committees, identifying physician champions and educating physicians and staff on evidence-based practices. New protocols, order sets and transfusion guidelines were then established. Other factors that contributed to the savings were reductions in other blood costs including storage, additional products and staffing, as well as improved infection prevention and reduced complications.

In 2014, VHA Georgia started reporting data via bi-monthly meetings, the results of which have led to member facilities more consistently and appropriately collecting blood transfusions and managing the reduction of unnecessary transfusions and/or preventable complications. Of the participating members, three hospitals regularly lowered their transfusion ratio over three calendar years.

With the overall goals being to improve the health and safety of the patient population and to reduce the costs associated with avoidable transfusions, many VHA Georgia members have successfully made improvements or are well on their way to implementing changes, with a total reported savings for 2014 of $3,829,822.

Palliative Care CollaborativeAs the population ages and is experiencing the impact of chronic diseases, palliative medicine is increasingly being recognized as a way to improve patient care and to save valuable hospital resources. Palliative care programs are rapidly becoming an essential partner in transitions of care.

In response, the VHA Georgia Palliative Care Collaborative provided members the opportunity to participate with a network of hospitals and subject matter experts as they learned the building blocks of designing and implementing a new program based on standards and leading practices. The collaborative also engaged hospitals and systems with current programs as they explored ways to improve their programs, to increase referrals and to expand into outpatient services. Quarterly webinars were offered that focused on legislative and payment challenges related to palliative care, as well as provided insight into developing the clinical and business case for palliative medicine. Members shared solutions to challenges as they routinely reviewed the collaborative dashboard and highlighted improvements by leading practice organizations. In 2014, the Palliative Care Collaborative reported $5,176,918 in cost avoidance/savings.

Working Together to Solve Common Challenges Performance Improvement

Tim Adams, RNPalliative Care Director and Medical Oncology & Infusion Therapy ManagerFloyd Medical Center

Kenny Lowery, M.Ed., MT (ASCP)Director, Laboratory ServicesHamilton Health Care System, Inc.

“The VHA Georgia Palliative Care and Readmission collaboratives provided the opportunity to learn about varying approaches for meeting the needs and finding solutions for program leaders, clinical staff, patients, family members, administrators and organizational leaders. Additionally, the collaboratives provided an opportunity for open dialogue, education on best practices and care delivery and resourcing models—all from a point of view based in real-life experience. Our efforts, particularly in the Palliative Care Collaborative, have brought reduced lengths of stay and a six-figure cost avoidance that stand on their own. But at the end of the day, it is the networking and sharing of knowledge that makes a daily difference in our hospital.”

“Through participation in the VHA Georgia Blood Collaborative, Hamilton Medical Center was able to reduce the utilization of blood products and avoid preventable complications. By sharing information among members of the collaborative, we were able to implement new protocols, order sets and transfusion guidelines. We also learned how to improve our reporting process to make better use of our data and improve outcomes."

7

Readmissions CollaborativeHospitals are continually challenged with reducing avoidable 30-day readmissions, especially with high risk and chronic disease populations.

VHA Georgia’s Readmissions Collaborative provided an interactive environment to learn from subject matter experts and leading practices to enhance work already in progress on these initiatives. Evidence-based driver diagrams and VHA Leading Practice Blueprints® were used to identify key components for successfully addressing readmissions. These tools also enabled members to assess their current status and to identify gaps for improvement. Based on common opportunities, the collaborative focused on organizational processes and accountability for improvement, medication reconciliation and management, teaching and motivating a patient’s effective self-care, and discharge transitions related to long-term care facilities. Additionally, a collaborative dashboard was used to track and compare improvements among participants and to drive discussions around challenges and successes.

By building upon existing work and implementing new improvements, members of the Readmissions Collaborative realized a cost avoidance/savings of $3,595,902 for 2014.

Navicent Health is a designated Level I Trauma Center and is one of 130 hospitals worldwide to achieve its third designation as a Magnet® hospital for nursing excellence. It provides a broad range of community-based, outpatient diagnostic, primary care, extensive home health and hospice care, and comprehensive cancer and rehabilitation services. A premier teaching hospital, Navicent Health serves the surrounding communities of Central and South Georgia.

Over the past year, Navicent Health was actively involved in VHA Georgia’s Palliative Care Collaborative. By serving as a leading practice organization, they helped members improve upon their current programs by sharing the success they have had within their own hospital system—specifically, how they have integrated care, population health and palliative care by focusing on how their patients could find relief from the symptoms, pain, stress and suffering caused by serious illnesses. As a result of their efforts, Navicent Health realized $4.5 million in savings for 2014.

Not only have other members benefited from this collaboration, but Navicent Health has as well. By coming together and sharing experiences among peers and learning about new programs from experts in the field, everyone takes away valuable information that they can use to make improvements in their own organizations.

“VHA Georgia has always kept us informed of research related to palliative care. By bringing in leading practice experts, they have helped us learn more about the outpatient side of palliative care, as well as the many programs available to help us continually improve in this area,” said Carol Babcock, MFT, Manager of The Center for Palliative Care, Navicent Health.

Going forward, Navicent will continue to participate in other VHA Georgia educational programming, as everyone works toward solving the common challenges many hospitals are now facing in health care.

Navicent Health Leads the Way in Palliative Care

Jessica WhiteDirector of Quality & Performance ImprovementJohn D. Archbold Memorial Hospital

“Participating in the VHA Georgia Readmissions Collaborative provided the starting point we needed to launch our initiative. As a result, our team implemented a risk for readmission assessment and modified the medication reconciliation process. These changes have allowed us to better identify and respond to patients who are at high risk for readmissions.”

8

Working Together to Solve Common ChallengesNetworking & EducationVHA Georgia offers numerous council networks, an online 24/7 forum, regional initiatives and educational conferences. Participating in these programs fosters learning and development by connecting you to thought leaders, industry experts and leading practices. They also facilitate dialogue among peers who are experiencing—or have solved—similar challenges.

~ Blood Collaborative – $3,829,822

~ CFO Council Initiatives – $51,419

~ Charge Audit Council Initiatives – $7,435,254

~ CIO Council Initiatives – $1,099,598

~ CNO Council Initiatives – $289,031

~ Hospital Engagement Network (HEN) Initiatives – $13,221,021

~ Home Health & Hospice Council Initiatives – $3,323,751

~ HR Council Initiatives (also contributed to PCIP Savings) – $925,431

~ Infection Prevention Council Initiatives – $936,597

~ Lean Six Sigma Program – $3,087,992

~ Palliative Care Collaborative – $5,176,918

~ Patient Safety Initiatives – $5,155

~ Performance Improvement & Quality Council Initiatives – $293,683

~ Pharmacy Council Distribution Regional Enhancement – $3,196,027

~ Pharmacy High Impact Contract Launches – $1,068,017

~ Physician Practice Management Council Initiatives – $838,575

~ Radiology Council Initiatives – $25,637

~ Readmissions Collaborative – $3,595,902

~ Respiratory/ICU Council Initiatives – $20,159

~ Revenue Cycle Management/Managed Care Council Initiatives – $1,246,039

~ Supply Chain Regional Enhancements – $8,625,427

~ Supply Chain Medical/Surgical High Impact Contract Launches – $223,826

~ VHA Georgia Co-Op Cash Distribution – $296,834

$58.8 Million

Thank You Council ChairpersonsA vital part of our councils, the chairperson’s role is to assist the council coordinator in planning and leading meetings, as well as giving direction on how to best engage council members to work toward a common goal.

VHA Georgia would like to thank the following chairpersons for their leadership in 2014!

~ Amy Yost, Northside Hospital–Forsyth, Cardiology Leaders Council

~ Lisa Thomas, Hamilton Health Care System, Inc. and Kamela Sooknanan, WellStar Health System, Case Management Leaders Council

~ Rhonda Perry, Navicent Health, CFO Leaders Council

~ Wendy Allen, Phoebe Putney Memorial Hospital, Charge Audit Leaders Council

~ Guy McAllister, Tift Regional Medical Center, CIO Leaders Council

~ Elizabeth Gunn, Southeast Georgia Health System and Amy Cason, Phoebe Putney Memorial Hospital, CNO Leaders Council

~ William Peterson, Phoebe Putney Health System, Inc., Human Resources Leaders Council

~ Dr. William Guest, Tift Regional Medical Center, HTAG

~ Nancy Osborn, Navicent Health, Infection Prevention Leaders Council

~ Tripp Layfield, Columbus Regional Health, Legal Defense Forum

~ Tom Lynch, Gwinnett Medical Center, Managed Care Leaders Council

~ Melissa Anderson, Navicent Health, Pharmacy Leaders Council

~ Dr. Willie Cochran, Southern Regional Medical Center; Dr. Bill Guest, Tift Regional Medical Center; Dr. William Farr, University Health Care System and Dr. Reg Gilbreath, DeKalb Regional Health System, Physician Leaders Council

~ Melissa Cornwell, WellStar Health System and Heidi Nelson, University Health Care System, PI, Quality and LSS Leaders Council

~ Daniel Bosarge, Floyd Medical Center, Physician Practice Management Leaders Council

~ Twilla Hulett, Navicent Health, Radiology Leaders Council

~ David Ellwanger, Southern Regional Medical Center and Robin Godwin, Archbold Medical Center, Inc., Respiratory/ICU Leaders Council

~ Teresa Prevost, Floyd Medical Center, Revenue Cycle Management Leaders Council

~ Bill Foley, DeKalb Regional Health System, Supply Chain Leaders Council

William PetersonAssistant Vice PresidentHuman ResourcesPhoebe Putney Health System, Inc.

“Participating in VHA Georgia’s Human Resources Council has been very beneficial and a good resource to learn about what other members are challenged with, to collaborate and to also share best practices. Additionally, the 24/7 Forum has been a great tool to continue dialogue and ask questions in between face-to-face meetings.”

9

Leadership Awards ProgramIn addition to bringing members together for networking and education, VHA Georgia likes to recognize and reward those members that have achieved success as a result of participation. The Leadership Awards Program also serves as a means to share their success with others.

Every year, members submit their recent success stories through a leadership application process as part of our Leadership Awards Program.

This prestigious awards program recognizes VHA Georgia members that have exhibited extraordinary levels of performance by successfully implementing improvements within their organization.

In 2014, 65 applications were submitted, and 52 members participated in the peer review process to help determine the top three applications in each bed size category.

All 65 projects were shared at our annual Leadership Expo via a poster session where everyone’s success was celebrated, award winners were announced and peer reviewers were recognized.

A complete list of previous years’ winners can be found on our website at www.vhageorgia.com, as well as a listing of leading practice case studies.

Chris Hobbs, RNManager, Emergency Department and ICUPerry Hospital/Houston Healthcare

“It was an honor to be recognized at VHA Georgia’s 2014 Leadership Expo. The application process was smooth, and we enjoyed learning about leading best practices from other member organizations during the poster session at the event.”

2014 Leadership Award Program WinnersCongratulations to all of the hospitals that submitted winning entries to our 2014 Leadership Awards Program!

Category: 0-49 Beds (Acute and Non Acute Facilities)

~ 1st Place: Houston Healthcare (Perry Hospital) – “Increasing Patient Satisfaction and Throughput in the Emergency Department with Immediate Bedding”

~ 2nd Place: Floyd Medical Center (Limb Preservation Clinic) – “Outcomes of a Nurse Practitioner Driven Limb Preservation Clinic in Northwest Georgia”

~ 3rd Place: Southeast Georgia Health System (Camden Campus) – “Improving HCAHPS: One Patient at a Time”

Category: 50-149 Beds

~ 1st Place: Grady General Hospital – “Birth of a New Early Elective Delivery Rate”

~ 2nd Place: WellStar Douglas Hospital – “Stabilization of the Sick Newborn”

~ 3rd Place: WellStar Douglas Hospital – “Surge Protection: Overcoming Throughput Barriers in the Hospital Macro System”

Category: 150-349 Beds

~ 1st Place: Floyd Medical Center – “Reducing Sepsis Mortality”

~ 2nd Place: Hamilton Health Care System, Inc. – “NICU Multidisciplinary Rounds”

~ 3rd Place: Southeast Georgia Health System (Brunswick Campus) – “Minimizing Complications and Improving Maternal and Newborn Outcomes: Reducing Elective Deliveries After 37 Weeks and Before 39 Weeks of Gestation”

Category: Greater than 350 Beds

~ 1st Place: Navicent Health – “Embedded Infection Preventionist in the OR”

~ 2nd Place: WellStar Kennestone Hospital – “COPD Care Management Across the Continuum”

~ 3rd Place: University Health Care System – “Sweet Success Diabetes Program”

10

Phoenix Health CareManagement Services, Inc. Benefits of Scale

Phoenix Health Care Management Services, Inc. offers VHA Georgia members creative solutions to achieve economies of scale including shared risk, enhanced pricing and documented savings.

In 2014, the Phoenix companies reported $36,063,119 in total documented savings.

~ Georgia ADS, LLC – $13,972,510

~ Georgia Medical Resource Pool, LLC – $249,553

~ HSI Financial Services, LLC – $11,097,421

~ Phoenix Committed Insurance Program, LLC – $2,289,408

~ Phoenix Co-Op Cash Distribution – $372,084

~ Phoenix Regional Contracts – $8,082,144

Georgia ADS, LLCGeorgia ADS, LLC is a medical claims financing and stop-loss prevention program for the self-insured claims generated by members’ employees and dependents.

2014 highlights included:

~ The highest penetration of Phoenix stockholders (95 percent)

~ Reduced costs associated with catastrophic claims by sharing claims financing

~ Significantly reduced stop-loss premiums

~ Increased participant cash flow and the ability to manage annual claims expenses

~ The power of 53,000 employee covered lives and 111,000 total lives

~ The option to purchase unlimited stop loss coverage above the program’s $2M base coverage

Since its inception in 1991, Georgia ADS participants have jointly financed over $154 million in claims and have documented more than $95 million in value for stop-loss premium and administrative costs. For 2014 alone, Georgia ADS provided total documented value of $13,972,510 in savings to members.

Georgia Medical Resource Pool, LLCGeorgia Medical Resource Pool (GMRP), LLC, certified in health care staffing services by The Joint Commission since 2005, offers health care organizations a variety of human resource solutions. The company also provides temporary staffing or short- and long-term assignments, a vendor management service program to consolidate workforce support, workforce management technology and consulting services. By using GMRP’s services, health care organizations realize bottom line cost savings over using alternative health care staffing agencies and are guaranteed quality health care professionals for all aspects of clinical and administrative operations including nursing, allied and health information management.

In 2014, GMRP provided over 37,914 hours of contingent staffing, reflecting 3,588 shifts worked by 84 health care professionals. Savings for the year totalled $249,553.

2014 operational highlights included:

~ Renewed accreditation by The Joint Commission with certification in Healthcare Staffing Services. GMRP received 100 percent compliance as a result of the on-site review. In addition to receiving recognition for the gold standard for quality in all categories, there was a 5 percent reduction in annual professional liability insurance premiums – a cost savings benefit to members.

~ Continued participation in the Drug Free Workplace program. In addition to continuing education for employees, participation in this program nets a 7.5 percent savings on annual worker’s compensation premiums.

~ Continued use of social media (Facebook, Twitter and LinkedIn) to assist with recruiting efforts and to provide company updates.

$36.1 Million

11

Health Care Management Services, Inc.

HSI Financial Services, LLCHSI Financial Services (HSI), LLC offers innovative solutions for managing and resolving health care accounts receivable. For over a quarter of a century, HSI has been committed to developing and providing solutions designed to maximize net return, improve cash collections and optimize revenue performance, all while maintaining the utmost integrity and customer service to the patient community.

2014 offerings included:

~ Bad debt collections

~ Virtual Business Office self-pay services (early-out business office)

~ Insurance follow-up

~ Payment plan monitoring services

~ Legal collection services

~ Strategic partner alliances

– ARxChange: Provides analytical guarantor scoring and guaranteed funding solutions for accelerated cash

– Accelerated Claims: Motor vehicle claims collection solutions

– Nemadji: Medicare and Medicaid Recovery solutions

– Triage: Zero balance and underpayment claims review

– MCare: Transfer DRG recovery services

Total documented value for 2014 was $11,097,421. Since its inception, HSI has realized $1.4 billion in cash recoveries.

Phoenix Committed Insurance Program, LLCThe Phoenix Committed Insurance Program (PCIP) was created as a group benefit purchasing program in 2005 to provide VHA Georgia members an opportunity to take advantage of discounted pricing, rate guarantees and value-added services through volume purchasing. PCIP, through its partnership with the Lockton Companies, currently offers insurance and other programs for group term life insurance, supplemental life and disability insurance, long- and short-term disability, accidental death and dismemberment, dental insurance, vision insurance, pharmacy benefit management, dependent eligibility verification, absence management, employee health risk management and benefits communication insourcing, as well as benefit advisory services.

Since its inception, PCIP has saved VHA Georgia members over $38 million in lower premiums and generated $7 million in cooperative earnings and cash for members by servicing over 231,000 employee policies.

Highlights from 2014 included:

~ PCIP served 15 member organizations in 2014 and saved those members a total of $2,289,408 plus provided them over $300,000 in Phoenix Co-Op Cash Distributions.

~ PCIP renewed its group life and disability program effective January 1, 2014 with CIGNA providing premium savings to VHA Georgia members of over $2.4 million over the next four years. In 2014, CIGNA called for a 5% decrease in rates; however, PCIP and Lockton were able to negotiate an even better 9% rate decrease, with a guarantee to remain at 2014 levels through December 31, 2017.

~ The first ever Health Care Workforce Benefits Conference was held in April 2014 with over 40 participants learning about the latest trends in health care benefits and plan design, health care reform and the Affordable Care Act, health plan exchanges, the value of population health and the Piedmont-WellStar Health Plan story. Additionally, attendees gained a better understanding of the changing face of the workforce in Georgia. PCIP, Georgia ADS and the Lockton Companies have joined forces to develop future events, and given the overwhelming success in 2014, another conference is planned for April 2015.

Phoenix Regional Contracts As part of Phoenix Health Care Management Services, Inc., Phoenix Regional Contracts are agreements that provide discounted programs and services to members.

New regional contracts in 2014 included:

~ Care Logistics, LLC – An amendment to the previous agreement, the new contract incorporates the following software modules: Core Hospital Operating System Software (patient, demand and order logistics with patient itinerary); Intake Logistics; a Physician Rounding Application and a Clinical Care Coordinator (C3) Application.

~ Corprit Advisory Group – Decision management advisory and technology services, allowing clients to make informed, data- driven decisions.

~ Health Care Consulting Group, Inc. (HCCG) – Yellow Pages advertising, cost reduction and placement services.

~ PeraHealth, Inc. – An innovative platform that provides house-wide predictive surveillance based on the Rothman Index.

~ Soriant Healthcare – Services include project assessment, consulting and implementation services for various hospital departments.

~ Trane US, Inc. – An energy advisory and performance services program for delivering cost savings.

In 2014, Phoenix Regional Contracts documented value of $8,082,144.

12

$78 $79.8 $80.3

$96.4

$110.7

$94.9

$50

$60

$70

$80

$90

$100

$110

$120

2009 2010 2011 2012 2013 2014

$0

$500,000

$1,000,000

$1,500,000

$2,000,000

$2,500,000

2009 2010 2011 2012 2013 2014Actual VHA Georgia $269,674 $365,633 $249,176 $301,088 $259,663 333,851Actual Phoenix $438,547 $1,130,173 $1,188,756 $1,628,372 $2,116,833 1,932,385

Bottom Line Improvement Benefits of VHA Georgia and Phoenix

We are pleased to share that in 2014, VHA Georgia and Phoenix Health Care Management Services reported $94.9 million in regional cost savings, cost avoidance and revenue enhancements on behalf of our members and affiliates through our regional programs, services and initiatives. Based on our regional membership fees, these savings equate to an average local return on investment of 24.1 fold based on utilization of services and self-reporting.

*In 2014, an additional $29.2 million in value was reported through VHA Inc.'s national opportunities outlined on the next page.

Trended Regional Member Cost Savings, Cost Avoidance and Revenue Enhancements

Trended VHA Georgia and Phoenix Financial Performance

Mill

ions

13

Program Stockholder/Partner Total Affiliate Total Grand Total

Georgia ADS Stop-Loss Premium Savings $13,972,510 $0 $13,972,510

GMRP Savings $178,012 $0 $178,012

GMRP- API Contractual Savings $71,541 $0 $71,541

HSI $752,329 $0 $752,329

HSI - Accelerated Claims $3,709,059 $0 $3,709,059

HSI - Medlytix - CharityTel $55,000 $0 $55,000

HSI - Nemadji/GRE Medicare-Medicaid Recovery $3,383,959 $0 $3,383,959

HSI - MCare Transfer DRG & Medicare Advantage $3,186,430 $10,644 $3,197,074

PCIP - Benefit Communication Insourcing Program $1,107,465 $0 $1,107,465

PCIP - Employee Savings $414,297 $9,236 $423,533

PCIP - Employer Savings $753,946 $4,464 $758,410

Phoenix Health Care Management Services Co-Op Cash Distribution $372,084 $0 $372,084

Regional Contracts Savings $7,935,712 $146,432 $8,082,144

Phoenix Company Savings $35,892,343 $170,776 $36,063,119

Blood Management Collaborative $3,829,822 $0 $3,829,822

CFO Council Initiatives $51,419 $0 $51,419

Charge Audit Council Initiatives $7,435,254 $0 $7,435,254

CIO Council Initiatives $1,099,598 $0 $1,099,598

CNO Council Initiatives $289,031 $0 $289,031

Hospital Engagement Network (HEN) Initiatives $13,221,021 $0 $13,221,021

Home Health & Hospice Council Initiatives $3,323,751 $0 $3,323,751

Human Resources Council Initiatives (also contributed to PCIP savings) $925,431 $0 $925,431

Infection Prevention Council Initiatives $936,597 $0 $936,597

Lean Six Sigma Program $3,087,992 $0 $3,087,992

Palliative Care Collaborative $5,176,918 $0 $5,176,918

Patient Safety Initiatives $5,155 $0 $5,155

Performance Improvement & Quality Council Initiatives $293,683 $0 $293,683

Pharmacy Council Distribution Regional Enhancement $3,136,690 $59,337 $3,196,027

Pharmacy High Impact Contract Launches $1,015,320 $52,696 $1,068,017

Physician Practice Management Council Initiatives $838,575 $0 $838,575

Radiology Council Initiatives $25,637 $0 $25,637

Readmissions Collaborative $3,595,902 $0 $3,595,902

Respiratory/ICU Council Initiatives $20,159 $0 $20,159

Revenue Cycle Management/Managed Care Council Initiatives $1,246,039 $0 $1,246,039

Supply Chain Regional Enhancements $8,121,593 $503,834 $8,625,427

Supply Chain Medical/Surgical High Impact Contract Launches $197,252 $26,575 $223,826

VHA Georgia Co-Op Cash Distribution $291,270 $5,564 $296,834

VHA Georgia Activity Savings $58,164,112 $648,005 $58,812,117

2014 Total Phoenix and VHA Georgia Member Savings $94,056,455 $818,782 $94,875,236

Capital Group Buys $2,051,723 $0 $2,051,723

Cash Distributions $13,884,665 $0 $13,884,665

Performance Services $4,027,221 $0 $4,027,221

Purchased Services $2,002,869 $0 $2,002,869

Standardization Programs $3,822,182 $0 $3,822,182

Supply Networks $3,437,410 $0 $3,437,410

VHA Inc. Activity Savings $29,226,070 $0 $29,226,070

2014 Total Phoenix and VHA Georgia Member Savings – Regional & National $123,282,525 $818,782 $124,101,307

14

2014 Board of Directors VHA Georgia, Inc. and Phoenix Health Care Management Services, Inc.

Scott J. DowningExecutive Vice PresidentVHA Inc.

Reynold J. Jennings, FACHEChief Executive OfficerWellStar Health System

Carol H. BurrellPresident and CEONortheast Georgia Health System, Inc.

Gary R. Colberg, FACHEPresident and CEOSoutheast Georgia Health System

James R. DavisPresident and CEOUniversity Health Care SystemVHA Georgia/Phoenix Secretary/Treasurer

Charles A. Peck, MDPresident and CEOAthens Regional Health System

Ninfa M. Saunders, DHA, FACHEPresident and CEONavicent Health

Richard T. Howerton, III, FACHEPresident and CEOVHA Georgia, Inc. andPhoenix Health Care Management Services, Inc.

Kim Ryan, FACHEPresident and CEOSouthern Regional Health System, Inc.

Cary MartinPresident and CEOHouston Healthcare

J. Randall Sauls, MBA, FACHEChief Executive OfficerSouth Georgia Medical Center

J. Perry Mustian, FACHEPresident and CEOArchbold Medical Center, Inc.Phoenix Chair

Jeffrey D. MyersPresident and CEOHamilton Health Care System, Inc.

John A. Shelton, Jr., FACHEPresident and CEODeKalb Regional Health System

Robert T. QuattrocchiPresident and CEONorthside Health Services, Inc.

William T. Richardson, FACHEPresident and CEOTift Regional Health System

M. Scott Hill, FACHEPresident and CEOColumbus Regional Health*

Kevin BrownPresident and CEOPiedmont Healthcare+

Kurt Stuenkel, FACHEPresident and CEOFloyd Medical Center

Kenneth T. Calamia, MDPresident and CEOMayo Clinic Health System in Waycross

Joel Wernick, FACHEPresident and CEOPhoebe Putney Health System, Inc.

Philip R. Wolfe, FACHEPresident and CEOGwinnett Health System, Inc.VHA Georgia Chair

+ Phoenix board member only VHA Georgia board member only*VHA Georgia services member only

Health Care Management Services, Inc.

VHA Georgia, Inc.Phoenix Health Care Management Services, Inc.900 Circle 75 Parkway, Suite 1450Atlanta, GA 30339770.850.7400vhageorgia.comphoenix-healthcare.com

©2015 VHA Georgia, Inc. and Phoenix Health Care Management Services, Inc. All rights reserved.