Big Bang Health Mission Control Employer Overview 12.10.16

Selected by Employee Benefit Adviser as a
“Top 10 Benefit Industry
Trendsetter to Watch in 2016”
Copyright Big Bang Health. All rights reserved.
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Problems with Current Health Plans
 Ineffective Health Management
 Poor Integration, Coordination and Collaboration
 Ineffective Cost Management
 Limited Flexibility to Tailor Plan Design
 Poor Customer Service
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The Solution is…
Big Bang Health is a fully‐integrated, national TPA health plan for self‐funded
employers, ACOs and Taft‐Hartley organizations. We offer a Mission Control
driven total health care population management solution supported by big
data analytics, coupled with a full benefits administration suite of services
encompassing claims administration, Stop Loss Insurance, pricing
transparency, Reference Based Pricing and more.
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Core Competency / Competitive Advantage
 New disruptive/transformational health care benefits solution
 Customer‐centric continuous solutions innovation
 Anticipatory, proactive, real‐time responsive adaptation for fulfilling
changing customer needs
 Flexible / adaptable open source health information technology
architecture enables individualized mix‐and‐match / plug‐and‐play
plan design and features customization
 Powerful new brand that is different from standard health plans
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HIGH RISK POPULATION COST DRIVERS
 5% of the employer insured population generates 50% of health care costs
(while 15% generates 80% of health care costs) due to ineffective,
inefficient, uncoordinated care, and lack of care advocacy.
 As much as 20% of that cost is associated with diagnosis errors
(~$700,000,000,000 annually).
 Probability of those employer insured high‐risk populations receiving latest
recommended evidence‐based care — and adhering with evidence‐based
recommendations — is a coin‐flip 50%.
 Those high‐risk employer insured populations, typically with multiple
chronic medical conditions — frequently complicated by a behavioral
and/or substance use disorder — with limited knowledge of how health
care works — are left to fend for themselves in a sea of providers to select
between frequently confusing treatment options.
 Presence of behavioral and/or substance use disorder increases probability
for all cause hospitalization up to 300%.
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A Story of Unmet Needs
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Major Barriers for Delivering High Value Health Care
ZERO SUM VALUE EQUATION CONUNDRUM
 Average 50% coin‐flip probability of patients receiving latest
evidence‐based treatment at point of care1.
 Average 50 % coin‐flip probability of patients adhering with
recommended care2.
 Summing probabilities: 50% x 50% = 25% ROI
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Current State
A majority of employers and their
employees are dissatisfied with
currently available, empty promise
health insurance options.
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Solution: Mission Control
The Big Bang Health system-level
transformational solution converts that
lose-lose-lose, current state key player
relationship scenario into a win-win-win
value proposition scenario — through a
carefully selected, best-of-breed
comprehensive, integrated suite of
administrative service only health benefit
services — wrapped in a unique, Mission
Control service envelope, unavailable
through any other health insurance
products.
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Desired State
That three‐way, continuous
communication process removes barriers
to care — repairs broken trust — and
restores the inherent lost equity in
current state dissatisfied / unresponsive /
adversarial key player relationships —
transforming them into satisfied /
cooperative / collaborative relationships
to deliver health care value — defined as
meaningful, measurable, sustainable
improvement in health status — delivered
at lowest possible cost — with optimal
consumer experience.
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Mission Control Service Package
 Continuous right‐time / right‐place health care decision support
 Patient health advocacy and care coordination
 Enables collaborative communications between members,
providers and employers
 Guidance for using Big Bang Health suite of support services
 Benefit education
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Example Comment From Mission Control Customer
“Thank you so much for taking time on a Sunday to listen to my health concerns
and provide some insight. I have been in good health up until these symptoms
appeared in March, so the process of diagnosis has been overwhelming and at
times frustrating. To be given peace of mind that my doctors so far have made
good decisions, as well as learning some other avenues I could pursue in my
care was priceless. I hope to be back in my running shoes soon and on the road to
good health!
It was nice talking to all of you today. Thank you so much for your expertise and
guidance!”
Emily
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The Vision for Big Bang Health –
One Offering Connecting All Channels
Members connect
to their supplemental
benefits at the
touch of a finger
Accessing many content streams from a single platform
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Market Size
 100+ million covered employees / dependents in self-funded plans and growing.
 As Figure 1 shows, 80+% of Large Firms and approx. 15-17% of Small Firms are
covered partially or completely by self-funded plans.
Figure 1. Percentage of Covered Workers in Partially or Completely Self‐Funded Plans, by Firm Size, 1999‐2014.
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Current Infrastructure
 Claims Administration, Health Administration, Technology
Platform, Finance & Regulatory in Place
 Physician Network: 500,000 (PHCS)
 Pharmacy / PBM: 50,000 locations
 Referenced Based Pricing (pre‐authorization) in place
 Quality/Price Metrics available for all facilities and providers
 Quoting business now
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Business Model
 Best of Breed Strategic Partners / Vendors
 Benefit Administration on PEPM basis:
 Mission Control
 Claims Administration
 Network
 Pharmacy Benefit Management
 Reference Based Pricing
 Full Service Reporting (Financial, Claims, Utilization, ACA)
 National Stop Loss Insurance Carriers
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Management
 Chris Fey, Chairman & CEO
 Paul E. Risner, President & COO
 Jed Goldart, M.D., M.P.H., CEO Mission Control
 Despina Walsworth, M.D., Chief Medical Officer
 Lev Paukman, M.D., Medical Advisor
 Tom Lieven, CPA, Chief Financial Officer
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References
1. Mcglynn EA, Asch SM, Adams J, et al. The Quality of Health Care Delivered to Adults in the
United States. New England Journal of Medicine. 2003;348(26):2635‐2645.
doi:10.1056/nejmsa022615.
2. Why “Gap in Care” is a Wellness Budget Killer. 2016, July 06. Retrieved from
https://www.springbuk.com/why‐gap‐in‐care‐is‐a‐wellness‐budget‐killer/
Figure 1. MacIver Institute. (2016). Percentage of Covered Workers in Partially or Completely
Self‐Funded Plans, by Firm Size, 1999‐2014 [Graph].
In Benefits Expert: Self‐Funded Insurance Would Save Millions in Obamacare Taxes.
Retrieved from http://www.maciverinstituite.com
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Big Bang Health Mission Control Employer Overview 12.10.16

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