P.O. Box 211972 Bedford, Texas 76095-8972 Phone: 972-333-0409 Email: [email protected] Website: www.healthcare-excellence.org

Celebrating Health Care Heroes

The Alliance for Healthcare Excellence annually sponsors its Healthcare Heroes Awards and the Ron J. Anderson, M.D. Healthcare Servant Leadership Award to recognize and celebrate the contributions of individuals and organizations within our community to the promotion of access to affordable, quality health care. This year’s banquet is scheduled for Thursday, November 13th, at the Brookhaven Country Club.

The best hope for achieving immediate tangible improvements to our health system rests with the organizations and individuals participating in that system. By celebrating both the extraordinary contributions of high-profile individuals and organizations as well as the equally important—but often less celebrated—contributions of frontline employees and community volunteers working to deliver health care and health care coverage, the Alliance hopes to inspire individuals and organizations to help bridge the gaps within our system and to develop common sense solutions that mend the holes in our health care safety net.

. About the Health Care Heroes Awards

Whether as health care providers, employee benefit administrators and consultants, health insurance or health plan employees, community leaders, or family members, many people contribute their energies and talents to help improve the health care system and promote access to affordable, quality health care. The Healthcare Heroes Awards Program celebrates the leadership and contributions of these people working within the health care system. By annually recognizing and celebrating the contributions of the people working on the frontlines of the health care and health care finance systems, the Alliance seeks to inspire and encourage expanded leadership and individual acts of selflessness among the workers and community leaders. By doing so, the Alliance hopes to promote and improve morale among those working to support and improve our health care and health care finance systems while promoting trust and confidence in those same systems. The Alliance will present a 2014 Healthcare Hero Certificate to any individual or organization member of the Alliance that fulfills the following criteria as a Healthcare Hero:

. The candidate during the 12-month period ending September 30, 2014, either: . Performed a service in an activity that promotes access to quality, affordable health care or otherwise improves the health care industry in the community, or . Otherwise performed a service or other act that made an extraordinary contribution toward the promotion of access to quality, affordable health care or otherwise improves the health care industry in the community, or . . A Healthcare Heroes Award Nomination Form for the candidate, along with all required supporting documentation, is received by the Alliance for Healthcare Excellence before midnight on Sept. 30, 2014.

All 2014 Healthcare Hero Certificate recipients will automatically be eligible for consideration to receive one of several Healthcare Hero of the Year Awards. The Community Service Committee will select one recipient to receive each of the following awards from among the group of recipients of the 2014 Healthcare Hero Certificate recipients:

. Healthcare Quality Hero of the Year Award—For an exceptional contribution toward improving health care quality in the community.

. Healthcare Access Hero of the Year Award—For an exceptional contribution toward improving access to health care for the underprivileged in the community. Alliance for Healthcare Excellence Symposium May 23, 2002 Page 2 . Healthcare Affordability Hero of the Year Award—For an exceptional contribution toward improving the affordability of health care coverage or services in the community.

. Healthcare Education Hero Award—For an exceptional contribution by an individual or organization toward improving the effectiveness of patient participation through activities that improve patient understanding of the rights and responsibilities within the health care industry and fulfillment of these responsibilities.

Recipients of the Healthcare Hero of the Year Awards will be selected by the Board of the Alliance for Healthcare Excellence. To nominate yourself or someone else as a Healthcare Hero, please call Troy M. Risher at (972) 333- 0409 or see our Web site at: www.healthcare-excellence.org 2014 Health Care Hero Award Nomination Form

To nominate an individual or an organization, please complete and return this form to the Alliance for Healthcare Excellence by October 1, 2014 Return forms by mail to: P.O. Box 211972, Bedford, Texas 76095-8972 or EMAIL them to: [email protected] Award Category (Please check one award category)

Healthcare Quality Hero of the Year Award Healthcare Access Hero of the Year Award Healthcare Affordability Hero of the Year Award Healthcare Education Hero of the Year Award

Nominee Information (Please check one type AND one category of individual/organization)

Type: Individual: Patient Volunteer Health Care Provider Broker/Consultant Community Leader Other Organization IPA/PHO PPM/MSO/Managed Care Organization Hospital . Physician Practice Ancillary Provider Employer/Plan Sponsor . Insurer Consultant . Other

Name:

Title:

Company:

Address:

City: State: Zip:

Telephone Phone: Fax:

Email Address:

Website:

Supporting Information

Attach a detailed description of activities and other contributions that the nominee has made to promote access to quality, affordable health care and to improve our health care and health care finance systems.

Nominator Information

Name:

Title:

Company:

Address:

City: State: Zip:

Telephone Phone: Fax: Alliance for Healthcare Excellence Symposium May 23, 2002 Page 2 Email Address:

Please complete a separate nomination form for multiple nominations. THANK YOU!!