1. Quality health plans & benefits Healthier living Financial well-being Intelligent solutions ProVita Treatment Pilot A collaboration between Aetna Behavioral Health and CRC Health Inc. (CRC). Submitted for consideration for Aetna’s Second Medication Research Partnership change cycle.

2. Quality health plans & benefits Healthier living Financial well-being Intelligent solutions Aim: To increase the use of Vivitrol for the treatment of opiate dependence. The use of Vivitrol for individuals who have been diagnosed with opiate dependence has been shown to: Decrease relapse and readmission rates Improve quality of life Decrease behavioral health and medical costs for Aetna and involved plan sponsors

3. Quality health plans & benefits Healthier living Financial well-being Intelligent solutions Change: This pilot is a modification of the standard patient management process for the participating treatment facilities. A set number of days (10 residential and 10 partial hospital program) are authorized to allow for recovery treatment and the first dose of Vivitrol. Inclusion criterion: an opioid dependence diagnosis; member willingness to participate; and Aetna medical, behavioral health and pharmacy benefits.

4. Quality health plans & benefits Healthier living Financial well-being Intelligent solutions Results: The pilot launched May 1, 2012, with on-site training at three identified sites: Azure Acres, Camp Recovery and Recovery Ranch. To date, the volume has been lower than expected. The causes are believed to be an overall decrease in Aetna admissions and the strict program criteria. As part of the pilot, we continue to monitor admissions weekly and discuss options to increase the study volume.

5. Quality health plans & benefits Healthier living Financial well-being Intelligent solutions Steps to increase participation: We are actively working to increase the volume of members in the pilot. We have increased the number of CRC sites participating in the pilot to five, adding Starlite Recovery and Keystone Treatment Center. At this time, we are planning for the addition of two more sites to the pilot by year end, and we are discussing nationwide coverage by the first quarter of 2013. There was a joint Aetna/CRC Health press release issued in September 2012, highlighting the issue of increasing opiate dependence and the ProVita pilot. It is believed that public information about the program will also facilitate an increase in members in treatment at these facilities. We are also considering the possibility of expanding the qualifying diagnosis to include alcohol dependence.

6. Quality health plans & benefits Healthier living Financial well-being Intelligent solutions Impact: The impact of the ProVita program will be measured using two methods: Short-term impact – average length of stay (ALOS), discharges against medical advice (AMA ) rates, readmission rates and emergency room (ER) visits related to substance use Long-term impact – injection persistence, overall behavioral health (BH) costs and overall medical costs Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies. The Aetna companies that offer, underwrite or administer benefits coverage include Aetna Health Inc., Aetna Health of California Inc., Aetna Life Insurance Company, Aetna Health Insurance Company of New York, Aetna Health Insurance Company, Aetna Health Administrators, LLC, and Strategic Resource Company. (Aetna) Aetna Behavioral Health refers to an internal business unit of Aetna. Aetna and CRC Health Inc. are independent contractors and not employees or agents of the other.

7. Questions