Members Present: Jim Antinori, MD Shay Holley, MD

EPIC, L.L.C. Board Meeting

April 20, 2011

Time: 9:15 am Location: EPIC Office

Conducted by: Mark Flammer, MD

Members Present: Jim Antinori, MD Shay Holley, MD Russell Bradley, MD Bart Johansen, MD Dave Cole, MD William Sheffield, MD Greg Gardner, MD Richard Thurman, MD

Others Present: Robert Parker, CEO Teri Ball, Director Process Management Ingrid Gordon, COO Mike Hansen, CFO MaryAnn Gibson, EAA, OM

Mark Flammer, MD called the meeting to order at 9:15 am. Minutes: Minutes from March 16, 2011 Board meeting approved.

Financials Mike Hansen, CFO reviewed most recent financials.

Shared issues:  Revenue increase in RVU  SLED Income Guarantee  Comparative Data Month to Month  90 Day AR has decreased  Critical Care  Smoking Cessation  SLED Subsidy Discussion regarding the possibility of Critical Care Chart Audits to take place. David Cole, MD suggested the Audit include charts where Critical Care was missed. Terri Ball will follow up with EPBS to obtain the requested information and get it to the appropriate parties.

It was suggested that we look at moving the Board Meeting to the 3rd week of the month in order to review more current data from EPBS or having the data sent to us sooner in the month to avoid moving the meeting. Bob Parker and / or Mike Hansen will follow up with EPBS to see if data can be provided at an earlier date in the month prior to consideration of moving the meeting. If meeting needs to be moved, MaryAnn Gibson will look into what dates would be best.

EPIC Update Instacare Fees: Bob Parker reported the average Instacare Fee as $140.00. Bob Parker and Shay Holley MD updated the group on the recent trip to Texas with IASIS Healthcare. They informed the Board the trip was very valuable in the decision IASIS has made not to open an Instacare on the same property as DHMC, rather to actively look for property in different location that is still near the hospital. Bart Johansen MD informed all that IASIS is also looking toward Sarasota Springs area for and Urgent Care that could work well for JVH.

Multi-Plan negotiations: Bob Parker updated all with the success thus far and has a goal of 80%. Bob will continue to keep the Board informed on progress.

Bob met with John Oaks who is over Managed Care Contracts for IASIS Healthcare. Discussion regarding contract amendments, with the U of U, denied claims that prior approval had not taken place on, the Healthy U program and began discussions in ACO (Accountable Care Organization) reimbursement models that will be in the near future. After much discussion by the Board, it was decided that Bob Parker would begin to contact other groups that will be affected by the ACO payment model as well such as Anesthesiology, and Pathology. Bob will begin setting up meetings and include appropriate individuals. He will keep the Board informed at future meetings. Website Development & AMION- Bob reported the web site is in the process of being updated with the new company and WEP has made the decision to move forward with the AMION system. Bob also reported Codi Moore really likes the system as well. Bob will keep the Board informed on progress.

EIRMC Bob Parker reported Eastern Idaho Regional Medical Center will not be working with AIM at this time due to corporate changes.

Brigham City: - Bob Parker states there is still the possibility of working with the Hospitalists and a conference call is scheduled to discuss further opportunities. Bob will keep the Board informed.

St Marks Group – Bob has received word the group has voted to have representation on the EPIC Board by Mark Paradise MD Julie Fox, MD and Brian Shiozawa, MD. They will be invited to attend starting with the next meeting.

Operating Agreement Amendment – Bob presented the amended operating agreement which includes the mandatory retirement age of 70 for signatures, and reminded all it will be amended again to include the St Marks Group when appropriate.

One Call Kick Off – Bob reminded all to attend the upcoming kick off meeting for the One Call system if possible.

Radiology: Bob Parker informed the Board IASIS Healthcare has informed him they will make a change to the imaging group being used in the Utah Market Hospitals on May 19, 2011 at 5 P.M.

OPTICARE: Ingrid Gordon, COO introduced Vision Insurance options and requested the Board consider offering this as benefit on a voluntary participation. The Board agreed this would be offered on the basis it would be paid for by the individuals who choose to participate, and at no cost to EPIC or AIM. More information will be provided at later date.

Mountain View Hospital Bob Parker and David Cole met with Mark Bair, Managing Partner of the ER Physicians for Mountain View Hospital located in Payson Utah. David Cole will contact EPBS and have them contact Mark in follow up. Bob and David will keep the Board informed on progress of this relationship. Ragnar: Bob Parker met with Doug Boudreaux, Marketing Director for MountianStar Healthcare, regarding participation with the Ragnar Relay being held June 17th and 18th. Doug requested Emergency Physician coverage at the finish line of the race which will be located at the Canyons Resort. The schedule (see attached) was distributed, and all were requested to take it back to their Divisions for volunteers. Each participating Physician will receive a T Shirt from MountianStar. Discussion took place regarding the possibility of offering a room or a gift certificate to a sporting goods store such as REI. Division Managers to recruit Physician participation at the finish line. MaryAnn Gibson will look into the possibility discounted room rates at the Canyons Resorts once we know the participation level.

Rock Springs: Bob Parker, Kent Loosle, COO IASIS Healthcare, and Jeff Frandsen, CEO SLRMC, began discussions to work with Rock Springs, Wyoming Hospital. Bob will keep the Board informed on progress of this relationship. Extender Incentives Bart Johansen, MD reported on and opened discussion regarding extender incentives. It was decided a conference call would be set up to discuss further action needed. Bob will report at the next Board meeting the results

MVA_IASIS Hospitals & updates Teri Ball provided information regarding the need to have both Physicians and Nurses at Lakeview Hospital sign all orders in a timely manner to avoid being “locked out” of the system.

She also informed all the Motor Vehicle Accidents are reported as “Self Pays” in the IASIS system and are causing a delay in payment since the information is not sent to EPBS. She is working to find a way to avoid this in the future. Teri will send a letter to Ted Adair requesting assistance in this arena. Teri will keep the Board informed of the progress. Attendance at Annual Meeting & ACEP James Antinori, MD requested all to encourage their Emergency Ultrasound Course Physicians to attend the Annual Meeting being held November 10, 2011 at Little America. Discussion regarding ideas to encourage a high attendance, as well as for those physicians who are willing to cover the ER’s during the meetings too place. He requested all bring suggestions to the next meeting for further discussion.

James also provided information regarding the ACEP Emergency Ultrasound Course which is being held June 4th & 5th this year in Jackson Hole, Wyoming. He requested all provide this information to their respective Divisions and encourage all to attend if possible. Other ~Chris Rennar Chris Rennar presented information including, profit sharing, 401K match amounts and statement/account information. The Board requested Chris research both the 401K Match information and the possibility of current account information being available on the website in a timelier manner. Chris will report more information at the next Board Meeting in May.

MISC. Future Board Meeting dates were discussed and may change going forward.

Admin Assistant Day gifts were discussed and it was voted to give a $10.00 gift certificate from Chili’s to the ER Clerks. Ingrid Gordon and MaryAnn Gibson will arrange and deliver the gift cards to each facility.

Meeting dismissed at 12:25

Next meeting May 18m 2011 at EPIC Office June 15, 2011 at DHMC