Health Solutions Taking Services to the Workplace

1. Health SolutionsTaking Services to the Workplace

2. Objectives Better understand Health Solutions business Explain short-term and long-term business imperatives Understand keys to success and growth

3. Understanding Health Solutions

4. Overview of Concentra Founded over 30 years ago, Concentra has grown into a leader of employer health services in the United States. Our two primary entities are Concentra Health Solutions, where we bring health care into the workplace with over 250 on-site centers nationwide, and Concentra Medical Centers, where patients come to us at over 300 locations nationwide, to reach your entire employee population. Concentra Health Solutions Worksite Medical/Therapy Programs TotalCare and Wellness Programs Mobile Medical Services Industrial Hygiene Services Comprehensive Safety Services Medical Data Analysis and Storage Forensic Drug Testing Clinical Laboratory Services Physician Review and Medical Advisory Services Concentra Medical Centers Injury Care (Workers’ Comp) Urgent Care (Episodic) Physical Therapy Specialist Care Pharmacy Services Drug Testing Drug Screening Substance Abuse and Monitoring Services Physical Examinations Travel Health Total Worksite Centers: Over 250 State Coverage: 36 Total Medical Centers: Over 300 State Coverage: 40

5. Key Business Products & Services • Business Units: • Worksite • At Work • Mobile Services • Concentra Medical Compliance Administration • Advanced Toxicology Network • Concentra Physician Review and Medical Advisory Services • Concentra Environmental, Health, and Safety Services

6. Concentra Worksite Provides worksite medical services at more than 250 workplace locations nationwide, with staffs dedicated to providing occupational health services, urgent care, .prevention and wellness services embedded at employer worksites Fact: In a 12-month period, Concentra's on-site facilities helped an express-shipment company save more than $900,000 in workers' comp-related costs, as compared to the previous year.

7. Concentra At Work Episodic services at employer worksites: functional examinations, substance abuse collections, prevention services, ergonomic analyses, and wellness services. Services • Biometric screenings • Urine drug collections • Preventive Health Exams • Employer exams pre-employment and regulatory • Worksite ergonomic evaluations • Immunizations including flu shots and Hepatitis A & B • Training and education courses for employees and employers

8. Concentra Mobile Services State-of-the-art mobile units that bring medical services to the workplace, including; medical surveillance, hearing conservation testing, and physical and preventive wellness examinations. • Vision and hearing tests • Physical examinations • Chest X-rays • Electrocardiograms (EKG) • Pre-employment or random drug screens • Bio-monitoring • Respiratory fit • Pulmonary function • Laboratory testing for lead, ZPP, SMAC, etc. • Inoculations, vaccinations, or immunizations Client Testimonial "…a quick note to tell you how positive our experience was… A— was the utmost of a professional, was on-time and efficient, demonstrated a thorough knowledge of the process and provided tremendous customer service..." — Brian, Las Vegas, NV

9. 1. Compliance and information management (surveillance) services helps employers perform, document, and report on government-mandated occupational safety requirements, such as physical exams, blood tests, and audiograms. Concentra Medical Compliance Administration (Two Primary Services) 2. A centralized repository for data processing and aggregation for wellness program; in support of the biometric screening and Health Risk Assessment processing. According to the National Council on Compensation Insurance, 38%-50% of workers’ compensation claims are related to the abuse of alcohol or drugs in the workplace.

10. Concentra Physician Review and Medical Advisory Services Provides physician utilization review and consultants to maximize processes, contain costs related to most medical claims, and provide medical directorship in specialized areas. Concentra’s expert physicians are available on a consulting basis in at least six areas: • Physician Review • Medical Directorship • On-site Consulting and Training • Travel Health • National Medical Consultants • Medical Expert Panels • Internal & External Support • Urgent Care • Prevention & Wellness • Infectious Disease • Transportation Industry

11. Advanced Toxicology Network Advanced Toxicology Network (ATN) is Concentra’s testing laboratory for all clinical diagnostic testing and toxicology screenings. Based in Memphis, Tennessee, ATN is an independent subsidiary of Concentra and works closely with clinicians in our Concentra Medical Centers locations. Expertise and resources: ATN has provided patient screenings since 1997 and has quickly developed into one of the nation's most advanced toxicology laboratories. ATN currently performs over 8,000 immunoassay-screening tests per day, as well as over 900 GC/MS confirmations per day. This volume makes ATN one of the country’s largest single-site testing laboratories.

12. Concentra Environmental, Health, and Safety Services Provides industrial hygiene and comprehensive safety services to assist clients with compliance with all local, state, and federal regulations to help improve the health and safety of the workplace while decreasing the impact on the environment. We employ industry experts who design integrated solutions in: • Industrial Hygiene • Environmental Compliance • Occupational Safety • Ergonomics • Related Areas Client Testimonial "…Kay said that Tim did an amazing job. He completed their noise survey last week and hand delivered the report … he took great care in explaining the report and making sure she understood everything." — Cathy, Murfreesboro, TN

13. TotalCare Philosophy TotalCareis a corporate philosophy that strives to provide a comprehensive suite of medical, preventive, rehabilitative, environmental, health and wellness programs focused on America’s workforce to improve overall health and reduce health care spending. One of the major objectives is to have these services delivered the same whether at employers’ worksites or our Concentra Medical Centers.

14. Examples of TotalCare at Concentra • Integration of occupational medicine with urgent care and wellness within a client’s workplace clinic • Providing Preventive Health Exams and biometric screening for our clients through our At Work and Mobile Services teams AND through our Concentra Medical Centers AND providing fully integrated reporting. • Installing an Onsite Health Specialist (health coach) embedded within a client’s workplace and coordination of Health Risk Assessments and biometric screenings. • Providing worksite preventive services with an Athletic Trainer combined with wellness promotion • Operating a worksite clinic within a factory setting and recognizing the need for an environmental assessment for hearing conservation by our EHS team. • Operating a worksite clinic at a client’s location and using the local Concentra Medical Center for referrals of patients for urgent care, rehab, x-ray, and other services not accommodated at the worksite location. • Utilizing a local Concentra Medical Director to conduct a wellness or other pertinent health topic seminar arranged by our Onsite Health Specialist.

15. TotalCareHealth and Wellness Services

16. Health Care Crisis Growing for Employers In almost every national survey of employers, the rising cost of providing health care to employees is their #1 concern. Our customers have two additional concerns: Improving the access of health care to their employees and preventing disease among their employees; our research finds problems in those areas contribute to the increasing cost of health care. In 2007, employer health insurance premiums increased by 6.1% - over twice the core rate of inflation. Source: National Coalition on Health Care The average employee contribution to company-provided health insurance has increased more than 143% since 2000. Average out-of-pocket costs for deductibles, co-payments for medications, and co-insurance for physician and hospital visits rose 115% during the same period. Source: Kaiser Family Foundation U.S. health care spending is expected to increase at similar levels through the next decade, reaching $3 trillion in 2011 and topping $4 trillion by 2016. Source: National Coalition on Health Care Chronic illness, including heart disease, diabetes, and obesity, account for 75% of health care costs. Source: American Public Health Association

17. The U.S. Health Care System The Problem: Runaway Costs Ineffective “Solutions” In 2007, employer health insurance premiums increased by 6.1% - over twice the core rate of inflation. Source: National Coalition on Health Care • Shift costs to employees • Increased premiums • Increased co-pays • Decrease or eliminate health care benefits • Provide health care in the workplace via a piecemeal approach • HRA program • Worksite health club • Health fairs Employees find health care too costly, utilization rates decrease, and the employee population becomes more unhealthy Harder to recruit and retain quality employees, while employee population becomes more unhealthy Program is never integrated, so it’s hard for employers to manage, while employees are left on their own to try to navigate the offerings The average employee contribution to company-provided health insurance has increased more than 143% since 2000. Average out-of-pocket costs for deductibles, co-payments for medications, and co-insurance for physician and hospital visits rose 115% during the same period. Source: Kaiser Family Foundation U.S. health care spending is expected to increase at similar levels through the next decade, reaching $3 trillion in 2011 and topping $4 trillion by 2016. Source: National Coalition on Health Care Chronic illness, including heart disease, diabetes, and obesity, account for 75% of health care costs. Source: American Public Health Association

18. Health Improvement Program TotalCare’s Health Improvement Program brings a population-based health promotion approach to the worksite to support the overall health and well-being of the employees. Combining best-practice strategies that educate employees about lifestyle risk factors and ways to reduce illness and injury. Program Components: • Program Design and Implementation • National Logistics Planning and Communications • Know Your Numbers – biometric screening • Health Risk Assessment • Health Promotion, Education, and Coaching • Manage and Measure

19. 2010 and Beyond: Business Strategic Goals

20. Short-Term Focus on greater integration Centers Process Management People Continue to breakdown silos/barriers within internal businesses New technology launches to support business units goals Become excellent at our core offerings Long-Term Drivers of New Ideas & Products Continued adaptation and responsiveness to market demands and the changing health care environment Sleep Apnea Preventive Exams Bio Screens Providing greater access & quality care Unlocking Client Value Greater Integration with outside partners Brokers Carriers Continue to integrate new products & services into medical centers as standard offerings Business Strategic Imperatives

21. Growing the Business