Dear Your Health Organization Employees,

It is with great enthusiasm and a sense of purpose that I address you in our first State of the

Practice since the rebranding of our organization. The road ahead is filled with exciting

opportunities as we continue our dedication to improving healthcare for our patients throughout the

Southeastern region of the country.

Over the past few years, we’ve navigated significant changes in the healthcare industry and in

the CMS system, and I commend each of you for the tremendous strides we’ve made in meeting

these new expectations. Our leadership team has thoroughly reviewed these industry changes and

would like to address our plan moving forward and where our efforts will be focused in this new

year.

Financial Stability and Growth

In 2022, our organization experienced its largest loss to date.

Since then, we have shifted our attention to value-based systems, including the introduction of

Chronic Care Management (CCM), and thanks to these efforts and your drive and dedication, our

organization is excited to announce that 2023 was a profitable year for us. While this represents a

significant achievement, it is crucial that we intensify our efforts to recover from previous losses. We

will establish a financial goal for growth and prosperity as we look to our future goal of becoming

our own Accountable Care Organization (ACO) over the next few years.

Value-Based Care

Medicare defines value as cost savings compared to anticipated costs per

patient. Your Health has done well as we are currently exceeding our saving expectations with

Humana by approximately 85% of expected cost for our Humana patients. Unfortunately, we are

overspending by 115% for Medicare and United patients which could result in penalties or

repayments to these payers. While we have succeeded in reducing hospitalizations by providing

continuous, quality care, our hospice and home health services have extended lengths of stay. Home

Health is used for short term nursing and therapy services (60 days), and by utilizing outpatient

therapy services such as Part B, at home via our organization’s PTAs and COTAs, or by using other

Part B therapy providers, we can save 75% of the cost of the same services that being provided by

home health. Medicare studies indicate that these issues can be addressed by increasing patient

interactions with nursing and therapy but can be done cheaper with Part B services. As an example:

Home health will supply roughly eight encounters per month costing of $2,500 - $3,000, depending

on the diagnosis code. The same therapy and nursing services provided by members of our team

will only cost Medicare roughly $500. Meaning, it’s substantially more affordable for all parties if

patients were to use our organization’s Part B services. 1

Physical and Occupational Therapy

Our organization currently employs about 20 PTs and

OTs, and we plan to increase this number to 60 in 2024. By increasing the number of PTs and OTs,

we will be able to move all home health certifications to the therapy department, saving us, our

patients, and Medicare, countless dollars and time. We will soon roll out the plan of having NPs and

MDs send all therapy orders to the therapy department who will perform a consult, review, and

order Part B services.

Palliative Care

The Palliative Care Department will be enhanced with additional providers seeing

patients in both the home and via telehealth visits. Hospice orders will be sent to the Palliative Care

Team for evaluation and to complete the order. Hospice costs Medicare over $5,000 per month,

while our organization can provide all of these same services 2 for less than $1,000 a month.

2024 GOALS

Telehealth Follow-Up Visits

We must initiate telehealth follow-up visits within seven days of any

medication or order change, as this will greatly reduce the number ER and urgent care visits. The

responsibility for these follow-up visits go to the provider who ordered the change or medication.

Scheduling these follow-ups on the day of the visit will help to ensure they are completed. Providers

working 7 on / 7 off shifts will likely need to schedule these follow-ups on Sundays where possible,

to ensure the visit occurs before the provider’s 7 off shift. This proactive approach can improve

patient care and generate substantial cost savings. Your Health has already implemented incentives

for providers to encourage more frequent, shorter visits.

Chronic Care Management (CCM)

Medicare allows compensation for staff interventions,

including provider time and patient interactions. Providers should be mindful to capture their CCM

time accurately, for recording and billing practices, and as Your Health compensates all employees

for their respective CCM. On average, support staff should be at a minimum of 70% of their hours

worked, in conducting CCM.

Testing and Lab Services

These services are inexpensive compared to ER and in-patient stays.

Conducting lab panels on a more regular basis allows providers to be more accurately diagnose

patients and may help confirm the patients’ complexity.

Remote Patient Monitoring (RPM): New RPM equipment is available through Your Health.

Even when used only 2-3 times a week, it will give vital statistics to providers as well as help our

organization to build a more productive analytic software system that will benefit patient care and

outcomes greatly.

1 PTs and OTs may order therapy after an evaluation is performed, though the use of standing orders from their overseeing MDs delegating to them such rights.

2 With the exception of CNA services. Hospice CNA care costs roughly $1,000 per month, so we need ensure that hospice CNA care is a priority and that patients in need of it are receiving 5 to 7 days of CNA care each week in order to reach Medicare’s value.

Transitional Care

Your Health now has transitional care nurses in hospitals, nursing homes, and

rehab facilities on a daily basis. These nurses assist the facility in creating the discharge plan to

ensure the patient has a good transition home. Our payors require that we bill for a transitional care

visit within 7 days. TCPs will follow patients for 30 days after discharge via telehealth to ensure that

we schedule all necessary visits within in the first 30 days of discharge. A patient leaving the hospital

should be seen at least once per week, and the goal is to schedule visits with a visiting nurse, in-

person provider, tele-health provider, therapists, doctor, community health worker, health coach,

and any other services which may be benefit and be appropriate for the patient.

Therapy Services

All inbound certifications and recertifications will be monitored and reviewed

by a home health team (Case Manager, Referral Coordinator, Physical and/or Occupational

Therapist) to mitigate the overutilization of home health services. In the last six months our

organization has written 33,000 home health orders compared to 10,000 therapy orders which in

hindsight should be the opposite as we need more therapy and less of the nursing related services.

Moving forward, home health orders will be routed to the home health team for review of

appropriateness of requested services to mitigate overutilization of home health and promote the

utilization of outpatient therapy. In the coming weeks, information will be released as to the proper

ordering of home health and outpatient therapy services to ensure the required/necessary services

are delivered to our patients. We encourage the utilization of our physical and occupational

therapist to provide evaluations of patients to determine the necessity for home health and/or

outpatient therapy to ensure best outcomes.

Pharmacy

Your Health Pharmacy has expanded its services and is now able to provide next-day

delivery for medications and supplies to the patient’s home. While it’s typically not imperative that a

patient start a medication the same day as the prescribing visit, but where necessary, Your Health

Pharmacy is now able to coordinate with any Walgreens in the state of South Carolina to get the

patient’s medication delivered to their home on the same day by the community health worker.

Clinic Growth: In line with our commitment to Value-based care, our 2024 objectives involve a

strategic expansion of clinics in South Carolina and Georgia. This targeted growth aims to address

the healthcare needs of individuals nearing Medicare age, placing a strong emphasis on proactive

healthcare measures. By enlarging our clinic footprint, we seek to enhance our capacity to deliver

timely and tailored services, positioning ourselves as leaders in innovative patient care. This

expansion is not just about geographical reach; it’s a deliberate move to focus on preventive care

during the critical transition towards Medicare eligibility. Our goal is to make a significant impact on

healthcare spending by emphasizing long-term health outcomes and optimizing resource allocation.

This strategic venture reflects our dedication to creating a healthcare ecosystem that prioritizes

proactive measures, ultimately contributing to improved patient outcomes and fostering a more

resilient and patient-centric healthcare paradigm.

Productivity

Productivity is a vital aspect of our operations. Currently, our providers are operating

at less than 80% productivity, and our support staff is performing at less than 50%. Ultimately, this

means that we while we continue to provide great, quality healthcare to patients throughout the

region, it is imperative that we emphasize the importance of productivity to every person on our

team in 2024. Our productivity is calculated in a method where providers should be in excess of

100% productivity, and providers with the majority of their visits conducted via telehealth should

reach up to 140% productivity. It is imperative that we capture all time spent with patients with

CCM except for the time spent making actual medical decisions. Employees can track their

productivity on Power BI in the CCM report.

Productivity Goals

In support of our commitment to improving patient care, outcomes, and

reducing costs, in 2023, Your Health invested an additional $1.5 million in staffing each month,

however, to continue this growth, we must ensure productivity is a priority. Our goal is for all team

members to reach a minimum productivity level of 70%, while providers should strive for 90%

productivity or higher.

Talent Acquisition Department

To assist us in reaching these productivity goals, we haveintroduced a new Talent Acquisition Department, who will be responsible for recruiting new

employees across all regions and departments and focusing on productivity goals.

Social Determinants of Health

As our home providers recognize, we encounter a wide variety of

issues that relate to housing, food insecurity and basic needs with our patients. CMS has given us the

opportunity to take credit for services we provide through a variety of billing sources (CCM, Z

codes, etc.). We understand clearly that people cannot achieve a health life without having basic

needs met. In order to accomplish this, Your Health has added social workers, health coaches, and

community health workers to capture this billable data and to meet the needs of our patients. Very

soon, you will be receiving a detailed workflow which will enable us to capture these important data

points and to complement the total health care journey.

Conclusion

We are embarking on a journey to enhance healthcare quality, delivery, improve financial

stability, and ensure the highest level of patient care. Your dedication and contributions are vital to

our success, and I have full confidence in your ability to rise to the challenges ahead. The weekly

Your Health Newsletter will provide additional insight, information, and updates. Thank you for

your unwavering commitment to Your Health and our mission to provide exceptional healthcare to

our patients.