Per Member Per Month (PMPM) Financial Benchmarking Report 2015

Transcription

1 R NATIONAL PACE ASS O CIATIO N Per Member Per Month (PMPM) Financial Benchmarking Report Alexian Brothers Community Services - Chattanooga CENSUS

2 Table of Contents I. Using the Reports A. Description of the Data Set and Limitations B. Calculation of Per Member Per Month (PMPM) Dollars C. Calculation of Expense as a Percent of Total Revenue D. Tables and Charts II. PMPM and Percent of Income Tables Summary of Reports and Statistics Used E. Report 1: Per-Member/Per-Month Dollar Report Summary Table F. Report 2: Per-Member/Per-Month % of Total Revenue Report Statistics Table III. Income and Expense, Income/Loss, Census Charts Summary of Charts Income, Expense, Income/Loss, Census A. Income Charts Chart 1: Your Income Sources Chart 2: All Programs Income Sources Chart 3: All Income PMPM and % Chart 4: PACE - Medicare PMPM and % Chart 5: PACE - Medicaid PMPM and % Chart 6: PACE - Other PMPM and % Chart 7: Other Income PMPM and % B. Expense Charts Chart 9: Your Top 5 Expenses Chart 10: All Programs Top 5 Expenses Chart 8: Expenses - All Chart 9: PACE Center Chart 10: Primary Care Chart 11: Adult Day Care Chart 12: Community Primary Care Chart 13: Community Adult Day Care Chart 14: Social Services Chart 15: Therapy Chart 16: Home Care Chart 17: Meals Chart 18: Transportation Chart 19: Outpatient Specialist Chart 20: Pharmacy Chart 21: DME and Supplies Chart 22: Labs and Diagnostics Chart : Nursing Home Chart 24: Hospital Chart 25: Sub-Acute Rehabilitation Chart 26: Assisted Living/Residential Care Chart 27: Administrative Chart 28: Marketing Chart 29: Insurance Chart 30: Depreciation Chart 31: Facility Chart 32: Other Expense C. Income/Loss Chart Chart 35: Income/Loss PMPM and % D. Census Chart Chart 36: PACE Center Average Enrollment by ZIP Code Appendices: A. Per Member Per Month (PMPM) Cost Category Definitions and Specifications B. Per Member Per Month (PMPM) Frequently Asked Questions about Data Entry PER MEMBER PER MONTH (PMPM) FINANCIAL BENCHMARKING REPORT 2

3 I. Using the Reports A. Description of the Data Set and Limitations The Data Set: The income and expense data presented in the following reports and charts were submitted to the National PACE Association by its member PACE programs. The data represent the income and expense of only fully capitated (i.e. capitated for Medicare and Medicaid) programs. The submitted data was evaluated for internal consistency to assure that: the total income reported equaled the sum of the values for each of the income categories reported the total expenses reported equaled the sum of the values for each expense category The net income or loss reported equaled the difference between the total income reported and the total expenses reported Limitations: Beyond the tests for internal consistency for reported values that were significant outliers, an attempt was made to verify with the PACE program that submitted the information that the reported value was correct. In several cases, this resulted in adjustments to the data in consultation with the submitting program. In other cases, the outlier result was either accurate or could not be resolved because of data gaps. For outlier results reflecting a gap in data, there were two common reasons: For some programs, costs for the PACE Center category could not be accurately allocated across this category s two subcategories: Adult Day Center and Primary Care. As a result, one of the two subcategories may have been assigned a disproportionately high amount of cost and the other a disproportionately low amount of cost. Extremely low values in either subcategory probably do not reflect true cost experience. The PACE Center category which rolls up the two subcategories is a more reliable indicator of cost experience. Internally contracted costs incurred by some PACE programs for services provided by another component of the program s sponsoring organization could not be fully accounted for or isolated. As a result, in some cost categories, such as transportation or adult day care, the reported experience may underestimate the actual cost of providing these services. As a result of these data gaps, the median value for all programs is likely to be a more reliable comparison than the mean (or average) which can be skewed by a single missing or inappropriately low value. Also, when considering the minimum value reported in a category, allowances should be made for the possibility that the value reflects a data gap rather than actual experience. B. Calculation of Per Member Per Month (PMPM) Dollars To calculate the PMPM for a revenue or expense item, the value reported for that item is divided by the total member months. Member months are months of service for each enrolled PACE participant. Each month of a participant s enrollment in a PACE program is equal to one member month of service. For example, if a participant was enrolled in a PACE program for nine months from March through December, this participant would contribute nine member months to the program s total number of member months. Member months were not reported separately for Medicare, Medicaid or other payers; therefore, the income PMPM results for each of these payers reflect the average across all PACE participants rather than the average for just those participants covered by a particular payer. C. Calculation of Income and Expense as a Percent of Total Revenue To calculate income and expense as a percent of total revenue, each income or expense category s value is divided by the value reported for total revenue. This percent represents the percentage of total income that is either: derived from a particular income source, e.g. Medicare or Medicaid expended in a particular expense category, e.g. Social Work D. Reports and Charts PER MEMBER PER MONTH (PMPM) FINANCIAL BENCHMARKING REPORT 3

4 II. Reports The two reports provided present the underlying data used to create the charts that follow. The first report, Per-Member/Per-Month Dollar, presents your program s PMPM dollar value information for each revenue and expense item. The second report, Per-Member/Per-Month % of Total Revenue, presents your program s PMPM percent of total revenue value information for each revenue and expense item. In both reports, your program s reported values are presented in the first column to the right of the item description. In addition to your own program s value, the reports also contain information to help you compare both the dollar amount and percent of total revenue your program derives from specific revenue sources or expends on specific expense categories to other programs. The additional reported values on each report present a range of statistics for each income and expense category. The statistics presented on the reports include: Minimum» The lowest value reported across all the programs 1 st Quartile» 25% of the programs reported a result that is below the 1 st quartile value while 75% reported a result that is above Median» 50% of the programs reported a result that is below the median value and 50% reported a result that is above the median value. The median is a measure of the central value, or typical result, reflected across all programs 3 rd Quartile» 75% of the programs reported a result that is below the 3 rd quartile value, while 25% reported a result above Maximum» The highest value reported across all programs Mean» The average across all programs, including reported values of zero Standard Deviation» It measures the distribution of reported results below and above the mean. Assuming a normal distribution of results, you would expect 66% of all results to be within plus or minus one standard deviation from the mean. For example, the mean for All Revenue is $5,401 and the standard deviation is $906. We would expect 66% of all programs to have an All Revenue result between $4,495 ($5,401 - $906) and $6,307 ($5,401 + $906). You would expect 99% of all results to be within plus or minus two standard deviations from the mean. Observations» The number of individual programs that contributed data that were used in the calculation of the statistical values reported for the specific measure item PER MEMBER PER MONTH (PMPM) FINANCIAL BENCHMARKING REPORT 4

5 III. Income and Expense, Income/Loss, Census Charts The charts are presented in two sets: Income Charts and Expense Charts. At the beginning of each set, two pie charts represent your program s experience and the experience of all programs combined. The Income pie charts show the sources of income for your program and for all programs as a percent of total income. The Expense pie charts show the top 5 expenses plus all remaining expenses for your program and all programs combined. These pie charts can help you compare your program s income sources and top 5 expense categories to other programs. Note: The Expense pie chart expresses expense categories as a percent of total expenses, not as a percent of total revenue. All other charts express the expense category s value as a percent of total revenue. A. Income Charts Following the pie charts in the Income section, a bar graph depicts the range of experience reported across all programs as well as your program s own result for total income. The first chart Income: Total PMPM shows your total income PMPM. In this chart and all other charts, the result for your program is plotted on the graph in relation to your program s reported dollar value as it compares to the value being reported for the minimum, 1 st quartile, median, 3 rd quartile, and maximum results for the benchmarking item. You can use these results to compare your program to other programs. Subsequent bar graphs in the Income section show your income PMPM for each particular source (e.g. Medicare) as well as the percent of your total income derived from the source. In the charts showing both the PMPM (in bars) and the percent of income (in a line), the axis on the left is used to read the PMPM dollar value and the axis on the right is used to read the percent of income value. B. Expense Charts Following the pie charts in the Expense section, a series of bar and line graphs present the PMPM dollar values and percent of income values for each of the expense categories. Your program s result is plotted on the graph in relation to your programs reported dollar value as it compares to the value being reported for the minimum, 1 st quartile, median, 3 rd quartile, and maximum results for the benchmarking item. Similar to the income charts, the axis on the left is used to read the bars reflecting the PMPM dollars and the axis on the right is used to read the line reflecting the percent of income expended. C. Income/Loss Chart The Income/Loss chart follows the same format as the income and expense charts. This chart shows values indicating a net loss below the line and programs with a net income above the line. The bars correspond to the left axis indicating PMPM dollars and the line corresponds to the right axis indicating percent of revenue. D. Census Charts The first of the census charts presents a graphic representation of PACE program enrollment and physical location in relation to ZIP Code on a national level. Your program s values for Member Months and Average enrollment are displayed at the top the page. The key to the left of the map displays six value ranges representing average enrollment with corresponding symbols. The symbols are plotted on the map area representing PACE programs with an average enrollment that falls within the listed range. The number shown to the left of the map key reports the number of individual PACE programs that are being plotted for a particular enrollment range. PER MEMBER PER MONTH (PMPM) FINANCIAL BENCHMARKING REPORT 5

6 Appendix A Per Member Per Month (PMPM) Cost Category Definitions 1. Functional Cost Categories Generally, costs are reported by function (e.g. PACE Center) rather than by input or resource (e.g. RN salaries). Each functional cost category should include all expenses directly associated with the function (e.g. salaries, supplies). General and administrative costs should be reported in the designated cost categories for these items (see Item Reference numbers below) rather than allocated across all categories. 3. Complete Transmittal In order to transmit a complete set of cost information, you must provide all of the required items. If you have incurred no expenses in a cost item, enter Cost Item Specifications The table below provides specific information on the costs to be assigned to each of the Per Member Per Month cost categories. The Item Reference Number in the table refers to the item s number in the related data entry screen (the Excel spreadsheet). 2. Allocation of Staff Expense Staff expenses should be allocated to one of the expense items as appropriate. For staff expenses, include the following: salary, benefits (to include health insurance, pension, workmen s compensation, employee transportation assistance, parking, uniforms), taxes, employee recognition, professional development expenses, productive and nonproductive time, and professional licenses paid by the organization. An individual staff member s expense may be allocated across multiple cost categories if the individual contributes to multiple functions. PER MEMBER PER MONTH (PMPM) FINANCIAL BENCHMARKING REPORT 6

7 Per Member Per Month (PMPM) Cost Category Specifications Cost Category Specifications Item Ref. # Item Specification 1 Year-Ending Date for Data Transmitted The last day of the period for which income and expenses are being reported 2 Number of days in reported period Total number of days in the period for which income and expenses are being reported 3 Enrollment Total number of participants enrolled in the PACE program at the year-ending date 4 Member Months - All Total number of member months for the period being reported 5 Income - All Total income for the PACE program 6 PACE - Medicare Income received from Medicare for the provision of PACE services 7 PACE - Medicaid Income received from Medicaid for the provision of PACE services 8 PACE - Other Income received from sources other than Medicare or Medicaid (e.g. private pay) for the provision of PACE services 9 Income - Other Income not related to the delivery of PACE services (e.g. foundation grants, interest income) 10 Expenses - All Total of all expenses related to the PACE Program, as detailed below in items below 11 PACE Center Sum of Primary Care (item # 12) and Adult Day (# 13) below 12 Primary Care PACE Center based 13 Adult Day Care PACE Center Medical Director Primary Care Physician(s) in Clinic or Home Nurse Practitioner in Clinic or Home Nursing Staff in Clinic or Day Center who provide Primary Care (Note: not home care nursing) Clinic Administrative Staff Medical Records Medical Records Staff PACE Day Center Staff - all PACE Day Center Staff Assistants PACE Day Center Supervisor Recreational Therapy - Program Recreational Therapy - Contracted Laundry PER MEMBER PER MONTH (PMPM) FINANCIAL BENCHMARKING REPORT 7

8 Cost Category Specifications Item Ref. # Item Specification 14 Contracted, Off-site Primary Care Contracted, Primary Care Costs of Physicians, Nurse Practitioners, and Nurses for delivering Primary Care in a location other than a PACE Center or Participant s Home. 15 Contracted, Off-site Adult Day Care Contracted, Adult Day Care costs for services in a location other than a PACE Center 16 Social Services Social Work staff - all 17 Therapy 18 Home Care 19 Meals 20 Transportation Occupational Therapy - Program Occupational Therapy - Contracted Speech Therapy - Program Speech Therapy - Contracted Physical Therapy - Program Physical Therapy - Contracted Therapy Provided Under Contract Other (Note do not include Recreational Therapy, see # 12 above) Therapy - Other Home Care Nursing Home Care Personal Assistance Lifeline Monitoring Home Care - Other Food Plates and Cutlery Staff Contracted Service Meals - Other Outsourced Transportation Costs (incl. Ambulance for non-inpatient) Van Fleet: Van Leasing, Van Repairs, Van Maintenance, Auto Gas and Oil Transportation Staff Drivers, Assistants, Other Other PER MEMBER PER MONTH (PMPM) FINANCIAL BENCHMARKING REPORT 8

9 Cost Category Specifications Item Ref. # Item Specification 21 Outpatient Specialist Audiology Dentistry Optometry Podiatry Surgery Pathology Radiology Outpatient Dialysis Psychiatry/Psychology Other 22 Pharmacy DME and Supplies 24 Labs and Diagnostics 25 Nursing Home Prescription Drugs Over the Counter Drugs Dispensing/Administrative Pharmacist Other Durable Medical Equipment Supplies: Clinic Supplies, Day Center Supplies, Therapy Supplies, Other Supplies Other Lab Costs Other Diagnostic Service Costs (e.g. x-ray, MRI) Other Short Stay/Respite Long Stay/Permanent Placement Other PER MEMBER PER MONTH (PMPM) FINANCIAL BENCHMARKING REPORT 9

10 Cost Category Specifications Item Ref. # Item Specification 26 Hospital Ambulance Emergency Room Intensive Care Unit Medical/Surgical Inpatient Rehabilitative (Acute Care Stay) Inpatient Dialysis Inpatient Psychiatric Other 27 Sub-Acute Rehabilitation Sub-Acute Rehabilitative Care/Skilled Nursing Facility Sub-Acute Rehabilitative Care/Hospital Sub-Acute Rehabilitative Care/Other Place of Service 28 Assisted Living/ Residential Care PACE Housing Foster Care/Group Home Residential Care/Assisted Living ICF (>30 days) Other 29 Administrative Admissions and Eligibility Staff Program Management Staff Travel Postage and Courier Photocopying and Printing Bank Charges Accounting Services Books and Subscriptions Management Support Services Information Systems Licensing Fees Legal Fees Translation Services Administrative Supplies Other PER MEMBER PER MONTH (PMPM) FINANCIAL BENCHMARKING REPORT 10

11 Cost Category Specifications Item Ref. # Item Specification 30 Marketing 31 Insurance 32 Depreciation 33 Facility Marketing Staff Marketing Expenses Liability Insurance Stop-loss Insurance Facility Related Insurance Equipment Building Vehicles Information Systems/Computers PACE Center Rent/Mortgage PACE Center Utility Costs Facility Maintenance Equipment Maintenance Maintenance Staff Other 34 Other Expense Expenses not specified above (please describe in Notes section) 35 Income (Loss) from operations Total Revenues minus Total Expenses 36 Medical Loss Ratio (MLR) Note: LISTED on the % of Total Revenue Report Only Medical Loss Ratio is the ratio of the value of medical services provided to the amount of the premiums paid (Items / Item 5) PER MEMBER PER MONTH (PMPM) FINANCIAL BENCHMARKING REPORT 11

12 Appendix B Per Member Per Month (PMPM) Frequently Asked Questions about Data Entry PMPM Item # Subject Question Answer multiple Employee Benefits How do I assign Employee Benefits expenses? Assign employee benefits expenses to the cost item that the staff s salary is associated with; you can prorate your total Employee Benefits expenses using the proportion of your total salaries that is assigned to different cost items multiple FICA How do I assign FICA expenses? assign these expenses to the cost item that the staff s salary is associated with; you can prorate your total FICA expenses using the proportion of your total salaries that is assigned to different cost items 26 Inpatient Specialist How do I assign inpatient specialists costs? 33 Interest Expense How do I assign interest expense incurred by the program for cash flow/ short term borrowing? Assign inpatient specialists costs to the Hospital item (# 26) Assign interest expense for cash flow/short term borrowing to the Other expense item (# 33) and include a note explaining this multiple, 31 Minor equipment How do I assign minor equipment expenses? Assign minor equipment expenses to the expense item with which it is associated (e.g. Adult Day Care # 13) if the equipment is not depreciable; if the equipment is depreciable, assign the annual depreciation expense to the Depreciation expense item (# 31) 19 Nutritionist How do I assign Nutritionist Expense? Assign nutritionist expenses to the Meals item (# 19); this item will be retitled to be Meals and Nutrition 26 Outpatient Hospital Services How do I assign outpatient hospital service expenses? Assign outpatient hospital service expenses to the Hospital expense item (# 26) 33 Pastoral Care How do I assign pastoral care staff costs? Assign pastoral care staff costs to the Other expense item (# 33) and include a note explaining this 32 Phone How do I assign phone costs? Assign phone costs to the Facility item (# 32) multiple Professional Development How do I assign Professional Development (e.g. seminars, travel to conferences, registration fees) expenses? Assign professional development expenses to the cost item that the staff s salary is associated with; you can prorate your total Professional Development expenses using the proportion of your total salaries that is assigned to different cost items Prosthetics How do I assign prosthetic expenses? Assign prosthetic expenses to the DME/Supplies expense item (# ) PER MEMBER PER MONTH (PMPM) FINANCIAL BENCHMARKING REPORT 12

13 H4402 PMPM Dolars($) Report AuditYear (Financial Data) Item # Chart# Category Your$ Minimum $ 1stQuartile$ Median$ 3rdQuartile$ Maximum $ #ofpos(n) 5 3 REVENUE-ALL $22,403, $2, $5, $6, $6, $8, Revenue-Medicare $11,884, $1, $2, $2, $3, $3, Revenue-Medicaid $10,418, $1, $2, $3, $3, $4, Revenue-PACEOther $42, $1.50 $84.00 $ $ Revenue-Other $58, $1.00 $39.00 $90.50 $ EXPENSES-ALL $19,962, $1, $5, $6, $6, $8, Expenses-PACECenter $2,320, $ $ $ $ $1, Expenses-PACECenter:PrimaryCare $2,029, $ $ $ $ $ Expenses-DayCenter $291, $ $ $ $ Expenses-CommunityPrimaryCare $ Expenses-CommunityAdultDayCare $ Expenses-SocialServices $449, $35.00 $89.00 $ $ $ Expenses-Therapy $717, $95.00 $ $ $ $ Expenses-HomeCare $1,080, $61.00 $ $ $ $2, Expenses-Meals $534, $41.00 $98.50 $ $ $ Expenses-Transportation $1,610, $ $ $ $ $ Expenses-OutpatientSpecialist $1,039, $92.00 $ $ $ $ Expenses-Pharmacy $2,225, $ $ $ $ $1, Expenses-DMEandSupplies $181, $50.00 $86.00 $ $ Expenses-LabsandDiagnostics $134, $28.00 $48.00 $66.00 $ Expenses-NursingHome $2,387, $55.00 $ $ $ $1, Expenses-Hospital $1,420, $ $ $ $ $1, Expenses-Sub-AcuteRehabilitation $98.50 $ Expenses-AssistedLiving/ResidentialCare $528, $22.00 $ $ $ Expenses-Administrative $4,062, $ $ $ $ $1, Expenses-Marketing $391, $35.50 $60.00 $86.00 $ Expenses-Insurance $24, $13.00 $35.00 $50.00 $ Expenses-Depreciation $364, $12.00 $62.50 $86.00 $ $ Expenses-Facility $486, $19.00 $ $ $ $ Expenses-Other $21.00 $ $ INCOME(LOSS) $2,441, ($1,589.00) ($81.00) $ $ $793.00

14 AuditYear (Financial Item # Chart#Category #ofpos_%) Data) 5 3 REVENUE-ALL 6 4 Revenue-Medicare 7 5 Revenue-Medicaid 8 6 Revenue-PACEOther 9 7 Revenue-Other EXPENSES-ALL Expenses-PACECenter Expenses-PACECenter:PrimaryCare Expenses-DayCenter Expenses-CommunityPrimaryCare Expenses-CommunityAdultDayCare Expenses-SocialServices Expenses-Therapy Expenses-HomeCare Expenses-Meals Expenses-Transportation Expenses-OutpatientSpecialist Expenses-Pharmacy Expenses-DMEandSupplies Expenses-LabsandDiagnostics Expenses-NursingHome Expenses-Hospital Expenses-Sub-AcuteRehabilitation Expenses-AssistedLiving/ResidentialCare Expenses-Administrative Expenses-Marketing Expenses-Insurance Expenses-Depreciation Expenses-Facility Expenses-Other INCOME(LOSS) MEDICALLOSSRATIO (MLR) % 46.50% 0.19% 0.26% 89.10% 10.36% 9.06% 1.30% 2.01% 3.20% 4.82% 2.39% 7.19% 4.64% 9.93% 0.81% 0.60% 10.66% 6.34% 2.36% 18.13% 1.75% 0.11% 1.63% 2.17% 10.90% 65.31% % 45.00% 86.00% 6.00% 6.00% 7.00% % 65.00% % % 6.00% 6.00% % 7.00% % % % 9.00% 6.00% 5.00% % 8.00% % % % 9.00% 7.00% % 6.00% % 6.00% % % % 5.00% 29.00% 8.00% % % %

15 H4402 Chart1 YourRevenueSources 53.05% % 4 YourResults_% % 0.26% Revenue-Medicare Revenue-Medicaid Revenue-PACEOther Revenue-Other Chart2 AverageRevenueSourcesforAlOrgs % 51.94% 4 Avg.YourResults_% Revenue-Medicare Revenue-Medicaid Revenue-PACEOther Revenue-Other 2.98% 1.33%

16 H4402 Chart3 Revenue-ALL PMPM Dolars($) REVENUE-ALL $8, $8, $7, $6, $6, $6, $6, $5, $5, $4, $3, $2, $2, $1, YourResult_$ Minimum $ 1stQuartile$ Median$ 3rdQuartile$ Maximum $

17 H4402 Chart4 Revenue-Medicare PMPM Dolars($) Revenue-Medicare $4, $3, $3, $3, $3, $2, $2, $2, $1, $1, YourResult_$ Minimum $ 1stQuartile_$ Median$ 3rdQuartile$ Maximum $ H4402 Chart4 Revenue-Medicare Percent(%)ofTotalRevenue AuditYear(FinancialData)/Category Revenue-Medicare % % 49.00% % 2 1

18 H4402 Chart5 Revenue-Medicaid PMPM Dolars($) Revenue-Medicaid $4, $4, $3, $3, $3, $2, $3, $2, $1, $1, H4402 Chart5 Revenue-Medicaid Percent(%)ofTotalRevenue Revenue-Medicaid % 45.00% 48.00%

19 H4402 Chart6 Revenue-PACEOther PMPM Dolars($) Revenue-PACEOther $ $ $ $ $ $ $84.00 $13.00 $1.50 H4402 Chart6 Revenue-PACEOther Percent(%)ofTotalRevenue Revenue-PACEOther 6.00% 6.00% 5.00% 0.19%

20 H4402 Chart7 Revenue-Other PMPM Dolars($) Revenue-Other $ $ $90.50 $50.00 $39.00 $17.00 $1.00 H4402 Chart7 Revenue-Other Percent(%)ofTotalRevenue Revenue-Other 1.50% 0.50% 0.26%

21 H4402 Chart8 YourTop6ExpenseCategoriesbyPercent(%)ofTotalExpense AuditYear(Fin.Category Expenses- Administrative Expenses-Nursing Home Expenses- Pharmacy Expenses-PACE Center:Primary Care Expenses- Transportation Chart# % 10.66% 9.93% 9.06% 7.19% Expenses-Hospital % Chart9 MeanofAlOrgs Top6ExpenseCategoriesbyPercent(%)ofTotalExpense AuditYear(Fi. Category Expenses- Administrative Chart# % Expenses-Pharmacy % Expenses-HomeCare % Expenses-Hospital % Expenses-Nursing Home % Expenses-PACECenter 12 :PrimaryCare 7.32%

22 H4402 Chart10 Expenses-ALL PMPM Dolars($) EXPENSES-ALL $8, $8, $6, $5, $5, $6, $6, $4, $2, $1, H4402 Chart10 Expenses-ALL Percent(%)ofTotalRevenue EXPENSES-ALL % % 86.00% %

23 H4402 Chart11 Expenses-PACECenter PMPM Dolars($) Expenses-PACECenter $1, $1, $1, $1, $ $ $ $ $ $ $ $ $ H4402 Chart11 Expenses-PACECenter Percent(%)ofTotalRevenue Expenses-PACECenter 25.00% % 15.00% % 9.00% % 5.00%

24 H4402 Chart12 Expenses-PACECenter:PrimaryCare PMPM Dolars($) Expenses-PACECenter:PrimaryCare $ $ $ $ $ $ $ $ $ H4402 Chart12 Expenses-PACECenter:PrimaryCare Percent(%)ofTotalRevenue 1 Expenses-PACECenter:PrimaryCare % 9.00% 8.00% 6.00% 6.00% 7.00%

25 H4402 Chart13 Expenses-DayCenter PMPM Dolars($) Expenses-DayCenter $ $ $ $ $ $ $ $87.00 H4402 Chart13 Expenses-DayCenter Percent(%)ofTotalRevenue Expenses-DayCenter % 6.00% 7.00% 1.30%

26 H4402 Chart14 Expenses-CommunityPrimaryCare PMPM Dolars($) Expenses-CommunityPrimaryCare $ $ $ Dolars_$PMPM $ $ $ $50.00 H4402 Chart14 Expenses-CommunityPrimaryCare Percent(%)ofTotalRevenue Expenses-CommunityPrimaryCare 5.00% 5.00%

27 H4402 Chart15 Expenses-CommunityAdultDayCare PMPM Dolars($) Expenses-CommunityAdultDayCare $ $ $ $50.00 H4402 Chart15 Expenses-CommunityAdultDayCare Percent(%)ofTotalRevenue Expenses-CommunityAdultDayCare 1.50% 0.50%

28 H4402 Chart16 Expenses-SocialServices PMPM Dolars($) Expenses-SocialServices $ $ $ $ $ $ $89.00 $ $50.00 $35.00 H4402 Chart16 Expenses-SocialServices Percent(%)ofTotalRevenue Expenses-SocialServices 2.50% 2.01% 1.50% 0.50%

29 H4402 Chart17 Expenses-Therapy PMPM Dolars($) Expenses-Therapy $ $ $ $ $ $ $ $ $95.00 H4402 Chart17 Expenses-Therapy Percent(%)ofTotalRevenue Expenses-Therapy 5.00% 5.00% 3.20%

30 H4402 Chart18 Expenses-HomeCare PMPM Dolars($) Expenses-HomeCare $2, $2, $1, $1, $ $ $3.00 $ $ $61.00 H4402 Chart18 Expenses-HomeCare Percent(%)ofTotalRevenue Expenses-HomeCare % 25.00% % % 5.00% 4.82% 6.00%

31 H4402 Chart19 Expenses-Meals PMPM Dolars($) Expenses-Meals $ $ $ $ $ $ $98.50 $ $50.00 $41.00 H4402 Chart19 Expenses-Meals Percent(%)ofTotalRevenue Expenses-Meals 2.39%

32 H4402 Chart20 Expenses-Transportation PMPM Dolars($) Expenses-Transportation $ $ $ $ $ $ $ $ $ $ $ $ $ H4402 Chart20 Expenses-Transportation Percent(%)ofTotalRevenue Expenses-Transportation 8.00% 7.19% 7.00% 8.00% 6.00% 6.00%

33 H4402 Chart21 Expenses-OutpatientSpecialist PMPM Dolars($) Expenses-OutpatientSpecialist $ $ $ $ $ $ $ $ $ $92.00 H4402 Chart21 Expenses-OutpatientSpecialist Percent(%)ofTotalRevenue Expenses-OutpatientSpecialist % 6.00% 4.64% 5.00% 6.00%

34 H4402 Chart22 Expenses-Pharmacy PMPM Dolars($) Expenses-Pharmacy $1, $1, $1, $ $ $ $ $ $ $ $ $ H4402 Chart22 Expenses-Pharmacy Percent(%)ofTotalRevenue Expenses-Pharmacy 16.00% 15.00% % % 5.00%

35 H4402 Chart Expenses-DMEandSupplies PMPM Dolars($) Expenses-DMEandSupplies $ $ $ $ $ $86.00 $50.00 $54.00 $50.00 H4402 Chart Expenses-DMEandSupplies Percent(%)ofTotalRevenue Expenses-DMEandSupplies 2.50% 1.50% 0.81% 0.50%

36 H4402 Chart24 Expenses-LabsandDiagnostics PMPM Dolars($) Expenses-LabsandDiagnostics $ $ $ $66.00 $50.00 $40.00 $28.00 $48.00 H4402 Chart24 Expenses-LabsandDiagnostics Percent(%)ofTotalRevenue Expenses-LabsandDiagnostics 1.50% 0.60% 0.50%

37 H4402 Chart25 Expenses-NursingHome PMPM Dolars($) Expenses-NursingHome $1, $1, $1, $1, $ $ $ $ $ $ $ $55.00 $ H4402 Chart25 Expenses-NursingHome Percent(%)ofTotalRevenue Expenses-NursingHome % % 9.00% 5.00% 5.00%

38 H4402 Chart26 Expenses-Hospital PMPM Dolars($) $1, Expenses-Hospital $1, $1, $1, $ $ $ $ $ $ $ $ $ H4402 Chart26 Expense-Hospital Percent(%)ofTotalRevenue Expenses-Hospital % % 7.00% 8.00% 5.00%

39 H4402 Chart27 Expenses-Sub-AcuteRehabilitation PMPM Dolars($) Expenses-Sub-AcuteRehabilitation $ $ $ $ $98.50 H4402 Chart27 Expenses-Sub-AcuteRehabilitation Percent(%)ofTotalRevenue Expenses-Sub-AcuteRehabilitation 5.00% 5.00%

40 H4402 Chart28 Expenses-AssistedLiving/ResidentialCare PMPM Dolars($) Expenses-AssistedLiving/ResidentialCare $ $ $ $ $ $ $ $ $22.00 H4402 Chart28 Expenses-AssistedLiving/ResidentialCare Percent(%)ofTotalRevenue Expenses-AssistedLiving/ResidentialCare 15.00% % 2.36%

41 H4402 Chart29 Expenses-Administrative PMPM Dolars($) Expenses-Administrative $1, $1, $1, $1, $ $ $ $ $ H4402 Chart29 Expenses-Administrative Percent(%)ofTotalRevenue Expenses-Administrative % 19.00% 15.00% 15.00% % 5.00%

42 H4402 Chart30 Expenses-Marketing PMPM Dolars($) Expenses-Marketing $ $ $ $ $ $ $ $ $86.00 $60.00 $35.50 H4402 Chart30 Expenses-Marketing Percent(%)ofTotalRevenue Expenses-Marketing % 6.00% 1.75%

43 H4402 Chart31 Expenses-Insurance PMPM Dolars($) Expenses-Insurance $ $ $ $50.00 $35.00 $50.00 $13.00 $7.00 H4402 Chart31 Expenses-Insurance Percent(%)ofTotalRevenue Expenses-Insurance 1.50% 0.50% 0.11%

44 H4402 Chart32 Expenses-Depreciation PMPM Dolars($) Expenses-Depreciation $ $ $ $ $ $86.00 $62.50 $50.00 $12.00 H4402 Chart32 Expenses-Depreciation Percent(%)ofTotalRevenue Expenses-Depreciation 2.50% 1.50% 1.63% 0.50%

45 H4402 Chart33 Expenses-Facility PMPM Dolars($) $ AuditYear(FinancialData)/Category Expenses-Facility $ $ $ $ $ $ $ $ $19.00 H4402 Chart33 Expenses-Facility Percent(%)ofTotalRevenue Expenses-Facility % 6.00% 2.17%

46 H4402 Chart34 Expenses-Other PMPM Dolars($) $ Expenses-Other $ $ $ $ $ $21.00 H4402 Chart34 Expenses-Other Percent(%)ofTotalRevenue Expenses-Other % 6.00%

47 H4402 Chart35 Income(Loss) PMPM Dolars($) $1, $ INCOME(LOSS) $ $ $ $ ($500.00) ($81.00) ($1,000.00) ($1,500.00) ($1,589.00) H4402 Chart35 Income(Loss) Percent(%)ofTotalRevenue INCOME(LOSS) % 6.00% %

48 H4402 Chart36 MedicalLossRatio(MLR) MEDICALLOSSRATIO (MLR) % % 65.00%

49 Enrolment