Spiras Health is the premier next generation care management organization delivering nurse practitioner led in-home specialty care, utilizing predictive analytics and employing smart use of technology for members with advanced chronic conditions, specifically COPD and CHF made more complicated by co-morbidities and SDoH. The Spiras Health Solution combines monthly in-home services, telehealth, 2-way digital communications, and remote monitoring longitudinally. By treating patients with a whole-person approach through multiple modalities, developing clinician/patient relationships, and extending specialty services such as pulmonology, cardiology and palliative care into the home, Spiras Health is able to support adherence to treatment plan, coordinate care, communicate and collaborate with PCP/SCP and other care team members. The results are enhanced quality of life, improved patient/provider satisfaction, total cost of care reduction, and increased communication, coordination and collaboration among care team, patient, caregivers and community and referral back into a health system's ecosystem for continuity.

Spiras Health, headquartered in Brentwood, TN, provides longitudinal care services to complex, chronically ill patients, specifically COPD and CHF. The Spiras Health approach combines home-based services, telehealth, 2-way digital communications, and remote monitoring. This multi-modal approach allows the patient access to care, regardless of situational complexities, in the mode that suits their preferences, needs, and risk. This also provides ongoing data, from a multitude of sources, to Spiras Health for accurate and efficient interventions. Spiras Health creates value to patients by improving quality of life and to health system/payor partners by reducing total cost of care by addressing avoidable costs and supporting quality metrics. Spiras Health utilizes/provides: 1. Multi-disciplinary team approach consisting of MDs, NPs, RRTs, RNs and community resources 2. Predictive modeling and machine learning to identify patients at highest risk for avoidable costs 3. Patient activation strategy for ongoing engagement, goal setting, treatment plan adherence, and behavior modification 4. Multi-modal approach to care delivery 5. Provider collaboration process to partner with patient's PCP and specialists, bridging care from physician office to home 6. Improved clinical and financial outcomes

Raziel's approach integrates CCM and RPM into a single solution (as applicable per patient). Chronic diseases supported in the solution include Pre and Post Surgery, Hypertension, Heart Failure, COPD/Asthma, Diabetes and Oncology. Care Teams monitor patient vitals and deploy smart AI-driven algorithms to identify and escalate for those requiring immediate intervention.

Benefits:

1. Continuous Care Platform across the health system
2. Substantial alternate revenue stream
3. Concierge style care model for all
4. Increased patient loyalty, engagement
5. Vanguard industry performance

Care is delivered via video visits, contextual surveys, alerts, interventions, escalations, emotional, lifestyle and nutritional coaching. Raziel's program begins with patient identification and delivery of custom FDA-approved monitoring devices for capturing the required vitals complete with a pre-paired smartphone for data transmission. Raziel also offers downloadable smart phone apps. and web portal access for surveillance and early warning detection of broader rising risk patient populations. Raziel's smartphone and apps. pair and integrate with hundreds of FDA-approved Medical Monitoring Devices and Activity Trackers for capturing Sleep, Mood, Stress, Physical Exertion and ever-expanding physiological metrics coming on the market. Whether a smartphone is shipped with kits or apps. are downloaded through the iOS or Android store, staying connected to patients has never been easier. ‍ On the clinical side, Care Workers are provided roles-based patient access and management through a robust point and click dashboard accessible from any web browser. Raziel's user interface delivers a rich set of tools for setting up and managing care pathways, early warning alerts, automated patient surveys, analytics and reporting.

Spiras Health is a next generation care management and care delivery provider bringing specialized services to members at home. Spiras focuses on members at highest risk of incurring avoidable spend due to unnecessary utilization of ER and hospital, primarily as a function of poor adherence to treatment plan and uncontrolled symptom exacerbations.

This solution begins by targeting patients with diseases of the heart and lungs (CHF/COPD) made more complicated by multiple co-morbidities and social determinants of health. However, care for all conditions is provided - with a whole-person approach.

Spiras is distinguished by:

• Predictive models that identify avoidable spend
• Specialty care delivery - in-home with multi-modal use of technology
• Longitudinal vs acute/episodic
• Ability to take risk for specialty care

1. Turnkey - we are able to provide a full service (patient enrollment to logistics to care management staffing)
2. Standard of care - remote model when data is "flying in" every min is not an easy model for health system. We have worked hard to develop protocols and pathways by collaborating with academics and leading institutions
3. Flexibility of a single platform - from chronic disease management to hospital at home

1. Experience and Tenure - we have been doing this for 15+ years. Our clients benefit from our learnings and best practices
2. Clinical Company - we are a clinical first company taht is founded by physician. We believe this is a new care model as opposed to simplistic thinking of using connected devices
3. Proven outcomes - we have studies to prove our approach works