Document:

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

	
$589.23VANGUARD HEALTH SYSTEMS, INC.

EXHIBIT 10.58

ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM ADMINISTRATION

DIVISION OF BUSINESS AND FINANCE

SECTION A: CONTRACT

	

 1. AMENDMENT NUMBER:

     5

		
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.

	
7.

	
 

	
THE CONTRACT REFERENCED ABOVE FOLLOWS

	
 

	
 

	
 

	
 

	
 

	
 

	
 

	
 

	
 

	
ADD  to Section B, CAPITATION RATES after the first subparagraph add the following language:

	
 

	
 

	
 

	
 

	
 

	
“The Contractor will be paid the attached Contractor specific capitation rates retroactively, per member per month, for the period of October 1, 2008 through December 31, 2008, to increase rural hospital inpatient
reimbursement. The retroactive rate adjustment is applied to the risk adjusted capitation rates. Only the impacted rates are included on the attachment; all other rates remain unchanged. The Administration requires that the Contractor then make one-time payments to
each rural hospital as prescribed on the attached schedule, pursuant to ARS §36-2905.02, to increase inpatient reimbursement to these small rural hospitals

	
 

	
 

	
 

	
 

	
 

	
The retroactive capitation rate payment for rural hospital reimbursement will be paid after the retroactive risk adjustment capitation is paid. The Contractor shall make the prescribed payments to the rural hospitals 15 days
from receipt of the funds and submit proof of payment to the rural hospitals to the Assistant Director of the Division of Health Care Management 30 days from receipt of the funds.

	
 

	
 

	
 

	
 

	
 

	
The capitation rates for the period of January 1, 2009 through September 30, 2009, are not impacted by this amendment.”

	
 

	
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

 10/01/2008-12/31/2009

	
 

	
 

	
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

	
SSI

 w/ Med

	
SSI

 w/o Med

	
Non-MED

					
	
4

	
Apache/Coconino/Mohave/Navajo

	
$581.54

	
$120.61

	
$303.00

	
$189.38

	
$778.94

	
$592.61

					
	
6

	
Yavapai

	
$580.04

	
$122.86

	
$314.80

	
$233.94

	
$820.40

	
$680.70

					
	
8

	
Gila/Pinal

	
$603.50

	
$111.53

	
$270.48

	
$158.67

	
$771.82

	
$510.66

					

Two percent Premium tax is included in the Capitation Rates.

Payments stated without Premium Tax.

	
Phoenix Health Plan

	
 

		
Payment

	
Benson Hospital

	
 

	
$

	
–

	
Carondelet Holy Cross

		
$

	
–

	
Cobre Valley Community Hospital

		
$

	
282,054.97

	
Copper Queen Community Hospital

		
$

	
–

	
La Paz Regional Hospital

		
$

	
69,228.71

	
Little Colorado Medical Center

		
$

	
252,927.08

	
Mount Graham Regional Medical Center

		
$

	
–

	
Navapache Regional Medical Center

		
$

	
507,870.68

	
Northern Cochise Community Hospital

		
$

	
–

	
Page Hospital

		
$

	
157,179.38

	
Payson Regional Medical Center

		
$

	
809,950.88

	
Sage Memorial Hospital

		
$

	
–

	
Sierra Vista Regional Health

		
$

	
–

	
Southeastern Az Medical Center

		
$

	
–

	
Valley View Medical Center

		
$

	
452,374.48

	
Verde Valley Medical Center

		
$

	
1,289,959.83

	
White Mountain Regional Medical Center

		
$

	
42,010.35

	
Wickenburg Regional Health Center

		
$

	
10,549.44

	
YRMC East

		
$

	
166,848.19

				

	
Total

		
$

	
4,040,953.99VANGUARD HEALTH SYSTEMS, INC.

EXHIBIT 10.61

AMENDMENT NO. 4

TO

AMENDED AND RESTATED EMPLOYMENT AGREEMENT

            This Amendment No. 4 (this “Amendment’) dated as of May 5, 2009, is made by and between Vanguard Health Systems, Inc., a Delaware corporation (the
“Company”), and Charles N.  Martin, Jr. (the “Executive”).

            WHEREAS, the Company and the Executive executed a certain Amended and Restated Employment  Agreement  dated as of September 23, 2004, as
further amended  (collectively, the “EA”),  to secure the services of the Executive as Chief Executive Officer and Chairman of the Board; and

            WHEREAS, the Company and the Executive wish the Executive’s base salary set forth in Section 6(a) of the EA to be increased to $1,098,079,
effective as of April 1, 2009.

            NOW, THEREFORE, in consideration of the premises and the mutual covenants herein contained, the Company and the Executive hereby agree that the EA is
amended as follows:

            1.         Defined Terms.  Except for those terms defined above, the definitions of capitalized terms used
in this Amendment are as provided in the EA.

            2.         Amendment to Section 6(a).  Section 6(a) of the EA entitled “Base Salary” is
hereby  deleted and replaced with the following new Section 6(a):

                        “(a)  Base Salary.  Effective April 1, 2009, the
Executive’s base salary hereunder

                         shall be $1,098,079 per year, payable semi-monthly. Commencing July 1, 2010, the

                         Board shall review such base salary at least annually and make such adjustments from

                         time to time as it may deem advisable, but the base salary shall not at any time be

                         reduced from the base salary in effect from time to time.”

            3.         Ratification.  All other provisions of the EA remain unchanged and are hereby 
ratified  by the Company and the Executive.

1

            IN WITNESS WHEREOF, the Company has caused this Amendment to be executed by  its duly authorized officer and the Executive has executed this
Amendment, each as of the day and year first set forth above.

                                                                       
Vanguard Health Systems, Inc.

                                                                       
By:/s/ Ronald P. Soltman                                 

                                                                                   
Ronald P. Soltman

                                   
                                               
Executive Vice President

                                                                       
Executive:

                                                                       
/s/ Charles N. Martin, Jr.                                 

                                                                       
Charles N. Martin, Jr.

2

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00162-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00162-of-00352.parquet"}], [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00162-of-00352.parquet"}]]