1. NBC National Network Initiative: Update and Discussion San Diego September, 2007

2. Contributing Organizations

3. Psychiatrists Doctorate Level Psychologists Masters Level Clinicians Clinical Nurse Specialists Total 4,3614,02813,8772,48724,753 Total Count of Providers in the NBC Network

5. NBC NATIONAL NETWORK

6. STATE FACILITY COUNT STATE Arkansas13 North Dakota 5 California9Nebraska9 Colorado2 New Jersey 2 Florida2 New York 5 Georgia4Ohio15 Iowa10Oklahoma6 Illinois76*Oregon5 Indiana12Pennsylvania9 Kansas8 Rhode Island 2 Louisiana8 South Dakota 2 Massachusetts3Tennessee12 Michigan1Texas10 Minnesota23*Virginia2 Missouri10Washington4 Mississippi1Wisconsin13 North Carolina 50* TOTAL333 * We are doing further research to identify how many reported facilities are inpatient or residential units vs. outpatient services. Count of Facilities by State

7. State Total TotalStateTotalStateTotal AK AK2 DE DE7 KY KY117 AL AL797 FL FL5,911 LA LA195 AR AR119 GA GA246 MA MA161 AZ AZ681 HI HI7 MD MD179 CA CA2,788 IA IA290 ME ME22 CN CN1 ID ID250 MI MI101 CO CO151 IL IL911 MN MN148 CT CT49 IN IN137 MO MO1,561 DC DC11 KS KS1,148 MS MS50 Count of Providers by State

8. State Total TotalStateTotalStateTotal MT MT18 OH OH635 TX TX1,016 NC NC1,817 OK OK104 UT UT134 ND ND64 VA VA192 NE NE128 OR OR867 VT VT6 NH NH28 PA PA184 WA WA285 NJ NJ144 RI RI10 WI WI129 NM NM1,063 SC SC1,295 WV WV40 NV NV16 SD SD24 WY WY29 NY NY226 TN TN220 TOTAL TOTAL24,714 Count of Providers by State

9. Discipline CPT Code 90801 90806 90862 99233 Psychiatrist$65-$234 Mean of $123 N/A$45-$80 Mean of $58 $65-$128 Mean of $89 Doctorate Level Psychologist $60-$182 Mean of $91 $60-$85 Mean of $76 N/AN/A Masters Level Clinician $55-$134 Mean of $80 $55-$86 Mean of $67 N/AN/A Clinical Nurse Specialist $55-$150 Mean of $105 $55-$125 Mean of $66 $30-$117 N/A Ranges and Mean of NBC Fees by CPT Code

10. Definitions ► “Contributing Members” are NBC Members (or associated non-NBC members) who agree to the use of their provider network to create a national network ► “Participating Members” are NBC Members who use the NBC network under terms and conditions established by NBC’s Contributing Members

11. Questions & Issues for Discussion Contractual ► How does NBC best protect the interests of Contributing Members?  Non-solicitation  Competitive issues  Confidentiality ► Does the Contributing Member’s provider contract allow for network rental? If not, what are the options?  Amending existing contracts that don’t allow for network rental  Other options ► What kinds of contracts are needed between Contributing and Participating Members to support an NBC Network?  Create a network of inter-Member agreements  Develop a single Member-NBC network usage agreement

12. Questions & Issues for Discussion Operational ► How do we establish a single source (master provider file) for the network?  NBC out sources to a “neutral” vendor and share the costs  NBC out sources to an NBC member company and shares the costs (should be minimal) ► How is the NBC network maintained?  Updates by each Contributing Member to NBC on a quarterly basis ► Who handles what kinds of provider issues?  Problems with a provider – Contributing or Participating Member?  Problems with claims/authorizations – Participating Member

13. Questions & Issues for Discussion Operational ► We will need to create a standardized set of definitions so that we can accurately describe the network ► How do we show specializations for outpatient providers and facilities? ► How do we insure compliance to accreditation standards for credentialing? ► Each Participating Member must load the network and associated rates into their own claims payment system from the master provider file

14. Questions and Issues for Discussion Financial ► Who gets paid for what and how much?  ASO rates are around 0.70 PMPM to 1.00 PMPM  Even 0.10 PMPM will make any of us non-competitive on price ► Contributing to the network involves minimal cost while significantly expanding opportunities for revenue  Whatever we charge for our networks will be charged back to us by others

15. Turning Gold into Lead ► Excessive legal review and risk management ► Charging too much for network rental ► Over thinking legal and operational issues

16. QUESTIONS? Level of interest? Where do we go from here? Next steps?

18. StatePsychiatrist Ph.D. Psychologist Masters Level Clinician CNS/ARNPTotal AK00202 AL1621944410797 AR14159090119 AZ8312744328681 CA371625178842788 CN00101 CO1211290151 CT0742049 DC128011 DE01607 FL1834595120422785911 GA22371870246 Count of Providers by Discipline and State

19. StatePsychiatrist Ph.D. Psychologist Masters Level Clinician CNS/ARNPTotal HI03407 IA33542030290 ID11571793250 IL981107030911 IN1327970137 KS18620375901148 KY1615806117 LA27241440195 MA12371120161 MD4231520179 ME0418022

20. StatePsychiatrist Ph.D. Psychologist Masters Level Clinician CNS/ARNPTotal MI419780101 MN10331050148 MO278260102301561 MS1641250 MT0414018 NC3633601066281817 ND161335064 NE1630820128 NH0820028 NJ13171140144 NM113183729381063 NV1312016 NY6351850226 OH1474542419635 Count of Providers by Discipline and State

21. StatePsychiatrist Ph.D. Psychologist Masters Level Clinician CNS/ARNPTotal OK422780104 ON0123024 OR14027640249867 PA6261520184 RI109010 SC196164917181295 SD3120024 TN43371400220

22. StatePsychiatrist Ph.D. Psychologist Masters Level Clinician CNS/ARNPTotal TX7414879221016 UT3301001134 VA6141720192 VT21306 WA106220310285 WI1541730129 WV2434040 WY0425029 AB-CANADA00202 BC-CANADA00112 QC-CANADA00101 QU-CANADA00303 SK-CANADA00707 TOTAL436402813877248724753 Count of Providers by Discipline and State