Quality Scorecard overall heart attack care overall heart failure overall pneumonia care overall surgical infection rate patient safety survival

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1 Quality Scorecard s are required to report quality statistics to the s for Medicare and Medicaid Services (CMS) and the Department of Health (DOH). This information is made available at or In addition, Health Grades is the leading independent healthcare ratings organization and can be found at Empire BCBS reviews the publicly available data at these websites as one way to assess the quality of the services our members receive at our participating hospitals to ensure that the quality is in alignment between the price you pay and the value you receive. Below you will find several charts. In Section A you will find a comparison of the quality scores of four major quality indicators, overall heart attack care, overall heart failure, overall pneumonia care and overall surgical infection rate, reported by CMS for each of the Stellaris hospitals compared to peer hospitals and the New York State Average. In Section B you will find the results of the patient safety, survival and complication ratings identified on the Health Grades website. Overall, Stellaris hospitals did not out perform other community hospitals in County and surrounding communities on the CMS quality measures or perform better than expected on the Health Grades quality measures.

2 Section A - DOH Measures Below is a comparison of the quality scores of four major quality indicators, overall heart attack care, overall heart failure, overall pneumonia care and overall surgical infection rate, reported by DOH for each of the Stellaris hospitals compared to peer hospitals and the New York State Average. As you will see, approximately 60% of the time, the Stellaris facilities quality score exceed the New York State Average while 40% of the time, the quality scores fall at or below the New York State Average. Stellaris hospitals did not out perform peer hospitals on these measures. Comparison of 4 Major Quality Measures (7/1/08 6/30/09) Overall Heart Attack Care Peer % Peer % 97.9% NY State Average 97.7% White Plains 97.7% Peer % 97.0% Peer % Peer % 92.5% Peer % Overall Pneumonia Care Peer % Peer % Peer % 94.0% 93.8% 93.4% White Plains 91.0% Peer % NY State Average 90.3% Peer % Peer % Overall Heart Failure Peer % Peer % 98.1% 95.5% Peer % 95.4% Peer % NY State Average 94.4% Peer % White Plains 81.5% Peer % Overall Surgical Infection Rate Peer % 95.9% 95.0% Peer % NY State Average 94.9% Peer % Peer % White Plains 92.7% 89.1% Peer % Peer % Source: DOH

3 Section B Health Grades The chart below summarizes the results of the patient safety, survival and complication ratings identified on the Health Grades website by looking at the total number of measures in each of those categories and summarizing, for each Stellaris hospital, how that hospital performed on an overall basis. For instance, you will note that there are 12 patient safety measures. On these measures, the below summary would tell you that performed better than expected on 3 out of 12 measures, as expected (average) on 1 out of 12 measures and worse than expected on 8 out of 12 measures. Overall, Stellaris hospitals performed as expected or worse than expected on the majority of the measures in these three categories. Chart 1 provides an overall summary while charts 2 and 3 provide the detail behind the summary. Chart 1 Summary Data Indicators Patient Safety Indicators Health Grades Summary White Plains Better Than Average 3 out of 12 1 out of 12 4 out of 12 3 out of 12 1 out of 12 0 out of 12 1 out of 12 2 out of 11 4 out of 12 3 out of 12 Average 1 out of 12 9 out of 12 5 out of 12 5 out of 12 7 out of out of 12 7 out of 12 6 out of 11 5 out of 12 6 out of 12 Worse 8 out of 12 2 out of 12 3 out of 12 4 out of 12 4 out of 12 2 out of 12 4 out of 12 3 out of 11 3 out of 12 3 out of 12 Survival Ratings Better Than Average 0 out of 11 1 out of 11 0 out of 11 0 out of 11 1 out of 9 0 out of 11 0 out of 11 0 out of 8 0 out of 10 0 out of 10 0 out of 10 Average 6 out of out of 11 7 out of 11 6 out of 11 7 out of 9 10 out of 11 8 out of 11 3 out of 8 6 out of 10 8 out of 10 5 out of 10 Worse 5 out of 11 0 out of 11 4 out of 11 5 out of 11 1 out of 9 1 out of 11 3 out of 11 5 out of 8 4 out of 10 2 out of 10 5 out of 10 Complications Ratings Better Than Average 2 out of 9 0 out of 10 2 out of 8 1 out of 11 0 out of 2 1 out of 9 0 out of 7 0 out of 5 3 out of 10 1 out of 8 1 out of 8 Average 4 out of 9 9 out of 10 6 out of 8 6 out of 11 2 out of 2 7 out of 9 3 out of 7 3 out of 5 4 out of 10 3 out of 8 6 out of 8 Worse 3 out of 9 1 out of 10 0 out of 8 4 out of 11 0 out of 2 1 out of 9 4 out of 7 2 out of 5 3 out of 10 4 out of 8 1 out of 8

4 Chart 2 Patient Safety Detail The chart below provides the 12 Patient Safety Indicators along with the corresponding ratings for each of the Stellaris hospitals. Patient Safety Indicators Prevention of death in procedures where mortality is usually very low Lack of pressure sores or bed sores acquired in the hospital Patient Safety Ratings White Plains Ability to diagnose and treat in time Avoidance of collapsed lung due to a procedure or surgery in or around the chest Lack of infections acquired at hospital Absence of hip fracture after surgery Avoidance of excessive bruising or bleeding as a consequence of a procedure or surgery Adequate organ function and electrolyte and fluid balance after surgery Avoidance of respiratory failure following surgery Lack of deep blood clots in the lungs or legs after surgery Avoidance of severe infection following surgery Lack of surgical wound site breakdown Key: Better Than Expected Average Worse

5 Chart 3 Survival & Complications Ratings Detail The chart below provides the Survival Ratings for patients while in the hospital for 11 conditions/procedures and the Complication Ratings for 11 conditions/procedures as scored by Health Grades (Best, As Expected, Poor) for each of the Stellaris hospitals. Chronic Obstructive Pulmonary Disease (COPD) Pneumonia Bowel Obstruction Health Grade Quality Metrics Survival Ratings White Plains Diabetic Acidosis and Coma Gastrointestinal Bleed Gastrointestinal Surgeries and Procedures Pancreatitis Pulmonary Embolism Respiratory Failure Sepsis Stroke Complication Ratings Back and Neck Surgery (Spinal Infusion) Back and Neck Surgery (except Spinal Infusion) Hip Fracture Repair Total Hip Replacement Total Knee Replacement Maternity Care Appendectomy Bariatric Surgery Carotid Surgery Cholecystectomy Prostatectomy Key: Best As Expected Poor