Cambia Profiles in Innovation: 100 Years of Driving Health Care Transformation CAMBIA PROFILES in INNOVATION / TABLE of CONTENTS

Cambia Profiles in Innovation: 100 Years of Driving Health Care Transformation CAMBIA PROFILES IN INNOVATION / TABLE OF CONTENTS

Table of Contents

03 Forward by Cambia CEO Mark Ganz: Putting People at the Center of the Health Care Experience

04 Cambia Health Solutions: A 100 Year-Old Start Up

06 Palliative Care: Powering Palliative Care 2.0

09 Strategic Investing: A Cause-Driven Approach

12 Cambia Grove: A Pacific Northwest Hub for Seeding Innovation in Health Care

16 Internal Culture of Innovation: Driving Innovation from the Inside Out

Forward by Cambia CEO Mark Ganz: Putting People at the Center of the Health Care Experience

My mother spent most of her As the son of a family up with an idea based on the our industry was built to help. adult life raising six children. physician in Spokane, need to protect themselves We are not just talking She inspired our love of Washington, I watched my and their families. They pooled about innovation, we have learning and our commitment father provide care for his a percentage of their weekly restructured our business to the community. She was patients and their families wages, creating a safety net in model to lead innovation. a remarkable woman with a that always centered on their case of injury or sickness. It We hope these stories will great sense of humor. When needs. I learned from him that was an innovation based on help you remember and she was diagnosed with keeping people well involved neighbor helping neighbor, reflect on your own stories, congestive heart failure in treating the whole person, and it was from this idea our because it is our own 2004, it felt as if my siblings their mind, body and spirit company and the health personal experiences and I had to arm-wrestle and that healing was not insurance industry was born. that inspire and empower the hospital staff to avoid just about finding a cure. In 2003, when I became us to lead change. unnecessary tests and invasive These are my stories. CEO, I reflected on my own procedures that would not Read on to see what we are Two personal health care stories and the story of those change her outcome. Worse learning. We invite you to experiences that continue timber workers, and realized yet, their recommendations take this journey with us, so to fire my passion toward our health care system was would have added to her that together we can create creating health care centered failing the people it was built stress and ours as a family. the seamless health care on the needs of people and to serve. We had strayed experiences we have always On the night my mother their families. Health care is from the original intent of wanted for ourselves and passed, she went into full personal to all of us and we our founders. So we defined for our families. cardiac arrest. The medical all have our own stories which Cambia’s Cause: to be a team ignored the “Do Not shine a light on how health catalyst to transform health Mark Ganz Resuscitate” sign my mom had care should and should not be care, creating a person- President and CEO insisted be posted in full view experienced. Our company focused and economically Cambia Health Solutions on her door, and proceeded and the health insurance sustainable system. to do a full code on her. When industry also has a story, On this journey, we have been we asked the medical team of how it all began. squarely focused on steering why they ignored our mother’s One hundred years ago, a our company and leading the wishes, they responded group of timber workers in industry toward change— “we didn’t want her to die the Pacific Northwest came refocusing on helping those on our shift.”

Cambia Health Solutions: A 100-Year-Old Startup

In 2017, Cambia Health Solutions celebrates its Centennial and 100 years of innovating for health care consumers. With deep roots in the Pacific Northwest, the spirit of Cambia was born from an idea in 1917 when timber workers decided to pool their wages in case of injury or sickness. It was an innovative idea based on neighbor helping neighbor, with the goal of serving people and their families.

As a “100-year-old startup” with taken its legacy business and Finally, we have six health a long tradition of innovation, pivoted to meet the needs plans in four states, providing Cambia committed several of today’s health care insurance to more than years ago to removing the consumers—through our 2.6 million people; and we complexity and inconvenience numerous companies, offer best-in-class member from the consumer health care investments and the satisfaction as measured experience in an economically Cambia Health Foundation. by Forrester CXi. Through sustainable way. This became bold thinking and innovative our Cause. To put it into action, Harnessing the power technology, we are delivering of entrepreneurism, the the company realized it would solutions that make quality company has delivered have to upend its own business many first-to-market health care more available, model—to recreate its core. solutions including: affordable and personally That’s when CEO Mark Ganz relevant for everyone. set out to create a whole new • bringing transparency to business category: a total 70 million consumers in health solutions company. 50 states (HealthSparq and MedSavvy); and Today, Cambia is a family of more than 20 companies • using strategic philanthropy with a national footprint to grow palliative care and and approximately 5,000 improve the experience employees, all focused on of individuals with serious creating a more person-focused illness (Cambia Health and economically sustainable Foundation). health care system. Cambia has

Palliative Care: Powering Palliative Care 2.0

DELIVERING A RETURN ON HUMANITY At Cambia, we believe palliative care represents a model for how health care in general can— and should—be experienced. It is when people are facing serious, long-term or chronic illness that they need the “care” in health care the most. This is why we have invested in palliative care to fulfill Cambia’s Cause and as the company’s first version of fixing a broken health care experience.

OUR APPROACH Key to our approach is placing Keeping the consumer at the people and patients at the Palliative care was the first version center of our focus serves as our A 2011 national poll found 76% center of our planning and North Star, guiding our leaders and of Cambia’s focus on addressing actions. When designing employees to challenge traditional of Americans were unfamiliar pain points in the consumer’s products and services and choosing philanthropic thinking with innovation. with the term “palliative care” health care experience from end to end. This journey started in investments, Cambia’s leaders and employees look through OUR ACTIONS But when educated about it, 2007 when the Cambia Health a consumer lens to ask to We didn’t start with the business 97% agreed it’s important that Foundation, Cambia’s 501(c)(3) ensure that palliative care: grant-making organization, was side of the equation, our health patients and their families be founded. It has continued with • Makes their path through plans. Instead we started educated about palliative care strategic investment in companies serious illness smoother with our Foundation and then and end-of-life care options. that innovate health care delivery, and easier made investments in innovative and has advanced further with companies and ventures. Finally, • Focuses on what matters to Cambia Health Foundation the development of the most in June 2014, we launched what patients rather than on National Journal survey comprehensive palliative care experts in the field have called what’s the matter with them benefits in the industry for the most comprehensive palliative our regional health plans • Involves shared decision- care benefits program through our across four states. making that helps them feel regional health plans. We believe in control of their experience we are the only health plan in We have focused all of these the United States with support in efforts on changing the experience • Provides an extra layer of place for the entire palliative care of people with serious illness support for patients and spectrum, from birth—and before by empowering them with more families that demonstrates birth—until natural end of life. control and changing the the palliative care team has paradigm of health care. the best interests of patients and families at heart

Through our Foundation, we The response and uptake have WRITING THE NEXT have invested in philanthropy Today, approximately exceeded expectations. In the CHAPTER, TOGETHER that advances the field of first two years, case managers: All of this work starts with a shared palliative care leadership. 90 million hope that we can create a system Americans are living with serious illness, • Almost 2,000 cases have been • Significant funding to and this number is expected to more than opened in palliative care case that supports and empowers people organizations and initiatives double over the next 25 years (state by management serving 1753 to have grace and respect when state report card). (CAPC state-by-state report) that enhance quality, access individual members and their navigating through serious illness and awareness of palliative care caregivers, up nearly 900% or end of life. across our four-state region from two years ago. We invite others—individuals, and across the nation. We have • 94 percent satisfaction score employers, community leaders invested more than $30 million and groups, and policy makers—to over the past seven years in from members. join us by promoting advance care regional and national palliative • Reduced hospital readmissions With our regional health plans, planning; supporting pro-palliative care programs, including we have invested in the people by 12% against an industry low care legislation; driving education $10 million for the Cambia we serve through our health point of 18%. and awareness; and investing in Palliative Care Center of plan benefits and provider companies that are developing next- Excellence at the University partnerships. And with our investment generation palliative care solutions. of Washington, a $1.8 million portfolio, we have invested in • Often called most comprehensive annual investment for the building and growing innovative palliative care program in the Sojourns Scholar Leadership solutions that address the nation (serving more than issues of aging, caregiving and DEMOGRAPHICS Program to create the next 2 million individuals through coordinated care. DRIVING A NEED FOR generation of palliative care these regional health plans). PERSONALIZED CARE leaders, and a $4 million grant to • Investments in emerging solutions Doernbecher Children’s Hospital • Partnerships with local provider in the palliative care and senior to create “The Cambia Health organizations to pilot innovative services spaces. Foundation Endowed Chair in new palliative care models, 90 MILLION Pediatric Palliative Care” and including first provider Americans live with serious illness “The Cambia Health Foundation grief initiative. Innovation Fund in Pediatric 76.4 MILLION • First-in-nation pediatric palliative Palliative Care. Baby Boomers in the country care case management, perinatal • Programs in underserved areas and neonatal hospice support. such as pediatric palliative care, 4 IN TEN AMERICANS culturally appropriate care and Have cared for a loved one expansion in rural communities.

Strategic Investing: A Cause-Driven Approach

INVESTING IN TOMORROW’S GREAT HEALTH CARE COMPANIES At Cambia, we established a long-term, strategic investment model that re-defines traditional corporate investing to advance the company’s Cause. In November 2016, we combined our investment resources and philosophy with Mosaic Health Solutions, a Durham-based strategic investment firm, to create Echo Health Ventures. This 50/50 strategic collaboration is a new health care investment company focused on investing in great companies and transforming health care for consumers. Together with Cambia, Echo Health Ventures has published its Investment Charter and opened its strategic investing playbook for all to see. It’s an example of how the investment model can work differently—at a time when the future of health care innovation depends on all of us getting the model right and raising our game.

A SEASONED POINT OF VIEW Cambia’s success is not long-term, strategic As a corporate venture capital measured by how many investments that align investor, we have had to companies it invests in or has; with our enterprise strategy demonstrate we can accelerate it’s defined by whether we’re to improve the health growth and build value in transforming health care for all care experience. of us with scale and distribution. new and sustainable ways. • We’ve made a different kind Our strategic approach has of commitment to the start- To us, making health care better helped the companies we’ve ups we invest in—one that demands investment that shuns invested in integrate with other supports them with: the outdated and impersonal; solutions and opportunities reduces cost and inefficiency; that are now revolutionizing – Long-term, stage-agnostic and refuses to prop up the old health care as we know it. financial support system. Corporate health care – Flexibility investors are well positioned It has taken courage and to achieve this. We have patience to build this kind – Hands-on participation the data, distribution, long- of strategic investment standing market relationships, approach. It’s been a journey – Access to pilots and testing system insight and willpower shaped by mistakes and a grounds willingness to change course. to help a new generation of Here is what we’ve learned: – Unique and coveted entrepreneurs hurdle the resources and expertise counter-productive innovation • Having a Cause makes us cycles that currently exist different and is making a – Opportunities to build in the space. difference. It’s our compass, relationships across our helping ensure we make portfolio companies and with industry leaders

• We have a dedicated investment Some of the companies we’ve • mPulse Mobile: Mobile team, now a part of Echo invested in are already making engagement solutions that Health Ventures, carefully and a difference: improve member and patient intentionally assembled to engagement and create • Carena: Offers a telehealth focus on investments that platform that allows health administrative efficiencies. support our Cause. systems to extend their services mPulse enables the leading health plans, providers and • We recognize that enterprises with cost-effective virtual clinics, pharmaceutical companies to have different structures than where consumers can receive improve the health and wellbeing startups. By embracing the care 24/7 from brands they of consumers by making health differences, we work together know and trust. care communications relevant more effectively. Our business • lifeIMAGE: The nation’s largest to the modern lifestyles. development team helps support and most utilized network our investment portfolio. for sharing medical imaging JOIN US information. Its services allow • Financial returns are important We are at a tipping point in health hospitals, physicians and patients but not the only metric. We have care. The old-school bureaucracy to securely connect and exchange to know if we’re adding strategic and insular focus are phasing exams, anywhere, leading to value to the companies we’ve out, creating opportunities for a faster, better quality care invested in and ultimately new breed of corporate, strategic delivered at a lower cost. improving the health care investor ready to change a experience for everyone • Maxwell Health: Partners with dysfunctional system that’s not brokers to provide employers working for anyone. The time is now HAVING AN IMPACT with its revolutionary online for all of us to come together, to We believe there is real opportunity benefits platform and app. It’s a “reach across the aisle” if you will, to to bring digital health tools to the centralized place to access health create the health care experience we market that pull cost out of the and benefits services, engage all want. So, let’s roll up our sleeves, system, increase transparency, employees and incentivize a share our expertise, and support and enable a more personalized holistic view of health. the kind of extreme innovation TM health care experience. that can change lives.

Cambia Grove: A Pacific Northwest Hub for Seeding Innovation in Health Care

CONVENING THE COMMUNITY It’s not for lack of bright ideas and bold thinking that meaningful change has been slow to come to the U.S. health care system. The ingredients for real transformation do exist. In fact, we believe they’re in our own backyard, a geography we call Cascadia. It’s a region that reaches from Oregon, north to British Columbia, Canada, and east to Idaho, and it’s an area that’s long been home to pioneers.

We built the Cambia Grove, our and home, where people can In our groundbreaking Anchor health care-focused hub in Seattle, drop in and get to work. We have Partner Program, health plans, ANCHOR PARTNER PROGRAM: 2015-17 Washington, for the regional engaged some of the region’s most providers and large employers that SNAPSHOT health care community to meet visionary health care leaders here. might normally compete with each like-minded innovators and solve Government officials at state and other gather here at a common 7 ANCHOR PARTNERS 7 REVERSE PITCHES problems together. We wanted national levels have embraced table. They share their business • MultiCare Health System • EvergreenHealth to offer a community space for our programming. And we’re concerns with entrepreneurs • UW Medicine • Multicare Health System • CHI Franciscan • UW Medicine the Pacific Northwest’s emerging helping today’s health care leaders and commission pilot projects • EvergreenHealth • CHI Franciscan health care economic cluster— and next-generation companies to solve for them. • Overlake Medical Center • Overlake Medical Center • Regence • Regence to make good on the region’s develop their aptitudes and Our Anchor Partners benefit • Aon Hewitt • EvergreenHealth #2 enormous potential to step up appetites for working together. from the novel approaches and become a national leader. entrepreneurs have to solving ~75 applications/program We knew the Cambia Grove had to CATALYZING CHANGE intrinsic industry problems. (local, national, international) be different than an accelerator or How are we converting bright Importantly, Anchor Partners gain an incubator. It needed to convene ideas into revolutionary solutions? solutions developed specifically ~150 Cascadia startups cataloged leadership and catalyze continuous By inviting long-term investment for their needs, at an accelerated innovation in health care. To drive and new ways to scale innovation pace. The startups flourish with 5 months from Reverse Pitch Day real change, it would have to that are different from accelerator solid proving ground partners, and to pilot implementation transcend industry silos and unite and incubator models. once-in-a-lifetime opportunities 5 AREAS OF INTEREST: people under a common mission. to solicit valuable feedback about Six curated programming tracks • Health care transformation their technologies and they even Now, industry influencers, even help our audiences grow their • Health care consumerism generate early revenue. competitors, are commingling strategic and tactical business • Digital health startups at the Cambia Grove. It’s a acumen, while providing • Early-stage investment “third place” that belongs to the opportunities for innovators to • Health IT community, separate from work connect with other leaders.

LEADING BY EXAMPLE The work being done to transform our health care system is driving significant growth for Cascadia’s economy already. As our tech titans and consumer brand gurus collide and collaborate with a growing population of health care innovators, we increase the region’s influence on the sector nationwide. We’ll cull this fertile ground to forge new frontiers in heath care, akin to what the region has already has done for aerospace, high technology, mass retail, coffee, forestry and apparel. This is how we get to work!

MAKING CHANGE HAPPEN IN 2 YEARS’ TIME

Catalyzing Change, Connecting • Host to Dr. Robert Bree • Three-event series on Social • Governor’s Committee: Startups with Industry Collaborative, Health Innovation Determinants of Health Life Science & Global Health Leadership Network, Washington Advisory Council • 5 Reverse Pitch events with • Episodes of Care Summit, driving Health Alliance, Washington State 6 Anchor Partners (7 startup the move to value for our region • Health Innovation Health Advocacy Association, winners selected). Leadership Committee Health Innovators NW, Women • Under the Boughs series with UW • 3 pitch clinics with Cambia in Bio, AWS Forums and others President Emeritus Lee Huntsman, • Rural Health Committee for Grove Sounding Board bringing highly visible health care the State of Washington Original Programming that innovators to engage with Cambia Inspires Action: Convening Community on Grove community Growing virtual presence, Behalf of the Drivers of Change including 350 unique visits/month • Spring Forward with Women Providing Leadership & Vision by health care visionaries and • Hosted Senator Patty Murray, Leaders series on gender equity, over 1,650 Twitter followers Governor Jay Inslee diversity & inclusion. Series is a • High-profile speaking partnership with 8 organizations • University of Washington Palliative engagements, including at the that presented 12 events over Care Measurement Summit 2x 2015 NIH conference, GE Health 2 years Forums, AWS Summits, American • Seattle Start-up Week 2x • Economic development event Heart Association Breakfast, Future of Healthcare Conference • Aging 2.0 Conference with Leroy Hood, president and co-founder of the Institute of (HIMSS WA), BCBSA Blue National Systems Biology Summit, Oregon Bio Association Conference, Stanford Medicine X

“ I’ve been in venture in Seattle since ’98, and it’s been Groundhog Day—until now. The provider community, the payer community, the technology community— everybody is starting to talk to each other. I’ve never seen anything like this in Seattle, and it’s exciting.”

Joe Piper, Managing Director, Point B Capital

CAMBIA PROFILES IN INNOVATION / © 2011-2017 Cambia Health Solutions, Inc. 15 Internal Culture of Innovation: Driving Innovation from the Inside Out CAMBIA PROFILES IN INNOVATION / INTERNAL CULTURE OF INNOVATION

Internal Culture of Innovation: Driving Innovation from the Inside Out

EMBRACING CREATIVITY AND POSITIVE CHANGE Over a decade ago, Cambia realized that the health care system as it stood was not sustainable and that our own business was not meeting people’s needs. In response, we drafted a Cause: to serve as a catalyst to transform health care, creating a person-focused and economically sustainable system. It was an ambitious goal. It meant reinventing the organization’s business model to become a total health solutions company that had people at the heart of everything we do. And that required diversifying our portfolio with new solutions.

We realized our vision could only CULTIVATING A prototypes. They also oversee come to fruition though if all of the DIFFERENT MINDSET a crowd-sourcing platform that company’s employees collectively For Cambia, embedding innovation invites employees to submit, represented the kind of innovation in the company’s culture didn’t comment on and rate ideas that Cambia wanted to see in the health start with generating awareness solve consumer pain points. care industry. We know that to for it. That came later. Instead, we In tandem, Cambia’s growing solve for the consumer we must started by asking how we could family of companies are fueling capitalize on the diversity of deliver results that would show innovation and taking action within our employees. that innovation is valuable. Then, their own landscapes—hosting So, we set out to change the as the company saw the value in it, hackathons, for example, to company’s internal culture by we were able to drive awareness. pioneer groundbreaking software making innovation a value—a We built a team dedicated to and mobile applications, health shared belief that new ideas engaging the organization in care marketplaces, non-traditional are necessary to transform the innovation, accelerating problem health care delivery models, health care system. Cambia has solving for our business units, and wellness and consumer accomplished this by creating and creating purpose-driven engagement platforms. an inclusive environment that businesses and products. This By delivering results, awareness empowers and rewards employees Innovation Force team acts as a and engagement have skyrocketed. for sharing their ideas, nurtures lightning rod for other people’s Nearly one-third of our employees leaders, and consistently prioritizes ideas, curating information, are actively involved in innovation, people and their needs. collaborating on business up over just five percent three design, coaching staff, building years prior. relationships and executing rapid

CULTIVATING LEADERS We’re passionate about nurturing HOME-GROWN INNOVATION Cambia believes the real currency the next generation of leaders too. Our Annual Intern Innovation By encouraging our employees INNOVATION IN ACTION of change comes from people with to pinpoint customer pain points Challenge pairs Cambia Igniters, ideas. That’s why we develop our and accelerating the problem- leaders to thrive in change, take our employees with ideas, with to-solution process, we’ve been • Investments in 20+ the right kind of risks, create interns who collaborate on able to build four new disruptive innovative health care health care companies from succession plans and emphasize business proposals to accelerate our business units from problem to the ground up. Here’s how a companies overall talent development. few of them are already solution. Some of these proposals having an impact: The leaders of our various make their way to our annual Pitch • 4 new companies created businesses gather annually at Day, bringing fresh insights and new • HealthSparq: Transparency a summit to share ideas, meet like- ways of thinking around how we health care solutions for health • 10 provisional patents filed minded innovators and discuss can work together to disrupt the plans and employers to empower how collectively their companies health care system. members and employees to • 2,200+ employees engaged are working to deliver personalized become more educated health in innovation health care experiences. Cambia’s care consumers. leaders also participate in • 1,660+ ideas shared design-thinking workshops • Hubbub: A technology-driven and rapid innovation training. wellness solution that uses social circles, the love of the game, a We host Igniter Days, which turnkey incentive engine and celebrate those employees taking the quickest health quiz on the action on their ideas to solve planet to inspire employees to consumer challenges in health care. get moving and live healthy. Cambia executive leaders join to learn what consumer pain point • MedSavvy: An online formulary inspires each Igniter and how to help people find the best they are solving for it. treatments and medications for their conditions.

• Basefit: Total health training in a team environment, directed by expert coaches with military experience.