2015 – A Year of Growth

With a look back at our 2015 successes and exploring some of our growth opportunities moving forward, we are pleased to share our annual report.

CEO Message

A. Dale Jenkins
Chief Executive Officer

I am pleased to report that we had strong financial results in 2015 that have continued into 2016, reinforcing our confidence and optimism about the years ahead.  It is important to acknowledge the efforts and excellent leadership of our management team. They have set clear strategic priorities for the company, and have attained them – increasing our annual earnings and generating substantial value for our members. Hiring talented employees is a high priority.  We are fortunate to have individuals on our teams in Raleigh, Philadelphia, and Harrisburg who have a clear sense of purpose in all that they do and who are thought leaders in their respective disciplines.

CEO Message

Financials

In our first full year as a holding company, Medical Mutual found more ways to facilitate growth and return value to our members. With more than $1 billion in assets, we continue to look for innovative ways to minimize our members' risk and protect their bottom line.

Medical Mutual Holdings Investment Activities

We made significant strides in 2015 to better align the Medical Mutual investment strategy with our overarching business strategy. Early in 2015, Medical Mutual commenced a fundamental shift from a historically defensive posture to one focused more on capital appreciation. With an increased emphasis on equity exposure, both public and private, we also realigned our approach to managing our equity exposure. While we shifted the domestic large cap exposure to in-house, passive management, we employed more active, third-party management to the small-cap, mid-cap, and international exposures. We continued to deploy capital into commercial real estate with a focus on commercial office and other property classes that offer more favorable valuations in this market.

We believe this portfolio maintains an abundance of short-duration, investment-grade fixed-income exposure and cash to meet our insurance and other near term obligations, but also puts our surplus capital to a higher, better use in support of the Medical Mutual strategy.

In the second half of 2015, we selectively liquidated a sizable portion of both the fixed-income and our large-cap stock portfolios, with proceeds reallocated to a diverse and carefully selected portfolio of four passive and six actively managed equity strategies. Due to market conditions, a considerable portion of the proceeds was held in cash as of December 31, 2015. As expected, a timely market correction in early 2016 provided an opportunity to deploy this capital into our revised corporate strategy at very favorable entry points.

In 2016, we expect additional reductions to our fixed-income exposure due to natural maturities, which will be reallocated into asset classes that offer greater opportunity for capital appreciation.

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Real estate investments continue to be a significant and successful component of our overall investment portfolio. Demographics, economics, and fundamentals within the Southeast real estate market continue to support this strategy. All exposure continues to be achieved by way of direct, private-placement investments.

Here are just a few of the highlights from 2015:

  1. • Nine new investments were made across multifamily, commercial office and retail properties, deploying over $25 million of Medical Mutual’s capital.
  2. • Five assets were sold or placed under contract, netting impressive returns.
  3. • Since 2014, nine properties have been sold, yielding approximately a 2-times multiple of invested capital.
  4. • At the end of 2015, the portfolio comprised 31 properties, with a heavy concentration in North Carolina but also spanning across contiguous states.

Looking forward, Medical Mutual will take advantage of the newly created SharpVue Capital to satisfy the bulk of our commercial real estate investment. We believe this fund will allow us to most effectively implement our real estate investment strategy by leveraging the fund’s robust underwriting capabilities and a broader suite of asset types while continuing to diversify the portfolio, both geographically and across property types. SharpVue will help us navigate the challenging investment environment.

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With our pursuit of robust capital appreciation, Medical Mutual continues to selectively place meaningful investments in the most promising private equity venture funds and companies. Products range from innovate biotechnology and pharma to manufacturing companies and clean energy. In 2015, we placed over $9 million into private equity investments, with commitments to follow on investments of more than $6 million. This portion of our portfolio, if methodically constructed, will be a strong contributor to our overall investment objectives.

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A Excellent Rating

AM Best Logo

We strive for the best

Medical Mutual has earned an “A” rating from A.M. Best for 12 consecutive years.

Financials

Company Highlights

Innovative services and resources uniquely designed for medical practices

Medical Mutual realizes that health care is evolving and that the programs, tools, and resources that we offer must evolve to meet the needs of our customers. Learn more about our philosophy on solutions-based offerings.

Protecting Our Profession

A look at our claims updates from 2015



Mitigating Risk

Our proficiency for proactively identifying and managing ongoing risks continues to be a key offering for our Medical Mutual physician members.

Members continue to seek out onsite risk assessments, and an impressive risk reduction success rate of 88% was measured – an increase of 4% over 2014 results.

More than 2,500 members contacted Medical Mutual's Risk Management team for support in 2015.

The Self Risk Assessment tool continues to be valuable for members. Since its inception three years ago, more than 840 people have completed the Self Risk Assessment in its entirety.

Comprehensive Risk Assessments

Year Provider-requested onsite comprehensive risk assessment CME credit awarded Certificate of Attendance
2013 408 276 173
2014 246 160 70
2015 274 144 73

Self Risk Assessments

Year Unique views to webpage Visitors accessing tool
2013 2001 618
2014 1559 554
2015 1881 492

Webinars

Recognizing the challenges of balancing education, and the ever-more-complex world of health care, we are continuing to build out the repository of online, educational webinars.

In 2015, five new and unique webinars were added to the website, bringing the total to nearly 30 webinars available to members. Webinars continue to be a part of the Premium Rewards Program (PRP), with a record 3,370 webinars viewed and submitted for PRP points.

The new webinars available online and via mobile include:

Meaningful Use Audits

Medical Record Documentation

Medical Practice Contracting Strategies

The Emerging World of Telehealth

Releasing Medical Records

2,500
Members Access Risk Management Tools
3,370
Webinars Viewed

Lunch Bytes

Mini webinars (or webinettes) lasting less than 10 minutes provide quick overviews on hot topics. In 2015, we added five new Lunch Bytes focusing on medical record release, scope of practice, managing patient complaints, electronic communication, and emergency management.

Toolkits

With changes in the health care market, Medical Mutual is committed to providing more sophisticated and robust tools.

Informed Consent Toolkit

Several popular toolkits were updated, but the Informed Consent Toolkit continued to be the most popular, with nearly 600 page views. It now includes 182 consent forms, with 61 forms translated into Spanish to better meet the needs of an evolving population.

Managing Patient Complaints

Managing Patient Complaints was the second most popular toolkit, with more than 400 views.
Company Highlights

Community Outreach

Medical Mutual gives back to the community by donating time, energy, and resources. We are fortunate to have a strong partnership with Alliance Medical Ministry, a non-profit medical clinic providing affordable primary care to working, uninsured adults in Wake County, North Carolina.

Alliance patients receive primary care from a staff physician, specialty care from volunteers (ENT services, gynecology, physical therapy, orthopedics, cardiology), select screenings (cardiac, mammograms, dental), and off-site medical referrals. Wellness Programs provide patients with foods harvested from their on-site community garden, yoga classes, walking programs, nutrition classes, diabetes education, and gardening opportunities. After establishing care at Alliance, patients make fewer trips to the emergency department, seek routine care at Alliance, miss fewer days of work, and improve their health outcomes.

"Partners like Medical Mutual enable Alliance to provide critical care to almost 3,000 patients, work towards improved health outcomes for an underserved population through innovative wellness opportunities, and address social determinants impacting our community. We are appreciative to Medical Mutual for supporting the health of our community.”

Megg Rader - Alliance Medical Ministry Executive Director

Dialogue with Physicians

Medical Mutual’s community and advisory boards met in 2015 in 10 communities across North Carolina, Virginia, and Georgia. Input and counsel from our physician and administrator members continued to provide valuable insight to the company. Today, there are 17 physician and administrator advisory boards throughout North Carolina, Virginia, and Georgia comprising 110 physician members and 146 practice administrators.

Responding to the rapidly evolving medical landscape presents unique challenges for the health care community.  Medical Mutual recognized that in order to better serve its members, a forum was needed for a two-way dialogue on emerging legislative issues, industry trends, and the company’s performance in key areas. As such, we strive to stay alert to trends and changes, and make necessary adjustments in order to provide physicians with the very best in professional liability coverage. Designing products and services that support the success of physicians in their practices is our primary focus. Community and advisory board member insight and candid feedback is invaluable in this regard.

Community Outreach

Ventures & Acquisitions

HPIX

Medical Mutual’s acquisition of Health Providers Insurance Exchange (HPIX) allowed us to expand our footprint in four Mid-Atlantic states while diversifying our insurance base and bringing in additional talent and revenue. This acquisition is a transformational event for Medical Mutual with high potential for growth.

SharpVue Capital

A new, additional benefit to members is the launch of SharpVue Capital, a new wealth management firm. In 2015, we laid the groundwork to launch SharpVue and help our members grow their private wealth.

Ventures & Acquisitions

Outlook

Our Vision

We recognize that physicians and medical practices face enormous pressures in today’s health care environment and we are committed to working alongside our members to build a strategy that allows practices to be as successful as possible for the long term.

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Outlook