2. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. Agenda Network Recruitment strategy –Network Requirements –Credentialing & Recredentialing Process Provider Education/Resources –www.providerexpress.comwww.providerexpress.com ALERT Clinician Quality Program - ACE 2

3. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. Network Recruitment Optum offers a robust network of clinicians, agencies and facilities throughout New York State To serve consumers through FIDA, HARP and Mainstream Medicaid carve-in plans, we are actively identifying providers who offer the following services for recruitment: 3 Assertive Community Treatment (ACT) Case Management Community Integration Counseling Continuing Day Treatment Intensive Psychiatric Rehabilitation Treatment programs Home Health Mobile Mental Health Treatment OMH licensed Community Residences Opioid Treatment Services Peer delivered services Personalized Recovery Oriented Services (PROS) Positive Behavioral Interventions and Supports TeleHealth 1915i-like Home and Community Based Services

4. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. Recruitment activities are currently being focused on the FIDA counties: –Bronx –Kings –Nassau –New York –Queens –Richmond –Suffolk –Westchester *Additional recruitment will occur in Upstate and Western NY counties for HARP and Mainstream Medicaid Main provider types –Community Clinics and Health Centers/Community based agencies/FQHC’s Network Recruitment FIDA – 1/1/15 HARP and non-HARP – Adults NYC 1/1/15 HARP – Adults rest of state 7/1/15 Children – 1/1/16

5. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. The participation process begins with submission of the agency application Additional required application materials include: –Signed UBH Group Agreement –Signed Disclosure of Ownership and Control Interest Statement –The American with Disabilities Act (ADA) Attestation with 100% compliance Pre-contractual site audits Required for unaccredited agencies pursuing group contracts –May be waived following Optum review of the agency’s most recent OMH and/or OASAS site audit results Approval by Optum Credentialing Committee Orientation to Optum clinical and administrative protocols via Provider Orientation Forums and webinars, or review of provider resources posted on www.providerexpress.com Network Participation Requirements

6. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. For provider group agencies that employ both licensed professional and unlicensed paraprofessional staff to render services under the umbrella of the agency, Optum will execute group contracts with the agency as the contracting entity Group agencies must submit the Optum agency application, indicating the services being provided and the licensed clinical professionals on the staff roster The individual clinicians on staff do not need to be individually credentialed when they work for the agency under an Optum group contract Credentialing of Group Agencies

7. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. Recredentialing Optum recredentials agencies at least once every 36 months: –State law or client requirements may require a different recredentialing cycle Very similar to initial credentialing, including Primary Source Verifications and notification to you of any discrepancies found during the process It is important that you maintain current demographic information with Optum To update the Agency’s information, use the Provider Express secure “Transactions” feature or contact your Network Manager 7

8. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. Provider Education and Resources www.providerexpress.com Our industry-leading Provider website includes both public and secure pages. Public pages include general updates and useful information. Secure pages are available only to network Providers and require registration. The password-protected “secure transactions” gives you access to Member and Provider specific information. Secure transactions include: –Check eligibility and authorization or notification of benefits requirements –Obtain initial authorization requests, if applicable –Create and maintain My Patients list –Submit professional claims and view claim status –Make claim adjustment requests –Register for Electronic Payments and Statements (EPS), including Electronic Funds Transfer (EFT) –Update your practice information To request a User-ID, select the “First-time User” link in the upper right hand corner of the providerexpress.com home page Click the “Provider Express Support” icon to access our “Live Chat” feature or call (866) 209- 9320 from 7 a.m. to 9 p.m. Central Time, Monday through Friday, excluding holidays 8

9. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. Provider Education and Resources (continued) Public Pages include: –Administrative news updates –Provider Directory –Network Manual State specific manual addendums –Clinical Resources Level of care guidelines Coverage determination guidelines –Access current and archived issues of Network Notes, the provider newsletter –Register for educational webinars 9

10. ALERT ® : Algorithms for Effective Reporting and Treatment Our Outcomes-driven Outpatient Care Advocacy Program

11. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. Value of ALERT ALERT Outpatient Care Advocacy Program –Integral component of our risk and utilization management process Values of ALERT model –Collaboration with providers to improve outcomes and manage care –Promotes outcomes-informed, patient centered psychotherapy –Allows for focus to be on cases with highest risk –Decreased administrative work for routine care –Wellness Assessments provide treatment feedback 11

12. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. ALERT – Wellness Assessment The ALERT model incorporates consumer responses to a validated tool, the one-page Wellness Assessment (WA), along with claims data. Both the WA and claims data is analyzed through a set of algorithms, or decision rules, to identify potential targeted clinical risk. WA is based on a psychometrically-tested instrument that uses the Global Distress Scale for identifying and monitoring change in psychological distress and identifying chemical dependency risk and medical issues. The WA, when completed at more than a single point in treatment, offers immediate feedback on changes in health status and functioning that may inform further treatment planning, including level of care changes or coordination with medical professionals. Completed at initial visit Follow up visits Four month follow up 12

13. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. ALERT – Wellness Assessment Optum uses two versions of the WA: one for adults and the other for youth under the age of 12. The adult scale includes 24 items that assess symptoms of depression and anxiety, functional impairment, well-being, daily functioning, health and medical co-morbidity, and substance risk and use. The youth scale has 25 items that assess global impairment in the child (including interpersonal, emotional, academic and behavioral), caregiver strain, parental workplace absenteeism and presenteeism and health. Monitoring of progress in treatment – Optum Care Managers receive ALERT-generated flags whenever the system identifies potential issues with a member’s medical condition or progress in treatment. ALERT also generates flags if a member is at risk for any one of 15 medical and behavioral complications ranging from anorexia nervosa to caregiver strain, chemical dependency, depression, and medical/behavioral co-morbidity. 13

14. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. Wellness Assessment – Patient Questionnaires 14 24 items Depression and anxiety symptoms Functional impairment Well-being Workplace absenteeism and presenteeism Substance abuse risk and use Health and medical comorbidity 24 items Depression and anxiety symptoms Functional impairment Well-being Workplace absenteeism and presenteeism Substance abuse risk and use Health and medical comorbidity “Adult” Wellness Assessment 25 items Global impairment in child (interpersonal, emotional, academic, behavioral) Caregiver strain Parental workplace absenteeism and presenteeism Health “Youth” Wellness Assessment

15. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. The future of providing health care has arrived Introducing Achievements in Clinical Excellence (ACE) A program that rewards providers that deliver both effective and efficient clinical care.

16. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. Leading the way Outpatient ACE and Pay for Value Member Transparency Preferred clinicians “star-rated” for quality can earn a second star rating for meeting cost-efficiency standards Seeking formal accreditation for our provider performance programs through NCQA Physician Quality Accreditation program Reward providers for increased outcome-based results and improved efficiencies Launching March 1 st for providers serving commercial members and achieving 2-star rating Quality Severity-adjusted effect size from the Wellness Assessments Cost NEW: Case-mix-adjusted average number of visits NEW: Average cost per episode Quality Severity-adjusted effect size from the Wellness Assessments Cost NEW: Case-mix-adjusted average number of visits NEW: Average cost per episode