Introduction to Beacon Health Strategies April 28, 2011

1. Introduction to Beacon Health Strategies April 28, 2011

2. Beacon serves 6 million members in 14 states, 10 Medicaid programs and 50+ health plans Medicare Medicaid Commercial Multi-Sector Health Plans

3. Beacon is one of the largest MBHO serving public populations in the state of NY New York Foot Print New York Business Highlights • Working with Four Health Plan Partners and CCSI/NYCCP • Working with members and providers since 1998 • Case Management and quality improvement partnerships with 7 county systems • Chautauqua, Erie, Genesee, Monroe, Onondaga, Westchester, Wyoming • NY clinical operationsbased locally in NY • UR, CM and Physician advisors • 7,000 contracted providers in NY State 3 Confidential

4. We provide a full range of clinical management services to our clients Administrative Services Utilization and Case Management Population Health • Predictivemodelingand informatic case finding • Total care management • Co-morbid mental illness and chronic disease • Psychotropic drugintervention program • Depression health management program • Medical necessity review • 3-tiered case management program • Case consultation • Care coordination • Intensive case management • Follow-up after hospitalization “Aftercare” program • Agency/Courts/School care coordination • NCQA and URAC accreditation • Fully integrated BH management system • Financial • Clinical • Network • Claims • Network creation and management • Provider credentialing • Claims processing and payment • Call center operations 4

5. Beacon’s system of care was developed to serve deep-end patients in public programs BH Inpatient Utilization – Days per 1,000 members Beacon’s CoreBusiness

6. Quantified correctly, behavioral health expenditures can be 20% of total spend 3-5% 3-5% 10+% 3-5% 6

7. Behavioral health co-morbidity drives cost in the highest of the high cost cases Average PMPM Expenditure for High Cost Cases - 2009 All MassHealth Members - 2009 +65% • 50,000 enrollees • $3.2 billion • 51% BH co-morbidity 7

8. BH and Chronic Disease: A Volatile Cohort Cost Variation of Chronic Diseases 8

9. Low Low High High Case Study: Value is driven by creating a care continuum and coordinating step-up / step-down Inpatient acute care Crisis Stabilization Responsive Alternative levels of care Enhanced Outpatient CAITS Service Intensity IOP w/out Walls Partial Hospitalization Day Treatment Intensive Outpatient Office Based Care Price of Unit of Service 9

10. “Diversionary” service penetration increased dramatically across all lines of business NHPRI Percent of OP Utilizers Utilizing Diversionary Services(Before and After Service Expansions) Before new services (2002-2005)* After new services (2006-2009)* 10

11. Admission rates amongst OP utilizers dropped with the introduction of new services Before new services (2001-2004)* After new services (2004-2007)* NHPRI Acute MH Admission Rates for Members OP Utilizers (37%) (54%) (55%) 11

12. More community care resulted in better value SubCare CSN Service Expenditures – Per Utilizer per Month RIteCare/Children 12

13. Creating “Health Homes” that incorporate BH results in quality gains and better value Co-location of BH on site increases penetration of specialty BH services… …reduces psychiatric hospitalization …and generates measurable medical cost offset. 13

14. Getting value from the current system – using data to target services matters % of Highest Cost* SPMI MembersReceiving County Services SPMI Care Management Program(Buffalo, Rochester, Syracuse) • 59% decrease in ER utilization • 62% decrease in IPMH ALOS • 34% decrease in self-harm incidents • 32% decrease in of physical harm to others • 32% decrease in suicide attempts • 50% decrease in arrests • 44% increase in gainful employment 14

15. Health Plans Community Services Providers Beacon Integrated Partner Model Government Partners Families & Advocates “Integrated Partner Model” stressed local knowledge and management • On-site at managed care plan • Beacon clinicians co-located with Medical Management team • After School Prgrms. • Rec. Prgrms. • Housing Svcs. • Mentoring Svcs. • Faith-based agencies • BH Specialists • Primary Care • BH in Medical Home • Hospitals • Diversionary Services • Mobile Crisis Teams • Schools • Mental Health • Child Welfare • Courts • Medicaid • DD/MR • Parent Advisory Cmte. • NAMI • Consumer Strategies • Education / Outreach • Peer Specialists • Parent Advocates Beacon provides connective tissue in a fragmented system of care 15

16. The top Medicaid health plans in America have chosen, and stayed with, Beacon Top 10 Medicaid Health Plans Beacon Client since ‘09 # 2. Boston Medical Center HealthNet Plan (HMO) Beacon Client since ‘99 # 3. Fallon Community Health Plan (HMO) # 4. Neighborhood Health Plan of Massachusetts(HMO) Beacon Client since ‘96 # 5. Blue Cross Blue Shield of Rhode Island (POS) Beacon Client since ‘03 # 7. Neighborhood of Rhode Island (HMO) Beacon Client since ‘01 #2, #3, #4, #5 and #7 Medicaid Health Plans in America are Beacon Clients 16