CYE 14 Mid-Year Cap Rate Adjustments - Confirmed Acute Care 1/1/14 Coverage for HPV for adults aged Expiration of Childless Adult mandatory copays effective 12/31/13 Acute Care 2/1/14 Rural Hospital Payments (please make payments as soon as possible!) ALTCS EPD 2/1/14 Quarterly NF Payments (10/1/13 – 12/31/13)

CYE 14 Mid-Year Cap Rate Adjustments - Potential Acute Care New mandatory copays – possibly 4/1/14 EPSDT – Dental varnish in PCP offices – possibly 4/1/14 Newborn screening – fee increase of $25 per test – possibly 4/1/14 CYE 14 Risk Adjustment – retroactive to October 1, 2013 – targeting 4/1/14 (experiencing some system issues) BHS Maricopa GSA rates – integration implementation – 4 /1/14 CMDP/DDD Possible shift in IT admin support dollars from DDD to CMDP – possibly 7/1/14

CYE 14 Mid-Year Cap Rate Adjustments - Potential All Programs Other Than Acute Care New mandatory copays – next time rates are opened or 10/1/14 (or CMDP 1/1/15) EPSDT – Dental varnish in PCP offices – next time rates are opened or 10/1/14 (or CMDP 1/1/15) Newborn screening – fee increase of $25 per test – next time rates are opened or 10/1/14 (or CMDP 1/1/15) All Programs Reviewing one category of FFS provider rates – more to come if any action taken

CYE 15 Capitation Adjustments – Preliminary Issues FQHC/RHC/Look-Alike Payments (FQHC) Contract language will be amended to mandate the payment of the AHCCCS-developed PPS rates Currently MCOs must pay FQHCs rates comparable to rates paid to providers of similar services – In FFY 2012, total payments to FQHCs = ~$173 M ~ $65 M (37%) paid by MCOs ~ $108 M (63%) paid by AHCCCS – Current process is lacking in transparency

CYE 15 Capitation Adjustments – Preliminary Issues ASC Shift Cap rates will be reduced to reflect a shift in outpatient hospital services that could be moved to ASCs for equally efficacious treatment – This is in support of the AHCCCS Payment Modernization Mission: To leverage the AHCCCS managed care model toward value based health care systems where patients’ experience and population health are improved, per-capita health care cost is limited to the rate of general inflation through aligned incentives with managed care organization and provider partners…