1. EVERY MOMENT COUNTS

3. WHEN FACING A
LIFE-LIMITING MEDICAL
CONDITION
EVERYONE deserves an experienced
advocate who seeks to understand what is
most important to you, who works to ensure
that every decision you make will be an
informed decision, and who recognizes that
every moment we have counts.

4. In the midst of so much new information
and specialty physician appointments,
patients may lose connectivity to their
primary care physician and care
coordination becomes a challenge.
Pain and symptoms related to treatment
increase the frequency of emergency
room visits and hospitalizations (many of
which may be completely unnecessary).
PROBLEM:
Existing Care Support Models are Failing the Sickest Individuals
The healthcare system is challenged to
meet the needs of patients with life-limiting
conditions. Providers often become
pre-occupied with medical facts and
treatment options, losing sight of individual
patient goals.
Pain and symptom management
Understand the costs of various
treatment options and manage
unecessary costs
To relieve any burden for their
families and family caregivers
A sense of control for the decisions
about their treatment and care
Avoid inappropriately prolonging the
dying process
Narus Health Advantage:
2

5. The top 5% make up
50% of the cost
25% 25% 47% 3%
Predominantly
end-of-life and
highly complex
cases – involving
multiple providers
working with
patients
The 50%
of members
with the least
annual spending
make up only
3% of cost
= Total cost of
private insurance
spending by members
= 1% of members
The top 1% of
members make up
25%
of total cost
3
Private Insurance Spending is Disproportionately Concentrated

6. NARUS HEALTH’S SOLUTION
A Technology Enabled, Community-Based Care Partner
Technology Enabled. Using technology,
the Narus Health triage process ensures that
the patients who are most in need of
palliative and care support are identified and
engaged.
Community-Based. An in-home
comprehensive assessment identifies the
qualitative issues (called Care Domains) that
impact the patient’s overall course of care.
These issues, coupled with a clear
understanding of the patient’s individual
goals and the physician’s overall care plan,
form the basis of the day-to-day interaction
between the Narus Health field team and the
patient.
Care Partner. Our interactions support the
patient’s physician(s) – and complement the
physician’s office visits with day-to-day
patient interaction and insight, helping avoid
complications, unwarranted emergency
room visits and unnecessary hospitalizations.
The Narus Health team also provides
support to the family and the patient’s care
giver (often a family member), so that the
patient’s support system is both informed
and engaged in the care process.
There are 5 elements of Narus
Health’s services that deliver
significant value to the patient, the
physician and to our payer partners:
1. Group Stratification and
Program Triage
2. Patient Engagement and
Program Enrollment
3. Patient Assessment using Care
Domains
4. Sharing Findings with
Physicians & Supporting the
Physician's Treatment Plan
5. Ongoing Care Support
4

7. Medical Claims
Daily Hospitalizations
Preauthorization File
Eligibility & Benefits
Pharmacy & Lab Data
Biometric & Consumer
Provider EMR
Data Sources
Vendor Program
Status Updates
DAILY
PROCESS
NEW ENROLLMENT AND/OR DAILY
PROGRAM UPDATES
MONTHLYCLAIMS
Triage & Case Enrollment
in Narus Health Program
TriageLogic
Daily&Monthly
• Knowledge Based Pathways
• Dynamic Care Plan
• Care ManagementWorkflow
CA | Stage 4
CA | Stage 3
CA | Stage 1 & 2
Neuro | ALS, MS
Neuro | Other
Kidney | Liver Failure
CHF | COPD | CAD
Outsourced &
Partner Programs
Dynamic & Adaptive
Care Management
HEALTHPLAN&
PROVIDERDATASOURCES
PHASE 1.
Group Stratification and Program Triage
Using pre-authorization data, emergency department visit data, hospital admissions and medical claims data, Narus Health uses a proprietary
set of case selection “rules” (that are vetted with the health plan) to ensure that the most appropriate cases are identified for enrollment. This
process may also be used by our health plan partners to identify and select cases for enrollment in other care support or disease specific
programs.
5

8. PHASE 2.
Patient Engagement and Program Enrollment
Once the right group of eligible patients are
identified (using the program triage filters)
the Narus Health Enrollment Team engages
each patient to explain our service (a benefit
offered by their health plan or employer) and
schedules an in-home (or on-site) visit with a
highly trained Narus Health Nurse Care
Partner.
This engagement process ensures that the
right patients are enrolled in the program,
and the value of the service is properly
described. Most recently diagnosed patients
have a myriad of questions; they are looking
for support; and they are seeking
clarification about "next steps."
The individuals we select for care
coordination services have at least two of
the following characteristics:
• High annual claims cost (average >
$50,000 per annum)
• Significant primary diagnosis: CA,
ALS, CHF, CAD, COPD, Kidney or
Liver Failure
• Multiple, severe co-morbidities
• Prognosis of progressive and
eventually fatal disease
• Multiple providers of care
• Significant pain and symptom
management issues
6

9. The Narus Health Team will complete an
in-home, personal assessment of the
patient, structured around Care Domains.
These Domains are qualitative drivers of the
patient’s overall engagement and are highly
predictive of future costs and complications.
These 7 areas of assessment include:
Knowledge & Choice
We confirm the patient's current knowledge
about their diagnosis and treatment choices.
If issues are identified, we collaborate with
their physician(s) to address the issues, so
the patient's anxiety is reduced, and they
have both knowledge and insight.
Pain & Symptom Management
We identify any discomfort, pain or other
symptoms. We ensure the symptoms are
carefully monitored and addressed
immediately. Pain, nausea, shortness of
breath and anxiety are the top reasons
patients visit emergency departments, most
of those visits are unnecessary with careful
daily monitoring and support.
Family & Community Support
We evaluate each patient's social and family
support system. Is there a caregiver
present? Are there transportation needs?
Issues within these support structures, if not
addressed, may disrupt treatment and can
lead to unnecessary complications.
PHASE 3:
Patient Assessment using Care Domains
7

10. Treatment Plan Support
A new, significant diagnosis can often
disrupt the continuity of care for patients
with underlying chronic diseases. Our team
provides a consistent, day-to-day support
system for the patient, ensuring that all of
the various providers (primary care physician
and specialists) are kept informed and have
full visibility of the patient's situation and
treatment plan. If the patient does not have
a primary care physician, we work with
the attending specialist and the health
plan to address non-specialty related
issues that arise.
Delivery System Access
Depending on where the patient lives, having
access to expert providers, urgent care,
hospitals, medical technology, experimental
therapies and support organizations may be
limited. We identify these barriers and work
with the physician and health plan to
address them.
Patient Goals and Terminal Care Planning
The Narus Health Team encourages each
patient to define their personal goals. Goal
setting empowers patients, guides
advanced directives and offers insights for
making informed terminal care decisions.
Benefit Coverage
We help each patient have insight into levels
of coverage available through their plan,
options provided and alternative choices
within their benefits plan. Also, Narus Health
helps patients think about funding and
support when specific services or selected
experimental options are not covered in their
benefit plan.
8

11. A complement to the clinical evaluations
provided by various physicians for the
individual patient, Narus Health’s evaluation
of the patient’s Care Domains delivers
valuable insight to the practitioner.
As each of the individual’s Care Domains are
evaluated, a list of open issues is created
within the Narus Health engagement plan.
Each issue requires a specific goal and a set
of actions that will mitigate the issue and
achieve the goal. Issues, Goals and Actions
are all set with specific target dates, and a
measurable outcome is recorded.
This methodology of documenting the
patient’s Issues and Goals, identifying
planned Actions, and desired Outcomes is a
powerful way to communicate meaningful
information to the attending physician,
specialty physicians, and the health plan
leadership.
The Narus Health Nurse Care Partners are
trained in systematic care processes and
receive specific training in palliative care. The
company further invests in these individuals
by helping each become fully CCM (Complex
Care Management) certified.
PHASE 4:
Sharing Findings with Physicians & IGAO Development
9

12. • Managing any overflow inbound
patient calls during the day, when
their nurse is busy
• Triaging and addressing all overnight
and weekend patient calls to the
nurse care partner so that seamless
support occurs
• Facilitating care coordination needs
identified by the field team
• Providing social services expertise for
psychosocial and resource needs
Narus Health Medical Director
Chief Clinical Officer & VP of Quality
Complex
Care Managers
NP Clinical Team
Leader
Complex
Care Managers
NP Clinical Team
Leader
NP Call Center
Leader
Complex Care Managers
Social Workers
Care Coordinators
Chapliancy
Call Center
Local Market 1 Local Market 2
Local market team support
CLINICAL TEAM STRUCTURE
The local market teams (nurse care partners
delivering services) are supported by a 24/7
Narus Health Patient Support Center.
The Support Center enhances the patient
experience by:
10

13. • Delivers a robust patient management
and palliation program focused on
pain and symptom management and
supporting coordination of care
among numerous providers
• Supports the patient in understanding
their options for treatment and the
patient’s decisions regarding their
care
• Counsels the patient in setting life
goals and, when appropriate,
advanced directives
• Transitions individuals to survivorship
or end-of-life care when appropriate
• Captures patient reported data
throughout the course of care (ESAS)
• Supports the caregiver and the family
throughout the process
PHASE 5:
Ongoing Narus Health Support
Throughout our engagement with the patient,
the Narus Health team:
Narus Health Scientific Advisory Board
Narus Health is partnering with thought
leaders in our space who will provide
insight of industry best practices. This
group of advisors also evaluates Narus
Health on our overall performance and
program outcomes to ensure exceptional
support for patients and their families.
11
Automated &
Ongoing
• Data Integration
• Analysis
• Reporting
• Communications
Measure
Outcomes
Population
Surveillance Identify
Care Gaps
Stratify
Risks
Engage
Patients
Manage
Care

14. NARUS HEALTH’S OPERATING MODELHEALTHPLAN&
PROVIDERDATASETS
Data
Assimilation
andAnalytics
Data Sources
Daily Hospitalization
Direct Referrals
Medical Claims
Pharmacy & Lab Data
Member Eligibility
Provider EMR Data
Biometric & Consumer
Population
Surveillance
Dynamic Care Plans
Knowledge Based
Pathways
Patient Triage
& Work Flow
Enterprise
Rules Engine
Access to Clinical
Expertise
Engagement
& Interaction
Symptom & Care
Support
Patients and families
have access to a care
management expert
24|7 to aid with
questions, address
symptoms, and
reduce worry.
Interactions include
identification and support
for the patient’s personal
goals, pain and symptom
management, appointment
scheduling, medication
refills. and changes.
The care management
process supports both
the patient and the family
care giver. We ensure
that each individual is
treated with dignity and
that care and treatment
wishes are followed.
PATIENT
Care Insights
Knowledge &
Choice
Pain & Symptom
Management
Family &
Community Support
Treatment Plan Support
Delivery System Access
Patient Goals & TCP
Benefit Coverage
Primary Care
Physician
Treating
Specialists
Ancillary
Providers
Narus
Health
Team
Patient
and
Family
Scientific Advisory
Board
Consulting Specialists
Medical Researchers
Palliative Experts
1. TECHNOLOGY ADVANTAGE
Through our stratification process, we are able to ensure
the right individuals are enrolled in our programs
2. SERVICE ADVANTAGE
The structured assessment and management of Care Domains using an
IGAO framework affords us the opportunity to share meaningful, new
information for the physicians overseeing the patient’s care.
3. CONSUMER ADVANTAGE
Our mobile framework encourages patient and family interaction
and ensures that the Narus Health care manager is always
immediately accessible.
13

15. PATIENT ACUITY AND PAYER BILLING PROCESS
Using mutually agreed upon diagnostic
categories, severity ranking, and IGAO
assessment, a patient acuity is assigned
that defines both the level of support
required and the fee charged to provide that
month’s support.
Using this methodology, the health plan and
Narus Health are afforded the opportunity to
define consistently the resource need of the
individual patient through a transparent and
verifiable process.
The Narus Health algorithm is dynamic,
adjusting as needed each time new data is
captured, either from the health plan or from
a Narus Health care partner. The patient’s
acuity, for purposes of both support and
billing, are then periodically adjusted as their
need for support changes.
The health plan and/or employer is billed
each month for Narus Health’s services
based on the level of service received by the
patient.
5
4
3
2
1
Primary and
Secondary Diagnoses
Comorbidities
Narus Assessment
IGAO
Specific
Chemotherapy
Regimens
Social Support
ESAS
Hospitalization
or ER Visit
High
Low
Service Levels:
14

16. OPPORTUNITY FOR MARKET IMPACT AND MARKET ENTRY
0.68%
Cancer patients as
a percentage of
total commercially
insured population
10%
Cancer costs as
a percentage of
total commercially
insured population
ANNUAL RATE
OF COST GROWTH
For Commercial Patient Population
9%
20%
Overall Cancer
Cancer Opportunity is Significant
$100+ Billion Marketplace —7.5% CAGR
1.7 Million
People in the U.S. Were Diagnosed With Cancer in 2014
By 2020, Cancer will surpass Heart Disease as the
Leading Cause of Death
The Narus Health program covers patients
who are defined in the “Top 1%” for the
health plan in terms of total costs. Most of
these patients have more than $50,000 in
annual costs with either a significant primary
diagnosis (CA, ALS, MS, CHF, CAD, COPD,
Organ Failure, Trauma) or they have multiple,
severe co-morbidities with significant pain
and symptom management issues.
A high-opportunity starting point for many
health plans are the patients with late stage
Cancers – due to the significant costs of
complications, frequent emergency
department visits and hospital admissions.
15

17. X-Ray
CT Scan
PET Scan
Bronchoscopy
Mediastinoscopy
EBUS
CT Scan
Needle | FNA
Surgery | Staging
Stain
Tissue Diagnosis
Staging
Localized | 7.2%
Regional | 22%
Distant | 53.1%
Unstaged | 7.7%
Adjuvant Therapy
Secondary CA
Prevention
Screenings
LT Side Effects
Surgery
Chemotherapy
Radiation
Clinical Trial
Palliative Care
ALK EGFR
Pathologist | Laboratory
Clinical Trials
Clinical
Treatment
Pathways
Molecular
Testing
Targeted
Therapy
Pulmonologist
PCP
Screening | Nodule
Pulmonologist
Intervental RAD
Thoracic Surgeon
Pulmonologist
Intervental RAD
Thoracic Surgeon
Thoracic Surgeon
Medical Oncology
RAD Oncology
PCP
Medical Oncology
Pulmonologist
Symptom
Presentation
Tissue
Collection
Histologic
Diagnosis
Clinical
Diagnosis
Treatment
Decision
Follow Up
Care
Care Management & Coordination | Pain and Symptom Management
▲▲▲ ▲▲▲
SAMPLE PATIENT JOURNEY: Patient with lung cancer
Within each of the treatment phases, the patient will encounter multiple providers. Should they elect to participate in a clinical trial, the number
of specialty providers only increases. This journey can feel overwhelming to a patient. Simply trying to navigate the appointment schedule is
challenging. The Narus Health Care Team provides a consistent, day-to-day support system for the patient, ensuring that all of the various
providers (primary care physician and specialists) are kept informed and have full visibility of the patient's situation.
16

18. High Utilization of Emergency
Department and Hospitalization
for Cancer Patients
ED visits for every 1,000
chemotherapy patients
Hospitalizations for every
1,000 chemotherapy patients
Average cost per ED visit
Average cost per inpatient
admission
Pain
Respiratory
GI
Malaise
Neurologic
Bleeding
Fever
Injury
Chief Complaint of Cancer Patients
Presenting at Emergency Departments
n = 37,760
Through our prior
work, we were able to
demonstrate a
40% drop in ER visits within
the population we managed
and a 25% drop in
Inpatient
Admissions.
Source: Mayer DK, et al., “Why Do Patients with Cancer Visit Emergency Departments? Results of a 2008 Population
Study in North Carolina,” Journal of Clinical Oncology, 2011, 29: 2683-2688; “Cancer Patients receiving Chemotherapy:
Opportunities for Better Management.” Milliman Client Report,available at: http://publications.milliman.com/research/health-
rr/pdfs/cancer-patients-receiving-chemotherapy.pdf, accessed May 3, 2013; Oncology Roundtable interviews and analysis.
NARUS HEALTH
A Sample Opportunity
Our founder has been a pioneer in the care
management and support space for over 20
years. Using a combination of technology
and expert services, we can make a
significant positive impact on the lives of
patients and families dealing with life-
limiting illnesses. Through a thoughtful
assessment of the patient’s Care Domains,
we deliver valuable insight to the patient’s
physician and overall care team. These
insights directly impact the patient’s total
cost of care while ensuring an exceptional
care experience.
The opportunity to reduce unwarranted ER
visits and admissions is significant. Most of
these are a result of pain, nausea, shortness
of breath or anxiety that occur either after
hours or when there is no one available to
support the patient and immediately
respond to their concerns.
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20. 618 Church Street, Suite 130, Nashville, Tennessee 37219
615.933.8265 www.narushealth.com