Ohio State University State of the Medical Center as presented by Dr. Steven Gabbe, CEO on January 27, 2011.

1. 2011 State of the Medical Center Steven G. Gabbe, MD CEO, OSU Medical Center January 27, 2011 Music don’t delete

2. 2 VisionMission & Values MissionTo improve people’s lives through innovation in research, educationand patient care VisionWorking as a team, we will shapethe future of medicine by creating, disseminating and applying new knowledge, and by personalizing health care to meet the needs of each individual ValuesExcellence, Collaborating as ONE University, Acting with Integrity & Personal Accountability, Openness & Trust, Diversity in People & Ideas, Change & Innovation, Simplicity in our Work, Leadership, Empathy & Compassion PromiseImproving people’s lives… through personalized health care

3. Become a top-20 academic medical center and a top-10 NCI-funded cancer program through advancements in research, education and patient care Become a high-performanceorganization & workplace of choice Generate an investment fund for mission development The Ohio StateUniversityMedical Center Strategicgoals Note: Top 20 across research, education and patient care as measured by NIH, Best Medical Schools, Best Hospitals, number of publications/citations and endowment 3 3

4. Today’s Goals Summary ofPast Year Share Good News 4 Look to theYear Ahead: Discuss CareCoordination & Accountable Care

5. 2010 Focus Focus on patient satisfaction, safety and quality Maintain financial strengthand stability Grow research – especially in personalized health care Protect and grow jobs including key recruits 5

6. Focus on Patient Satisfaction, Safety and Quality Observed mortality rate for first months of FY11 lowerthan expected HighestHCAHPS ever UH East ICU: No central line infections for400 days 6

7. Safety and Quality Scorecard OSUMC Total # of All Events 7 Lowest # since inception 2009 2009

8. Improved HCAHPS but Consistency Required Hospital Consumer Assessment of Healthcare Providers & Systems Data for UH, Ross, East and James (% 9,10) 90th percentile F11 Goal 74.2 Nat’l Avg 2009 2010 Source: OSUMC Patient Satisfaction Measurement Program Data is collected using a Press Ganeymailed survey 8

9. Crew Resource Management Training Goal: To create a culture of teamwork and become an even safer organization Signed contract with LifeWings Targeted areas OR – University Hospital L&D ED Procedural Areas

10. Operating and Financial Highlights(for the six months ended DECEMBER 31, 2010) Patient Admissions Total Expenses Maintain Financial Strength and Stability Admits & Obs Patients Gain from Operations Total Surgeries Excess Rev. over Exp. Outpatient Visits Operating EBIDA Margin ED Visits Days Cash on Hand Operating Revenues Debt Service Coverage

11. Growth in Research OSUMC Total Research Awards (in millions) 11

12. Growth in Research Related to P4 Grants SPORE – Experimentaltherapeutics for leukemia John Byrd, NIH$9.2 million Expression Genetics In Drug Therapy Wolfgang Sadee, NIH$9 million Development of novel therapeutics for a neglected tropical disease leishmaniasis AbhaySatoskar, NIH $2.6 million MicroRNAs/UCRs: biomarkers for cancer risk, tumor detection,progression and treatment Carlo Croce, NIH$1.9 million 12 Elucidating the role of NF-kB signaling in rhabdomyosarcoma Denis Guttridge, NIH $1.6 million

13. Protect and Grow Jobs Including Key Recruits 13 OSUMC Number of Employees

14. New Faces - attracting top physicians & researchers from across the country JohnCampo RicardoCarrau PeterEmbi TimHewitt RobertHiggins PeteMohler MikeRutherford RichardWhite 14

15. $100 Million Grant Largest grant theUniversity hasever received 558 local doctors madelist 483 (87%)are members ofOhio State’s faculty 15

16. Type 1 diabetic patient One of few medical centers to have successful whole pancreas and islet cell transplantation. 16 First Islet Cell Transplant

17. “This is a great organization” “This organization has cornered the market onthe best talent” Areas of Distinction Environmental risk assessment process for behavioral health patients Infection Control Legionella policy Moderate sedation training and credentialing process 17

18. National Recognition

19. 19 2011 In the coming year we will: Focus on our BIG 5 Continue to improve quality, safety and service Accountable Care: Proactive approach to changes based on the Affordable Care Act (ACA)

20. 20 Close Research Gap Growth/Access 5 Programsfor 5 Curriculum Revision IHIS Installation Years OSUP Integration

21. Each priority linked to several KRAs 5 Programs for 5 Years Innovation & Strategic Growth Service & Reputation Productivity &Efficiency Financial Performance Workplaceof Choice Quality

23. Strengthenbasic science

24. Enhance infrastructure

25. Improve management of resources

26. Recruit & retainthe best

28. Strength in research and education reflected by highly competitive awards 24 5 Close Research Gap OSU is one of 27 institutions to have both a CTSA and CCC 12 have been awarded an HHMI Med into Grad grant for training graduate students in medicine 6 part of the Pharmacogenomics Network (Wolfgang Sadee, PI)

29. 5 Growth / Access James CancerHospital & CriticalCare Expansion New home forJames Cancer Hospital New critical care center Integration of patient care, research & teaching spaces Supports thehighest-quality personalizedmedicine, makinghealth caremore effective& affordable 25

30. 26 5 Growth / Access Phyllis A. Jones Legacy Garden Gift

33. 28 5 Growth / Access JamesCare Comprehensive Breast Center Lewis Center East – Opening Summer Ambulatory Strategy CarePoint: Expert outpatientcare in neighborhood settings

34. 29 5 Growth / Access Ambulatory Strategy Convenient care for common illnessess Giant Eagle locations in Gahanna and Upper Arlington

35. 5 Growth / Access Commitment to our Community Partnering to improve community health Neighborhood revitalization: UH East $35 million job creation city tax incentive 30

36. 31 5 Curriculum Revision The Blueprint Curricular Domains based on the Core EducationalObjectives

37. Integrated Health Information System Ambulatory services installed Big Bang October 15, 2011 Ability to provide patient information at every care site Enhances quality and safety 5 IHIS Installation 32

38. 33 5 33 IHIS Installation October 15, 2011 Building Training Testing

39. OSU Physicians: Collaborating to Improve People’s Lives 34 5 34 OSUP Integration Sr VP & CEO Medical Center CEO OSU Health System DeanOSU Collegeof Medicine CEO OSU FacultyPractice Plan Executive Director Practice Managers Finance and IT Human Resources Operations

40. Faculty Group PracticeGeneral Operating Principles 35 5 35 OSUP Integration Physician Faculty will be employed solely by OSU in the Office of Health Sciences and COM OSUP support staff (billing, collection, compliance, etc) remains outside the University as an affiliated entity OSUP will continue to provide medical service organization (MSO) services to the faculty group practice

41. 5 36 OSUP Integration Faculty Group Practice Physician Employment Compensation plans updated Pension transition agreement with STRS confirmed Benefit rates within the University established University physicians employment contracts completed and hiring process established

42. Accountable Care A Time of Great Change at OSUMC External: State and Federal Leadership Health Care Reform New Models of Care Economic Downturn Technology Internal: Our Big 5 37

43. 38 Accountable Care Goal: Achieve“Triple Aim” Objective Integrated Care Delivery and Financing Mechanisms Accountable Care Organizations Health Innovation Zones Patient Centered Medical Homes

44. Accountable Care What is Value in Health Care? Outcomes measurement is the single most important tool to drive innovation in health care delivery. Porter, M.E. N Engl J Med 2010; 363:22477-81 Appendix 2

45. Value in Health Care:Outcome measurementdrives innovation 40 Accountable Care Risk Adjusted Quality Safety OVER TIME Outcomes Value = Cost Full cycleof care Full setof outcomes Porter, M.E. N Engl J Med 2010; 363:2477-81 Appendices 1 and 2

46. An active purchaser of care based on quality of service FY 2013 to use outcome measures: 17 Clinical process of care 8 HCAHPS 3 Mortality 8 HAC (Hospital Acquired Conditions) 9 AHRQ (Agency for Healthcare Research & Quality) 41 Accountable Care Centers for Medicare &Medicaid FY 2014 Medicare Fact Sheet, January 7, 2011

47. 42 Accountable Care Outcomes Value = Cost audio

48. Accountable Care Top 10 Actions Planned by Hospital CEOS Reduce operating cost Study avoidable readmissions More closely align with physicians Obtain funding from American Recovery andReinvestment Act for electronic medical records Study avoidable infections Hire primary care physicians Develop information system integratedwith primary care providers Ramp up efforts to achieve shorter length of stay Obtain capital for building/equipment upgrades Partner with community organizationsaround wellness activities 43

49. Accountable Care Accountable Care Organizations (ACO) Goal: Improve quality while reducing costs Network of physicians and other health care providers Willing to work together Accept responsibility to: improve quality reduce costs of health care services for a defined population Accountable to Patients Third-party payers 44

50. Accountable Care HealthInnovationZones: Assure Sustainability and Diffusion of Resulting Innovations Redesign care delivery Develop implementation research teams to Design & test new clinical processes Implement changesin education continuum Ensure physicians entering practice are prepared 45

51. 46 Accountable Care

52. Accountable Care Proactively managing your health 47

53. 48 Accountable Care Predict Prevent Personalize Participate

54. Accountable Care Building Our Bridge to Accountable Care OSU Health Plan integration OSUP Integration Team Leading Coordination of Care Signature Programs IHIS P4 Medicine Quality and Safety Reducing Costs and Expenses Training More Primary Care Physicians 49

55. Four Hide under a rock Stay informed Focus on quality, safety and service Prepare for IHIS Share success stories and ideas around improving coordination of care Stay informed Focus on quality, safety and service Prepare for IHIS Share success stories and ideas around improving coordination of care Five ThingsTo Do CoodinatingCare@osumc.edu To: From: 50

56. 2011 State of the Medical Center Steven G. Gabbe, MD CEO, OSU Medical Center January 27, 2011