VANGUARD HEALTH SYSTEMS, INC.



EXHIBIT 10.57








ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM ADMINISTRATION

DIVISION OF BUSINESS AND FINANCE

SECTION A: CONTRACT





	


 1. AMENDMENT NUMBER:

     4

		
2.  CONTRACT NO.:

      YH09-0001-07

		
3.  EFFECTIVE DATE OF AMENDMENT:

      August 1, 2009

		
4.  PROGRAM:

      DHCM - ACUTE


	


 5. CONTRACTOR/PROVIDER NAME AND ADDRESS:





VHS Phoenix Health Plan, LLC

 7878 N. 16th Street, Suite 105

 Phoenix, Arizona  85020


	


 6. PURPOSE OF AMENDMENT:  To amend Section B, Capitation Rates, effective October 1, 2008 and May 1, 2009.








	
7.

	
 

	
THE CONTRACT REFERENCED ABOVE FOLLOWS

	
 

	
 


	
 

	
 

	
 

	
 

	
 


	
 

	
 

	
To amend Section B, Capitation Rates, effective October 1, 2008 and May 1, 2009.


	
 


	
 


	
NOTE:  Please sign and date all copies and then return one executed original to:    
               Mark Held

                                                                                                                                
Sr. Procurement Specialist

                                                                                                                                
AHCCS Contracts

                                                                                                                                
701 E. Jefferson St., MD 5700

                                                                                                                                
Phoenix, AZ  85034


	
 


	
8.  EXCEPT AS PROVIDED FOR HEREIN, ALL TERMS AND CONDITIONS OF THE ORIGINAL CONTRACT NOT HERETOFORE CHANGED AND/OR AMENDED REMAIN UNCHANGED AND IN FULL EFFECT.


	
 

	
 

	
 


	
IN WITNESS WHEREOF THE PARTIES HERETO SIGN THEIR NAMES IN AGREEMENT








	
9.  SIGNATURE OF AUTHORIZED REPRESENTATIVE:

	
 

	
10.  SIGNATURE OF AHCCCSA CONTRACTING OFFICER:


	
     /a/ Nancy Novick

	
 

	
       /s/ Michael Veit


	
 

	
 

	
 


	
TYPED NAME:      NANCY NOVICK

	
 

	
MICHAEL VEIT


	
TITLE:                    CHIEF EXECUTIVE OFFICER

	
 

	
CONTRACTS & PURCHASING ADMINISTRATOR


	
DATE: 7/7/09

	
 

	
DATE: JUL 02 2009



















	



Contract Rates 27 - PHP








ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM

 REVISED CAPITATION RATE SUMMARY – ACUTE RATES

 Phoenix Health Plan

 10/01/2008-9/30/2009


	
 

	
Effective 10/01/08-4/30/09


	
Title XIX and KidsCare Rates:

	
TANF

 <1, M/F

	
TANF

 1-13, M/F

	
TANF

 14-44, F

	
TANF

 14-44, M

	
TANF

 45+, M/F

	
SSI

 w/ Med

	
SSI

 w/o Med

	
Non-MED


	
4

	
Apache/Coconino/Mohave/Navajo

	
$488.98

	
$111.67

	
$267.16

	
$156.50

	
$391.07

	
$155.98

	
$744.82

	
$556.47


	
6

	
Yavapai

	
$512.27

	
$116.16

	
$272.65

	
$183.26

	
$420.26

	
$143.44

	
$750.57

	
$627.84


	
8

	
Gila/Pinal

	
$582.27

	
$108.67

	
$259.14

	
$175.82

	
$367.14

	
$145.38

	
$746.22

	
$494.78


	
10

	
Pima

	
$487.79

	
$100.17

	
$235.04

	
$126.60

	
$395.59

	
$147.19

	
$769.81

	
$467.59


	
12

	
Maricopa

	
$546.62

	
$115.95

	
$237.49

	
$144.45

	
$407.72

	
$152.99

	
$712.79

	
$591.53


	
 

	
 

	
 

	
 

	
 

	
 

	
 

	
 

	
 

	
 


	
 

	
 

	
 

	
 

	
 

	
 

	
 

	
 

	
 

	
 


	
 

	
Effective 5/01/09-9/30/09


	
Title XIX and KidsCare Rates:

	
TANF

 <1, M/F

	
TANF

 1-13, M/F

	
TANF

 14-44, F

	
TANF

 14-44, M

	
TANF

 45+, M/F

	
SSI

 w/ Med

	
SSI

 w/o Med

	
Non-MED


	
4

	
Apache/Coconino/Mohave/Navajo

	
$484.41

	
$110.52

	
$263.94

	
$154.94

	
$386.38

	
$153.61

	
$739.59

	
$551.12


	
6

	
Yavapai

	
$507.50

	
$114.86

	
$269.41

	
$181.45

	
$415.33

	
$141.37

	
$745.38

	
$621.98


	
8

	
Gila/Pinal

	
$580.79

	
$108.46

	
$258.07

	
$175.32

	
$365.52

	
$144.65

	
$745.28

	
$492.87


	
10

	
Pima

	
$484.72

	
$99.43

	
$233.00

	
$125.72

	
$392.29

	
$145.79

	
$766.11

	
$464.33


	
12

	
Maricopa

	
$544.54

	
$115.27

	
$236.21

	
$143.85

	
$405.69

	
$152.21

	
$710.78

	
$589.23