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University Family CareProposed Change of Ownership

Community ForumAugust 25, 2014

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Purpose of Today’s Forum

Obtain your input on the proposed change of ownership for University Family Care from University of Arizona

Health Network to Banner Health

To begin, we will provide you with: A brief history of the University of Arizona Health Network and

University Family Care An overview of the proposed change of ownership An overview of AHCCCS’ process for reviewing and rendering a

decision on the proposed change of ownership

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University Family Care: Overview

Subsidiary company of The University of Arizona Health Network (UAHN) The University of Arizona Health Plans (UAHP) owns and operates UFC UAHP/UFC benefits from the efficiencies and value of being part of a larger delivery system UAHP/UFC retains the authority and control of health plan functions to ensure that the

needs of members and AHCCCS contractual obligations are met UFC has participated in the AHCCCS program since 1985 as either a direct contractor to

AHCCCS or an administrator for another health plan

UFC has demonstrated its ability to meet contractual requirements and add value to the AHCCCS program for over 27 years

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University Family Care: Mission and Vision

MissionTo ensure access to high quality, sustainable health care services to all members and to support

the educational and research mission of The University of Arizona Health Network through effective, socially and economically responsible administration of health plan programs and

community outreach efforts.

Vision We will be the preeminent leader in clinical quality, customer service and operational

performance by being the...- EASIEST health plan to work with

- most EFFICIENT in the services we deliver- most EFFECTIVE in the way we operate and seize opportunities to improve the health plan utilizing available technology, best practices, and creative problem solving to ensure optimal

results.

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University Family Care: History 1985-1998

– UFC begins participating in AHCCCS, providing health insurance to Arizona citizens eligible for Medicaid through subcontracts with commercial payers

1998 – UFC awarded a 5 year AHCCCS contract in Pima County

1999 – UFC begins offering Health Care Group coverage; a state-sponsored program that provides affordable healthcare

coverage to small businesses and their employees 2003

– Following unsuccessful bid, UFC enters into a capped enrollment contract with AHCCCS to continue to offer health insurance coverage for existing enrolled members

2005 – UFC, through an Administrative Service Agreement, begins administering Maricopa Health Plan, which is owned by

Maricopa Integrated Delivery System 2008

– UFC awarded a 5 year AHCCCS contract in 7 Arizona Counties and continues to manage MHP 2013

– UFC awarded a 5 year AHCCCS contract in 10 Arizona Counties and continues to manage MHP

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University Family CareGeographic Footprint

As of 08/01/14, UFC serves 130,277 members in 10 of 15 Arizona Counties

University Family Care: Community ContributionUFC is focused on providing high quality care to the members that we serve to improve their health status and quality of life

2013 Consumer Assessment of Healthcare Providers and Systems (CAHPS) Among the adult population, one of two Medicaid acute care health plans to receive a

four star rating or above for “rating of health plan” Among the adult and child populations, a five star and four star rating, respectively, in

the area of “customer service” 2014 Member Satisfaction Survey

Over 93% of respondents indicated that they were happy with the service received when calling University Family Care

UAHP contributes over $25 million annually into the local economies in both Tucson and Phoenix UAHP has 448 budgeted positions for fiscal year 2014 365 positions currently filled Offices in both of Arizona’s major metropolitan areas

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Proposed Change Of Ownership In June 2014, UAHN and the University of Arizona (UA) executed a Principles of Agreement

document with Banner Health to create a statewide health care organization and a comprehensive new model for academic medicine The proposed acquisition extends to UAHN and all of its affiliated companies, including

UFC Target date for the transition of UAHN and its affiliated companies to Banner is January 1,

2015 Why do we need to bring UAHN and its affiliated companies into Banner?

Enhance UAHN’s capabilities to meet its mission to support the Academic Medical Center goals of excellence in medical education, care delivery and research

To create an Arizona-based, statewide health system that improves care for the state’s citizens by reliably and compassionately delivering superior care

To create a health system that provides improved patient and member experiences at lower costs, improving the quality of care for Arizonans

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What You Can Expect If You Are a Member: No Change

– Banner Health shares UFC’s commitment to providing excellent care– You will be able to access the same services and same providers that you are able to access today without

interruption– Nothing will change about the care and services that you receive

If You Are a Provider: No Change– UFC and Banner Health are committed to offering providers the same high level of customer service that the

health plan has historically delivered– Banner Health will make no changes to the health plan’s provider network for the term of the AHCCCS

contract– Banner Health will make no changes to the composition of the current UFC leadership team and staff for the

term of the contract (barring occurrences that require personnel action consistent with standard business practice)

Notification– Members and providers will be formally notified of the change of ownership 45 days in advance of the

effective date– A dedicated customer service line will be available for members and providers from November 15, 2014 – January 1, 2015

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AHCCCS’ Role in Reviewing the Proposed Change of Ownership

AHCCCS has the authority to review and render a decision on all Arizona Medicaid health plan mergers, acquisitions, reorganizations, joint ventures and changes of ownership (see AHCCCS Contractor Operations Manual, Policy 317)

AHCCCS can take one of the following actions in rendering a decision– Approve the change of ownership without conditions – Approve the change of ownership with conditions, including, but not limited to, an open

enrollment for plan membership, more rigorous oversight for a specified period or a cap on enrollment

– Deny the change of ownership and, if the Contractor moves forward, terminate some or all of the geographic service areas that are part of the contract

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Why Is This Important to Arizona’s Medicaid Program?

AHCCCS wants to know that UFC will uphold the commitments made in its response to AHCCCS’ acute care procurement awarded in 2013, including its pledge to: Provide members with the highest quality care available without interruption Ensure access to care and work with the provider community to establish and sustain a

sufficient provider network in the 10 counties where the health plan serves as an acute care contractor

Staff the health plan with experienced, knowledgeable individuals that share UFC’s vision of functioning as a preeminent leader in clinical quality, customer service and operational performance

Effectively manage the health plan both operationally and financially AHCCCS wants to ensure that Banner Health will not affect UFC’s ability to honor

those commitments, including promises made to members, providers and the community

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Steps in the AHCCCS Review Process In order for AHCCCS to render a decision, UFC must provide the following information to AHCCCS

– Notification letter and transition plan (180 days prior to effective date), detailing/submitting• Proposed name change, if applicable• Potential/proposed organizational and staffing changes• Pertinent financial documents• Assessment of potential interruption of services to members and steps health plan is

taking to prevent interruptions• Potential/proposed changes to member information• Potential/proposed operational changes• Potential/anticipated changes to health plan’s provider network• Health plan’s communication plan related to the change of ownership

– Additional documentation required 90 and 45 days prior to effective date and 120 days subsequent to the completed change of ownership

AHCCCS reserves the right to obtain stakeholder input through a public notice and feedback process

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Where We Are Today

UFC submitted notification letter and transition plan to AHCCCS on July 1, 2014 AHCCCS issued its initial response, requesting additional information regarding the

proposed change of ownership, on July 23, 2014 UFC provided its response to AHCCCS’ July 23rd inquiry on August 22, 2014 AHCCCS will continue to take public comment until October 21, 2014 by email -

UFCAcquisitionInput@azahcccs.gov

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We Want To Hear From You

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