Solving the Health Care Delivery Puzzle. Ideas Into Action

CO-SPONSOR OF TRIHEALTH AND MAJOR FUNDER OF HEALTH CARE TRANSFORMATION

SOLVING THE HEALTH CARE DELIVERY PUZZLE. IDEAS INTO ACTION.

2 015 ANNUAL REPORT

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BETHESDA INC. J. James Pearce, Jr. Alan Altman, MD Michael F. Haverkamp CHAIRMAN AND Greg Carmichael Edmund Jones, MD BOARD OF TRUSTEES PRESIDENT Phillip Cox Kathy Kelly J. Mark Holcomb Stuart Donovan, MD Lisa Knutson VICE CHAIRMAN Rance Duke Myrtis Powell Ellen Katz Craig Eisentrout, MD Wayne Shircliff SECRETARY William Graf Yvonne Washington William A. Tsacalis Grant Hesser TREASURER

OTHER OFFICERS Mike Crofton ASSISTANT TREASURER, Bethesda Inc. SVP AND CHIEF FINANCIAL OFFICER, TriHealth, Inc.

Chip Crowther VP AND CHIEF INVESTMENT OFFICER, Bethesda Inc./TriHealth, Inc.

Donna S. Nienaber ASSISTANT SECRETARY, Bethesda Inc. SVP AND CHIEF LEGAL COUNSEL, TriHealth, Inc.

John S. Prout PRESIDENT AND CEO, TriHealth, Inc.

Andrew A. Swallow PRESIDENT AND CEO, Bethesda Foundation, Inc.

BETHESDA INC. Jill Miller EXECUTIVE DIRECTOR, Bethesda Inc. Bethesda Inc. CO-SPONSOR OF TRIHEALTH AND MAJOR FUNDER OF HEALTH CARE TRANSFORMATION

Bethesda Inc., in partnership with Catholic Health Initiatives, is one of two co-sponsors of TriHealth, the Cincinnati region’s Community Leaders leading integrated health delivery network. TriHealth is a full- service, not-for-profit health system that provides a wide range Circle Now Forming of clinical, educational, preventive and social programs at more Bethesda Inc. is a membership than 130 care sites through its nearly 12,000 employees and organization comprised largely of 550 physicians. hospital-affiliated individuals and a number of community representatives. Bethesda Inc. provides support to Bethesda Hospital Inc. and direct oversight for the Bethesda Fertility Center and Bethesda Now, with Bethesda Inc.’s renewed role as Foundation. The Bethesda Foundation provides philanthropic a strategic grant maker, efforts to engage support for Bethesda hospitals, Hospice of Cincinnati and community and organizational leaders in Fernside. our work are being retooled through the newly named Community Leaders Circle. In 2010, Bethesda Inc. began a grant making initiative to transform how health care is delivered in the Greater The initiative will enable Bethesda Inc. Cincinnati community. Over the past five years, the organization to better bring forward ideas on has awarded more than $24 million to TriHealth and community- transforming health care delivery in our based organizations to fund projects that lead to better care, region, as well as broaden participation in better health and lower cost. Bethesda/TriHealth grant making efforts, programs and services. New Community Our Mission: Improving the health and well-being of Leaders Circle members will become better connected to our grant work and all people in Greater Cincinnati. how it benefits their community and Our Vision: people they serve.

To be a leader and major supporter of health Outreach to this new, expanded group, care innovation, collaboration, education and via Bethesda Inc. Trustees and Executive research in Greater Cincinnati with the goal of Director Jill Miller, is now underway. helping our community become one of the most desirable places to receive and deliver health care in the United States.

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4 | BETHESDA INC. 2015 ANNUAL REPORT A LETTER FROM OUR CHAIRMAN AND PRESIDENT The Transformation Continues

Dear Bethesda Inc. friends and family,

People often talk about investing in the future. Bethesda Inc. is investing in making the future happen now.

It has been five years since we looked at community health needs and at ourselves, to create a new focus for Bethesda Inc. While we remain committed to supporting Bethesda Hospital Inc. and its entities, we agreed to make investments in TriHealth (including Bethesda Hospital) and in the community that would be TRANSFORMATIVE and lead to achieving our renewed vision and mission.

We wanted big, unique ideas that could change how people in Greater Cincinnati receive and deliver health care. Unabashedly, we hoped these investments would become successful models across the country.

And what a transformation we have made. Patient-Centered Medical Homes (PCMH) and electronic medical records (EMRs) are now the community standard, with TriHealth setting the pace. Southwest Ohio received the largest Medicare grant in the country to prove the efficacy of the PCMH model. Our community is leading the country in health data collection and public reporting, thanks to our investment in The Health Collaborative. Through Hospice of Cincinnati, we’re helping create a culture that embraces difficult end-of-life conversations, which leads to better care for patients and peace for loved ones who remain. In close cooperation with Cincinnati Children’s, we see progress in community efforts to lower infant mortality and prematurity rates.

There’s so much more we’ve done to identify and connect the pieces of the health care puzzle, as you will learn in the pages of this report.

Since 2010, it has been my privilege to serve as chairman and work with a great Bethesda Inc. Board of Trustees and our many volunteers to chart and deliver our plan. J. James Pearce Our trustees are incredibly dedicated — most serve on at least two committees and Chairman and President, Bethesda Inc. many also serve on the Bethesda Foundation, Hospice or TriHealth boards. Alongside are the leaders, physicians and staff of TriHealth, including CEO John Prout, who work hard every day to provide better care, improve patient experiences, and lower costs as they shape health care delivery for the future.

Perhaps most gratifying are the new partnerships and collaborations we are creating to identify new and better ways to improve health care delivery. Teaming with incredible community organizations has opened new doors and prompted people to think differently about how we can meet the community’s needs for better, more comprehensive care.

Now, a new leader will take us forward. I want to introduce Mark Holcomb, senior vice president at Merrill Lynch, who will become chairman of the Bethesda Inc. Board of Trustees beginning January 1, 2016. Mark is a respected community leader, passionate about health care and focused on fostering positive change.

There is a constant: We remain dedicated to our vision that Greater Cincinnati will become the best place to provide and receive health care. I look forward to seeing this transformation continue for many years to come.

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6 | BETHESDA INC. 2015 ANNUAL REPORT Bethesda Inc. Overview

Major Funder of Health Care Transformation

Section 1.0 pages 8-25 Bethesda Inc. is comprised of four major interests that work together to improve health care for our community.

Bethesda Fertility Center

Section 2.0 pages 26-27

Bethesda Foundation

Section 3.0 pages 28-29

Co-Sponsor of TriHealth

Section 4.0 pages 30-31

PAGE 7 1.0 Major Funder of Health Care Transformation

IDEAS

Solving the puzzle of how to transform health care delivery is complex. It is challenging to control costs while expanding access to care and improving care quality. In order to transform health care delivery, providers, payers, patients and communities must work together toward better care, better health and lower costs.

There are millions of ideas on how to do this — somewhat like building a puzzle whose pieces contain subtle, but important, differences. Selecting promising pieces and putting them into action is an essential part of what we do.

8 | BETHESDA INC. 2015 ANNUAL REPORT ACTION

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Bethesda Inc. Puts Big Ideas on Stage at First Ideas Expo This year, grantees were given the opportunity to bring Another said that the event led to added exposure for their transformational ideas to life at Bethesda Inc.’s their proposal and new networking opportunities. first Ideas Expo. Following the success of the first Ideas Expo, Bethesda Following a careful and considered review of more Inc. looks forward to incorporating this interactive than 20 preliminary grant applications, Bethesda Inc. event into future grant cycles. Bethesda Inc.’s grant invited eight applicant teams to present their proposals work can be shaped into three key actions: Engaging in front of a live audience, including Bethesda Inc. people to become more involved in their own health, Board and Grants Committee members, TriHealth and informing them and their care providers with data community leaders. that can make a difference in their care, and advancing care models to deliver care that is more comprehensive Applicants found the Ideas Expo a valuable step in the and effective. Bethesda Inc. grant making process. One participant noted that, “I loved the Ideas Expo! Getting hype Here’s how our work is leading to better care, better around projects is big and getting people excited about health and lower costs in our community. these endeavors is a great way to get others involved.”

10 | BETHESDA INC. 2015 ANNUAL REPORT Bethesda Inc. Grants Committee members Ellen Katz (left) and Robert Collins, MD (right)

Leading the way to better health care by:

1.1 Engaging patients and providers pages 12 - 17

1.2 Informing patients and providers pages 18 - 21

1.3 Advancing care models pages 22 - 25

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Building collaborative relationships with patients 1.1 and families is a core value of patient-centered care. Understanding patient needs and preferences is an Engaging Patients and important first step for providers, along with learning how to support patients and families to better manage their own Providers in Achieving chronic conditions and maintain their health care. Health care providers — enabled by grants from Bethesda Inc. — are rapidly developing an understanding of how Better Care and Better consumers engage in their own health care, to what level consumers are aware of health care quality, and why or how Health Outcomes health care information is used.

12 | BETHESDA INC. 2015 ANNUAL REPORT Small Changes in Lifestyle Lead to Health Improvements for People with Disabilities

Easter Seals and Bethesda Inc. have teamed to engage people with disabilities in their own health care. Over the past DID YOU KNOW? year, 153 people with disabilities have participated in Ohioans with Ohioans without a unique, customized wellness program. Disabilities Disabilities

Nearly half of the participants completing the Easter Seals 60% 27% wellness program have lost or maintained weight, while the same number have lowered their blood pressure. reported they did not get needed health care As Easter Seals analyzes program data, it is finding that results reflect the everyday lives and habit-changing nearly all 29% challenges of its participants: reported getting no regular exercise • A man developed the confidence to approach his parents about establishing a relationship with a primary care physician. Rates of obesity and smoking are • A young woman living independently lost weight with significantly higher for Ohioans with disabilities than for those help from Easter Seals’ staff and continues to make a without disabilities. conscious effort to drink more water and eat healthier. • A man with type 2 diabetes no longer drinks sugary sodas and has lost two inches from his waistline.

As Easter Seals enters the final year of its three-year Bethesda Inc. grant, steady progress in collecting and analyzing health data for 1,000 people is on track for completion by March 2016. A new database will link key health indicators and employment goals to help guide future work.

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DID YOU KNOW? 2015 TRIHEALTH COMMUNITY-BASED FALL PREVENTION INITIATIVE Falls are the leading cause of hospitalizations, emergency room visits, injuries and deaths in individuals over the age of 65. Preventing Falls Through Early Intervention and Coordinated Support 48% Bethesda Inc. recently awarded TriHealth and People Working of falls are in the home.1 Cooperatively (PWC) $1.2 million to help prevent falls among older residents. TriHealth emergency room personnel, hospital social workers, care coordinators and navigators, as well as medical assistants and office staff in primary care practices, will be trained to identify fall risks and make referrals. One out of three persons age 65 and older falls annually. The Community-Based Fall Prevention Program combines patient education, home evaluations and safety modifications (in partnership with PWC), as well as extensive training for more at least than 200 TriHealth staff and professionals. It incorporates 40% 2 of these falls result in injury. “Stepping On,” a CDC-approved, evidence-based approach to fall prevention education. Stepping On has been shown to reduce falls by 31 percent.

As part of the program, physicians determine patients’ fall risk and refer them to Stepping On and other specific community 1 U.S. Centers for Disease Control and Prevention resources as needed. The goal is to change the way that

2 Hamilton County General Health Department health care professionals think about fall prevention. Ultimately, success will be measured by decreases in emergency room and hospital visits, resulting in better health and lower health care costs.

14 | BETHESDA INC. 2015 ANNUAL REPORT Engaging Patients to Have Affirming Conversations About End-of-Life Choices Hospice of Cincinnati’s Conversations of a Lifetime™ program is helping thousands of patients and families have open and honest conversations about end-of-life. RESULTS Conversations of a Lifetime’s aim is to transform end-of-life care through physician coaching, advance care planning facilitation, documenting patient wishes using the electronic medical record, 176 and community engagement. providers have been coached in advanced care planning conversations through A key to the project is the documentation of patients’ wishes into the program. their electronic medical record. The electronic system will soon alert physicians when a patient meets the specific criteria for initiating an end-of-life conversation. This alert is recognized as a best practice and is being adopted across the country. 2,822 conversations have been initiated and Hospice of Cincinnati is also stirring up conversations through documented in medical records in the primary care setting since May 2014. its innovative Things You Shouldn’t Wait To Say campaign, a grassroots effort to normalize the conversation for both young and old alike, through street corner signage as well as traditional and social media to spark discussion in the community. Ninety-eight percent of physicians who have attended the training say they will use the skills they have learned with their patients.

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PERSPECTIVES ON CONVERSATIONS “End-of-life care conversations are difficult. It’s something patients would rather pretend doesn’t exist. To start the conversation, hear from our care coordinators how important it is, and have someone to guide them makes it less scary. It’s a relief for them to have the conversation and for their families and doctors to know what they want.” AMY NEAL, MD

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The saying goes, “Information is power.” In health care, 1.2 better information translates to more efficient and effective Better Informed Care care at lower costs. Bethesda Inc. funding has ignited information-based health Decisions for Patients transformation programs in recent years with the notion that and Providers transformation is continuous and that one pilot project has the potential to incubate another.

In five short years, Bethesda Inc. has seeded information transformation within TriHealth, helped set new care standards and is seeing the results of these activities benefit the community.

18 | BETHESDA INC. 2015 ANNUAL REPORT RESULTS 10% reduction in readmission rates for high-risk patients 2012 Care Transitions Navigator Program Provides Improved Coordinated Care and Reduced Readmission Rates for High-Risk Patients 96% Fueled by a $2.8 million Bethesda Inc. grant, the TriHealth Care increase in Transitions Navigator Program created a systematic process to community identify patients at high-risk for readmission by using predictive referrals analytics. A new communication system and hand-off process resulted in improved coordination of care among nurses, care managers, navigators and Patient-Centered Medical Home offices, vital for better informed and connected caregivers and mutual understanding of patient issues. Serves as Incubator and Roadmap for Predictive 3% Analytics Project decrease in The Care Transitions Navigator program also served as an emergency incubator and roadmap for the Hatton Research Institute’s room visits Translational Outcomes proposal. Bethesda Inc. awarded the Hatton Research Institute a $4.3 million grant this year to develop analytics that predict patient medical problems and arm physicians with the information at the point of care. Thus, physicians will be equipped to make more informed medical decisions that lead to better health outcomes and patient engagement and satisfaction.

Prevention, early intervention and ambulatory Applying big data, the proposed analytics model has management the potential to: have led to a greater focus on patient- · Predict the likelihood of a heart patient being at risk specific needs of a readmission, mortality or potential complication. · Uncover the trends that play into the development of sepsis while a patient is in the hospital. · Develop predictors of the likelihood of an infant dying before his or her first birthday.

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NAVIGATOR PROGRAM TESTIMONIAL “All hands on deck” were required when Diane, a high-risk patient well known to TriHealth care coordinators, emergency department staff and Hospice of Cincinnati, returned to the hospital one evening. A care coordinator immediately assembled the care team to review the patient’s frequent admissions. It was determined that home care services were no longer sufficient for her worsening condition. A tearful Diane admitted that she knew it was unsafe to live at home, but did not want to leave her beloved dog. The philosophy of comfort care was explained and Hospice secured funds from a pet care organization that allowed her dog to not only be cared for in her absence, but also visit Diane in the Hospice inpatient unit. The team worked quickly to coordinate her care and complete a Medicaid application. The communication systems and hand-off procedures in place ensured Diane received high-quality care and comfort in her final days.

Standardizing Health Data Collection

Bethesda Inc. awarded a $250,000 planning grant in June 2015 to the Health Collaborative of Greater Cincinnati to explore the development of a regional Triple Aim Dashboard.

The proposed dashboard could provide value in many areas of health care transformation: • Aid providers in benchmarking their performance against the community average.

• Provide employers with data related to their health spending and outcomes while assisting community agencies looking to identify opportunities to improve the health of their target populations.

• Make Greater Cincinnati an ideal venue to test the impact of new health care technology and processes.

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Factors affecting a patient’s health are varied and include 1.3 everything from community influences to comorbid conditions and genetics. To create true transformation, Advancing Care Models efforts must focus on systemic and cultural factors affecting a patient, as well as medical factors when considering new models of care.

Bethesda Inc. grants are helping to accomplish this by tackling important community health needs.

22 | BETHESDA INC. 2015 ANNUAL REPORT DID YOU KNOW?

This ranks Greater Cincinnati’s 522 infant mortality rate among the babies died in Hamilton worst 10% County from 2010 to 2014. in the nation.

Preterm birth remains the single biggest factor affecting infant mortality in our city. Three in four infant deaths in 2014 were babies that were born too early.

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Improving Maternal Health and GOAL Reducing Premature Births Reduce preterm birth rate by 10% The high infant mortality rate in Hamilton County has been widely reported in recent years. In 2013, Bethesda Inc. awarded RESULTS FROM PILOT a $3.2 million grant to Cincinnati Children’s Hospital Medical IN AVONDALE Center, Every Child Succeeds and TriHealth to pilot a mom- centered approach to reducing the preterm birth rate, beginning Enhanced Obstetric Care in priority communities such as Avondale. Two years later, there 0 are early signs that gestational age at birth is increasing for preterm births at Good Samaritan babies born in Avondale. Hospital’s Faculty Medical Center in the past six months. Good Samaritan Hospital’s Faculty Medical Center enrolls all Avondale mothers into a special nurse case management Prenatal Care on the Rise program. During the first six months of 2015, 70 Avondale mothers received care from the Nurse Case Manager and the 2015 2014 vs percent of women receiving support from a health worker or pregnant women women sought living in Avondale prenatal care home visitor increased from 45 to 82 percent. sought prenatal at 18 weeks. care at an average StartStrong has partnered with Cradle Cincinnati to create of 11.5 weeks. a learning collaborative to spread key learnings and partner health care providers with community organizations to Enhanced Pediatric Care coordinate services based on the needs of mothers and babies. 85% StartStrong’s expansion into Price Hill is supported by an of all newborns are now seen for their additional $161,000 supplemental grant from Bethesda Inc. first pediatric visit before nine days of life. “StartStrong helps new moms cope with crying and other things Enhanced Home Visiting babies do. It has been so helpful in Avondale, and if it works 122 here, it can work anywhere. Our moms and dads group helps prenatal home visiting referrals received us to be better parents.” by Every Child Succeeds in 2014. STARTSTRONG MOTHER LANIKA ABERNATHY

24 | BETHESDA INC. 2015 ANNUAL REPORT WinMed Health Services provides medical and dental services “Just being in a room by myself, waiting for economically disadvantaged people at 10 locations to see a doctor, it’s hard to ask questions. throughout Cincinnati. Fueled by a $375,000 Bethesda Inc. Centering helped me from the time I grant, WinMed has adopted a prenatal and postnatal centering was pregnant with my son until I gave model as its standard of care. The program provides well- birth. It taught me the things I should/ woman and well-baby group care, and provides continuity for shouldn’t eat or drink during pregnancy families during pregnancy and the transition from pregnancy and about not smoking or taking through the first 18 months of life. medicine when you’re pregnant, unless WinMed in 2015 received Centering Health Care Institute prescribed by a doctor. It helped me keep national certification, which makes WinMed the first Federally track of my baby’s development from the Qualified Health Center in the country to be certified for both the time he was in my stomach until the time CenteringPregnancy® and CenteringParenting® models of care. he was born.” KIKI, AGE 22, MOTHER OF TWO This project has proven that cultural change, a key element of transformation, is difficult to achieve and sustain. Nonetheless, WinMed’s commitment and tireless efforts are resulting in RESULTS positive outcomes. increase decrease in breastfeeding in prematurity rate and low birth weight

90+ 20+ mothers & fathers have attended multiple well-child check-up sessions 50+ 15+ women & men have attended multiple prenatal group sessions

Research shows that patients battling mental health conditions TriHealth seeks to along with medical issues do not progress as well as other Integrate Behavioral patients. In June 2015, Bethesda Inc. awarded TriHealth $300,000 to research and develop a model to integrate Health into Primary behavioral health into primary medical care. Medical Care Funding will enable evaluation of several evidenced-based models and the development of the best model for TriHealth.

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2.0 Bethesda Fertility Center

The Bethesda Fertility Center Founded in 1987 as Cincinnati’s first fertility center, the Bethesda Fertility Center continues its leadership in new technologies with in vitro fertilization success rates that consistently surpass national averages. Board-certified physicians and a sophisticated Reproductive Studies Lab combine to offer individualized and compassionate care.

26 | BETHESDA INC. 2015 ANNUAL REPORT Bethesda Fertility Center is Leading the Region in Preserving Options for Cancer Patients Bethesda Fertility Center is leading the region in helping people with cancer preserve their opportunity to become parents. Chemotherapy, radiation and even some cancer surgeries can reduce fertility in men as well as women. The degree of potential infertility depends on such factors as the patient’s age, type of cancer, chemotherapy drugs and doses used, as well as the location and dose of radiation. The toxicity of treatment can have a negative effect on a woman’s ovaries and eggs.

Enabled by breakthrough technology, a woman diagnosed with cancer no longer has to give up on her dream of having a child. Her eggs can be preserved by a new freezing technique called vitrification, which enables them to be thawed for later use. The Bethesda Fertility Center is the first in the region to achieve pregnancy and birth using frozen eggs.

“The goal of fertility preservation is to intervene prior to the initiation of treatment so that we can retrieve the eggs, either fertilize them with a partner’s sperm or freeze them, and allow the oncologists to do their job in trying to cure the cancer,” says Glen E. Hofmann, MD, medical director of the Fertility Center and director, Bethesda Division of Reproductive Endocrinology and Infertility.

Nationally, the American Society of Clinical Oncology urges cancer doctors to “advise patients regarding potential threats to fertility as early as possible to allow for the widest array of options for fertility preservation.”

“If a cancer patient is planning to have her ovaries removed, it is important for her to know that fertility preservation is an option,” says Kasey Reynolds, MD, at the Bethesda Fertility Center located in Montgomery.

(top) Glen E. Hofmann, MD

(bottom) Kasey Reynolds, MD PAGE 27 1.0 GRANTS > 2.0 FERTILITY > 3.0 FOUNDATION > 4.0 CO-SPONSOR

3.0 Bethesda Foundation

According to Maria Newsad, RN, department manager at Bethesda North, the hospital is the first in Cincinnati to customize its Emergency Department to better serve seniors (slip-resistant floors, reduced-glare wall paint, sound-dampening equipment, etc.) and is one of only a handful across the country. The project has improved comfort, safety and convenience for seniors, who account for 27 percent of Bethesda North’s 59,000 Emergency Department visits each year.

(left to right) Kenneth Patton, MD, medical director, Emergency Department of Bethesda North Hospital, Maria Newsad, RN, department manager, Emergency Department, and Andy Swallow, president and CEO of Bethesda Foundation

28 | BETHESDA INC. 2015 ANNUAL REPORT Bethesda Foundation Supports Innovation at Bethesda Hospitals, Hospice of Cincinnati and Fernside

Due to the similarity in names, community members sometimes ask what differentiates Bethesda Foundation from its parent, Bethesda Inc.

Bethesda Inc. is a co-sponsor of TriHealth and is a venture grant maker that funds new initiatives with the potential to transform health care delivery. It provides direct oversight for Bethesda Foundation and Bethesda Fertility Center.

Bethesda Foundation cultivates major gifts in support of specific projects at Bethesda hospitals, Hospice of Cincinnati and Fernside. The Bethesda Foundation focuses on keeping organizations it supports at the forefront of the latest technology, and fosters and supports dynamic community outreach programs, including those related to education and safety.

Over the past year, Bethesda Foundation has partnered with over 16,000 individuals, corporations and foundations to provide improved care, including: • A renovated, geriatric-friendly Emergency Department at Bethesda North, one of the first facilities of its kind in Ohio. • A revitalized and expanded Hospice of Cincinnati inpatient facility in Blue Ash. • A prevention-focused education program to keep babies safe and reduce unintentional injuries to infants.

Astronaut Mark Kelly, a Bethesda Lyceum keynote speaker

Bethesda Foundation hosts several high-profile fundraising events annually, such as the Bethesda Lyceum, to raise awareness and support for Bethesda programs. Bethesda Inc. Board members, such as Rance Duke, are passionate about supporting the Bethesda Foundation.

“Bethesda Foundation raises funds to improve the quality of health care in this community and to promote Bethesda North Hospital and make it a world-class hospital,” Duke says. “It’s nice to be part of that.”

PAGE 29 1.0 GRANTS > 2.0 FERTILITY > 3.0 FOUNDATION > 4.0 CO-SPONSOR Bethesda Butler Hospital Expands in Hamilton; 4.0 Adds Capacity to Better Serve Patients Co-Sponsor of Bethesda Butler Hospital, which became part of TriHealth in TriHealth 2012, is adding a significant 51,000-square-foot expansion to its Hamilton, Ohio campus to meet the needs of residents in fast-growing Butler County.

This includes a new, 45,000-square-foot, two-story inpatient building, which will enable the hospital to handle an increased number of inpatient surgical cases. The new inpatient unit is expected to open in late 2015.

Once the project is complete, Bethesda Butler Hospital will add up to 50 jobs, the majority of which will be in nursing. NEWS

Construction Starts on New Midwest Health Collaborative Formed TriHealth Rehabilitation Hospital Six of Ohio’s leading health systems have agreed to form TriHealth and Select Medical have broken ground on a large-scale entity whose mission is to improve the TriHealth Rehabilitation Hospital, a new, 60-bed, acute value of health care services delivered to patients and inpatient rehabilitation hospital scheduled to open in early communities throughout Ohio. Called the Midwest Health 2016 along Interstate 71 and Dana Avenue in Cincinnati. Collaborative (MHC), it includes more than 40 hospitals Select Medical, a long-time partner of TriHealth, is a and hundreds of care sites across Ohio, including those in national leader in providing inpatient rehabilitation services the Aultman, Cleveland Clinic, OhioHealth, Premier Health, and long-term, acute hospital care. ProMedica and TriHealth systems. While remaining independent, these six health care organizations will assess the feasibility of creating a statewide provider TriHealth Named Top Place to Work network, exchange best practices, share resources, TriHealth was named to Becker’s Hospital Review list of reduce costs and develop innovative ways to deliver “150 Great Places to Work in Health Care.” TriHealth is the health care across large populations. only local health care organization on the list and one of just nine hospital systems or health care organizations in the state to be recognized based on benefit offerings, wellness initiatives, professional development, diversity and inclusion, work-life balance, and a sense of community and unity Wilburn Named as Great Living among employees. Cincinnatian L. Thomas Wilburn, Jr., former Bethesda CEO who was instrumental in the McCullough-Hyde Memorial Hospital, creation of TriHealth, was named to the a TriHealth Affiliate 2015 class of Great Living Cincinnatians McCullough-Hyde Memorial Hospital and TriHealth have by the Cincinnati USA Regional Chamber agreed to affiliate. McCullough-Hyde remains a not-for-profit, of Commerce. This is an elite group of leaders who have tax-exempt organization that continues to have important risen above every call of duty to make Cincinnati a better local input on governance and strategic decisions. TriHealth place. Recipients are chosen for their community service, has 60 percent membership interest in the hospital, while business and civic attainment, leadership, awareness of the McCullough-Hyde Memorial Hospital Trust retains others’ needs, and distinctive accomplishments. Tom began 40 percent membership interest. This affiliation is a his career with Bethesda in 1971 and served as president significant move by TriHealth to improve services in the and CEO of Bethesda for more than 20 years. Tom was at the Oxford area and includes a $17 million commitment, a forefront of merging the operations of both Bethesda hospitals portion of which includes installation of an electronic and Good Samaritan Hospital to form TriHealth— patient medical records system. for which he served as CEO until he retired in 1998.

30 | BETHESDA INC. 2015 ANNUAL REPORT PEOPLE PEOPLE (Bethesda Inc.)

Mark Clement Named President of TriHealth Mark Clement, a Moeller High School and Xavier University alum, has been named president of TriHealth. Clement reports directly to Chief Executive Officer John Prout, the organization’s highest-ranking official. Clement has spent the past 23 years Jill Miller, as president or chief executive officer for major health care Executive Director systems or hospitals around the country. Most recently, he was Bethesda Inc. Names Executive Director responsible for transforming Rochester (NY) General Health Bethesda Inc. welcomes Jill Miller as our executive director. The System from a two-hospital, $600 million, locally focused Board created this new staff role to better lead our work as a organization into a $1.9 billion, five-hospital, regional integrated major funder of health care transformation and shepherd our health delivery system serving more than one million residents governance as a co-sponsor of TriHealth. of central and western New York. Tom Boggs Jill leads our grant making initiatives, works with the Bethesda Named President of Healthcare Inc. Board to drive strategic goals, promotes organizational Solutions Network activities, oversees communications, and partners with TriHealth to ensure collaboration and alignment. Healthcare Solutions Network, a collaborative venture of TriHealth and St. Elizabeth Healthcare, named Thomas (Tom) Jill has worked in the financial and insurance industries, and Boggs as its first chief executive officer. Boggs joins Healthcare has held leadership positions in the not-for-profit sector before Solutions Network from Aultman Health System in Canton, Ohio, joining Bethesda Inc. She has a business economics degree where he was chief operating officer and chief financial officer from Miami University and an MBA from Xavier University. of the system’s clinically integrated network. Boggs previously held leadership roles in population health management, clinical integration, physicians practice operations and finance. Robert Collins, MD Named Chief Medical Officer of TriHealth Dr. Collins previously served as vice president of medical affairs for TriHealth and as the vice president of medical affairs at Lisa Knutson, Grant Hesser, Bethesda North Hospital. He held a number of positions during Board Member Board Member his tenure at Bethesda North, including chairman, Department Bethesda Adds New Trustees, of Surgery, chairman, Division of Vascular Surgery, and director, Recognizes Service Vascular Surgery. Dr. Collins is also a member of the Bethesda Joining the Bethesda Inc. Board are Lisa Knutson, chief Inc. Grants Committee. administrative officer at E.W. Scripps, and Grant Hesser, Dee Ellingwood president, PDSC Corp. Lisa will also chair the Bethesda Inc. Named Senior Vice President of Strategy, Grants Committee, beginning in January 2016. Communications and Public Affairs at TriHealth Robert Walker, senior vice president Dee Ellingwood was appointed senior vice president of strategy, and CFO at Western & Southern communications and public affairs at TriHealth. Prior to joining Financial Group, has retired from the TriHealth, Ellingwood served in a community leadership role as Bethesda Inc. board after 14 years. the lead executive for Collective Impact on Health at the Health He also has served as chairman of the Collaborative in Cincinnati. Ellingwood had previously served TriHealth Board. We thank him for his as senior vice president of planning and business development unwavering dedication and outstanding at Cincinnati Children’s Hospital Medical Center, developing Robert Walker, service and commitment to Bethesda institutional strategy and leading organizational initiatives to Board Member Inc. and to improving health care in the pursue the institution’s vision to be the leader in improving community. child health.

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