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                                                                   EXHIBIT 10.17

                              AMENDED AND RESTATED
                         SEVERANCE PROTECTION AGREEMENT

      THIS AMENDED AND RESTATED SEVERANCE AGREEMENT (this "AGREEMENT") dated as
of September 23, 2004, is made by and between Vanguard Health Systems, Inc., a
Delaware corporation (the "COMPANY"), and [NAME] (the "Executive").

      WHERAS, the Company and the Executive executed a severance protection
agreement (the "EXISTING PROTECTION AGREEMENT") dated as of June 1, 1998;

      WHEREAS, the Company has entered into an agreement and plan of merger by
and among VHS Holdings LLC, Health Systems Acquisition Corp. and the Company,
dated as of July 23, 2004 (the "MERGER AGREEMENT") whereby the Health Systems
Corp. will merge into the Company with the Company as the surviving corporation;

      WHEREAS, the Company considers it essential to the best interests of its
shareholders to foster the continuous employment of key management personnel;
and

      WHEREAS, the Board of the Company (the "BOARD") recognizes that the
possibility of a Change in Control (as defined in the last Section hereof)
exists and that such possibility, and the uncertainty and questions which it may
raise among management, may result in the departure or distraction of management
personnel to the detriment of the Company and its shareholders; and

      WHEREAS, the Board has determined that appropriate steps should be taken
to reinforce and encourage the continued attention and dedication of members of
the Company's management, including the Executive, to their assigned duties
without distraction in the face of potentially disturbing circumstances arising
from the possibility of a Change in Control;

      WHEREAS, the Company and the Executive desire to amend and restate the
Existing Protection Agreement as set forth herein; and

      NOW THEREFORE, in consideration of the promises and the mutual covenants
herein contained, the Company and the Executive hereby agree as follows:

      1. Defined Terms. Except for those terms defined above, the definition of
capitalized terms used in this Agreement is provided in the last Section hereof.

      2. Term of Agreement. This Agreement shall commence on the date hereof and
shall continue in effect through December 31, 2004; provided, however, that
commencing on January 1, 2005 and each January 1 thereafter, the term of this
Agreement shall automatically be extended for one additional year unless, not
later than September 30 of the preceding year, the Company shall have given
notice not to extend this Agreement; and provided, further, however, that the
Company agrees that it shall not give such notice prior to the third anniversary
of the date first written above; and provided further, however, that if a Change
in Control shall have

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occurred during the term of this Agreement, this Agreement shall continue in
effect for a period of not less than thirty-six (36) months beyond the month in
which such Change in Control occurred. Furthermore, if the Executive's
employment with the Company shall be terminated prior to a Change in Control,
this Agreement shall automatically expire.

      3. Company's Covenants Summarized. In order to induce the Executive to
remain in the employ of the Company and in consideration of the Executive's
covenants set forth in Section 4 hereof, the Company agrees, under the
conditions described herein, to pay the Executive the Severance Payments
described in Section 6.1 hereof and the other payments and benefits described
herein in the event the Executive's employment with the Company is terminated
following a Change in Control and during the term of this Agreement. No amount
or benefit shall be payable under this Agreement unless there shall have been
(or, under the terms hereof, there shall be deemed to have been) a termination
of the Executive's employment with the Company following a Change in Control.
This Agreement shall not be construed as creating an express or implied contract
of employment and, except as otherwise agreed in writing between the Executive
and the Company, the Executive shall not have any right to be retained in the
employ of the Company.

      4. The Executive's Covenants. The Executive agrees that, subject to the
terms and conditions of this Agreement, in the event of a Potential Change in
Control during the term of this Agreement, the Executive will remain in the
employ of the Company until the earliest of (i) a date which is six (6) months
from the date of such Potential Change in Control, (ii) the date of a Change in
Control, (iii) the date of termination by the Executive of the Executive's
employment for Good Reason (determined by treating the Potential Change in
Control as a Change in Control in applying the definition of Good Reason), or by
reason of death, Disability or Retirement, or (iv) the termination by the
Company of the Executive's employment for any reason.

      5. Compensation Other Than Severance Payments.

            5.1 Following a Change in Control and during the term of this
      Agreement, during any period that the Executive fails to perform the
      Executive's full-time duties with the Company as a result of incapacity
      due to physical or mental illness, the Company shall pay the Executive's
      full salary to the Executive at the rate in effect at the commencement of
      any such period, together with all compensation and benefits payable to
      the Executive under the terms of any compensation or benefit plan, program
      or arrangement maintained by the Company during such period, until the
      Executive's employment is terminated by the Company for Disability.

            5.2 If the Executive's employment shall be terminated for any reason
      following a Change in Control and during the term of this Agreement, the
      Company shall pay the Executive's full salary to the Executive through the
      Date of Termination at the rate in effect at the time the Notice of
      Termination is given, together with all compensation and benefits payable
      to the Executive through the Date of Termination under the terms of any
      compensation or benefit plan, program or arrangement maintained by the
      Company during such period.

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            5.3 If the Executive's employment shall be terminated for any reason
      following a Change in Control and during the term of this Agreement, the
      Company shall pay to the Executive a lump sum amount, in cash, equal to
      the sum of (i) any incentive compensation which has been allocated or
      awarded to the Executive for a completed fiscal year or other measuring
      period preceding the Date of Termination under any incentive plan but has
      not yet been paid (pursuant to Section 5.2 hereof or otherwise), and (ii)
      a pro rata portion to the Date of Termination of the value of any
      contingent incentive compensation award to the Executive for all
      uncompleted periods under the plan for the year (or other measuring
      period) in which the Date of Termination occurs calculated by multiplying
      the target amount the Executive could have earned under such plan by a
      fraction, the numerator of which is the number of full months the
      Executive was employed by the Company during the fiscal year of the
      Company in which the Date of Termination occurs and the denominator of
      which is 12.

            5.4 If the Executive's employment shall be terminated for any reason
      following a Change in Control and during the term of this Agreement, the
      Company shall pay the Executive's normal post-termination compensation and
      benefits to the Executive as such payments become due. Such
      post-termination compensation and benefits shall be determined under, and
      paid in accordance with the provisions of, the Company's compensation or
      benefit plans, programs and arrangements.

      6. Severance Payments.

            6.1 Subject to Section 6.2 hereof, the Company shall pay the
      Executive the payments described in this Section 6.1 (the "SEVERANCE
      PAYMENTS") upon the termination of the Executive's employment following a
      Change in Control and during the term of this Agreement, in addition to
      the payments and benefits described in Section 5 hereof, unless such
      termination is (i) by the Company for Cause, (ii) by reason of death,
      Disability or Retirement, or (iii) by the Executive without Good Reason.
      The Executive's employment shall be deemed to have been terminated
      following a Change in Control by the Company without Cause or by the
      Executive with Good Reason if the Executive's employment is terminated
      prior to a Change in Control without Cause at the direction of a Person
      who (i) has entered into an agreement with the Company the consummation of
      which will constitute a Change in Control or (ii) has caused a Potential
      Change in Control to occur, or if the Executive terminates his employment
      with Good Reason prior to a Change in Control (determined by treating a
      Potential Change in Control as a Change in Control in applying the
      definition of Good Reason) if the circumstance or event which constitutes
      Good Reason occurs at the direction of such Person.

                  (a) In lieu of any further salary payments to the Executive
            for periods subsequent to the Date of Termination and in lieu of any
            severance benefit otherwise payable to the Executive, the Company
            shall pay to the Executive a lump sum severance payment, in cash,
            equal to [200% or 250%] of the sum of (i)

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            the higher of the Executive's annual base salary in effect
            immediately prior to the occurrence of the event or circumstance
            upon which the Notice of Termination is based or in effect
            immediately prior to the Change in Control, and (ii) the higher of
            the target amount which the Executive could have earned under the
            Company's annual incentive plan in the year in which the Date of
            Termination occurs or such target amount in the year in which the
            Change in Control occurs.

                  (b) For an eighteen (18) month period after the Date of
            Termination, the Company shall, at its cost (provided that Executive
            shall continue to be responsible to pay the standard employee
            portion of such cost), arrange to provide the Executive with life,
            disability, accident, health and dental insurance benefits
            substantially similar to those which the Executive is receiving
            immediately prior to the Notice of Termination (without giving
            effect to any reduction in such benefits subsequent to a Change in
            Control which reduction constitutes Good Reason). Benefits otherwise
            receivable by the Executive pursuant to this Section 6.1(b) shall be
            reduced to the extent comparable benefits are actually received by
            or made available to the Executive by a new employer of the
            Executive without cost during the eighteen (18) month period
            following the Executive's termination of employment (and any such
            benefits actually received by the Executive shall be reported to the
            Company by the Executive). If the benefits provided to the Executive
            under this Section 6.1(b) shall result in a decrease, pursuant to
            Section 6.2, in the Severance Payments and these Section 6.1(b)
            benefits are thereafter reduced pursuant to the immediately
            preceding sentence because of the receipt of comparable benefits,
            the Company shall, at the time of such reduction, pay to the
            Executive the lesser of (A) the amount of the decrease made in the
            Severance Payments pursuant to Section 6.2, or (B) the maximum
            amount which can be paid to the Executive without being, or causing
            any other payment to be, nondeductible by reason of Section 280G of
            the Code.

            6.2 Notwithstanding any other provisions of this Agreement (except
      the provisions of Section 6.5 below), in the event that any payment or
      benefit received or to be received by the Executive in connection with a
      Change in Control or the termination of the Executive's employment
      (whether pursuant to the terms of this Agreement or any other plan,
      arrangement or agreement with the Company, any Person whose actions result
      in a Change in Control or any Person affiliated with the Company or such
      Person) (all such payments and benefits, including the Severance Payments,
      being hereinafter called "TOTAL PAYMENTS") would not be deductible (in
      whole or part), by the Company, an affiliate or any Person making such
      payment or providing such benefit as a result of Section 280G of the Code,
      then, to the extent necessary to make such portion of the Total Payments
      deductible (and after taking into account any reduction in the Total
      Payments provided by reason of Section 280G of the Code in such other
      plan, arrangement or agreement), (A) the cash Severance Payments shall
      first be reduced (if necessary, to zero), and (B) all other non-cash
      Severance Payments shall next be reduced (if necessary, to zero). For
      purposes of this limitation, (i) no portion of the Total Payments the
      receipt or enjoyment of which the Executive shall have effectively waived
      in writing prior to the

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      Date of Termination shall be taken into account, (ii) no portion of the
      Total Payments shall be taken into account which in the opinion of tax
      counsel selected by the Company's independent auditors and reasonably
      acceptable to the Executive does not constitute a "PARACHUTE PAYMENT"
      within the meaning of Section 280G(b)(2) of the Code, including by reason
      of Section 280G(b)(4)(A) of the Code, (iii) the Severance Payments shall
      be reduced only to the extent necessary so that the Total Payments (other
      than those referred to in clauses (i) or (ii)) in their entirety
      constitute reasonable compensation for services actually rendered within
      the meaning of Section 280G(b)(4)(B) of the Code or are otherwise not
      subject to disallowance as deductions, in the opinion of the tax counsel
      referred to in clause (ii); and (iv) the value of any non-cash benefit or
      any deferred payment or benefit included in the Total Payments shall be
      determined by the Company's independent auditors in accordance with the
      principles of Sections 280G(d)(3) and (4) of the Code.

            If it is established pursuant to a final determination of a court or
      an Internal Revenue Service proceeding that, notwithstanding the good
      faith of the Executive and the Company in applying the terms of this
      Section 6.2, the aggregate "parachute payments" paid to or for the
      Executive's benefit are in an amount that would result in any portion of
      such "parachute payments" not being deductible by reason of Section 280G
      of the Code, then the Executive shall have an obligation to pay the
      Company upon demand an amount equal to the excess of the aggregate
      "parachute payments" paid to or for the Executive's benefit over the
      aggregate "parachute payments" that could have been paid to or for the
      Executive's benefit without any portion of such "parachute payments" not
      being deductible by reason of Section 280G of the Code.

            6.3 The payments provided for in Section 6.1 (other than Section
      6.1(b)) hereof shall be made not later than the fifth day following the
      Date of Termination, provided, however, that if the amounts of such
      payments, and the limitation on such payments set forth in Section 6.2
      hereof, cannot be finally determined on or before such day, the Company
      shall pay to the Executive on such day an estimate, as determined in good
      faith by the Company, of the minimum amount of such payments to which the
      Executive is clearly entitled and shall pay the remainder of such payments
      (together with interest at the rate provided in Section 1274(b)(2)(B) of
      the Code) as soon as the amount thereof can be determined but in no event
      later than the thirtieth (30th) day after the Date of Termination. In the
      event that the amount of the estimated payments exceeds the amount
      determined by the Company within six (6) months after payment to have been
      due, such excess shall be paid by the Executive to the Company, no later
      than the thirtieth (30th) business day after demand by the Company. At the
      time that payments are made under this Section, the Company shall provide
      the Executive with a written statement setting forth the manner in which
      such payments were calculated and the basis for such calculations
      including, without limitation, any opinions or other advice the Company
      has received from outside counsel, auditors or consultants (and any such
      opinions or advice which are in writing shall be attached to the
      statement).

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            6.4 Following a Change in Control (or a termination described in the
      second sentence of Section 6.1), the Company also shall pay to the
      Executive all legal fees and related expenses (including costs of experts,
      evidence and counsel) incurred by the Executive as a result of any dispute
      in connection with a termination of the Executive's employment, whether or
      not such dispute is resolved in the Executive's favor, but only if the
      dispute is pursued by the Executive in good faith (including all such fees
      and expenses, if any, incurred in respect of a dispute relating to any
      such termination or in the Executive seeking in good faith to obtain or
      enforce any benefit or right provided by this Agreement (or by any other
      plan or arrangement maintained by the Company under which the Executive is
      or may be entitled to receive benefits) or in connection with any tax
      audit or proceeding to the extent attributable to the application of
      Section 4999 of the Code to any payment or benefit provided hereunder).
      Such payments shall be made to the Executive within five (5) business days
      after delivery of the Executive's written requests for payment accompanied
      by evidence of fees and expenses incurred.

      7. Termination Procedures and Compensation During Dispute.

            7.1 Notice of Termination. After a Change in Control and during the
      term of this Agreement, any purported termination of the Executive's
      employment (other than by reason of death) shall be communicated by
      written Notice of Termination from one party hereto to the other party
      hereto in accordance with Section 10 hereof. For purposes of this
      Agreement, a "NOTICE OF TERMINATION" shall mean a notice which shall
      indicate the specific termination provision or provisions in this
      Agreement relied upon and shall set forth in reasonable detail the facts
      and circumstances claimed to provide a basis for termination of the
      Executive's employment under the provision so indicated.

            7.2 Date of Termination. "DATE OF TERMINATION", with respect to any
      purported termination of the Executive's employment after a Change in
      Control and during the term of this Agreement, shall mean (i) if the
      Executive's employment is terminated for Disability, thirty (30) days
      after Notice of Termination is given (provided that the Executive shall
      not have returned to the full-time performance of the Executive's duties
      during such thirty (30) day period), and (ii) if the Executive's
      employment is terminated for any other reason, the date specified in the
      Notice of Termination (which, in the case of a termination by the Company,
      shall not be less than thirty (30) days (except in the case of a
      termination for Cause) and, in the case of a termination by the Executive,
      shall not be less than fifteen (15) days nor more than sixty (60) days,
      respectively, from the date such Notice of Termination is given);
      provided, that in the case of a termination for Cause, nothing herein
      shall prevent the Company from immediately terminating the Executive's
      employment, so long as the Company continues to meet all of its
      responsibilities hereunder with respect to payment of salary, benefits and
      other obligations during the minimum notice period described in this
      Section 7.2 (and for purposes of measuring such obligations, the Date of
      Termination shall be deemed to be the end of such minimum notice period).

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            7.3 Dispute Concerning Termination. If within fifteen (15) days
      after any Notice of Termination is given, the party receiving such Notice
      of Termination notifies the other party that a dispute exists concerning
      the termination, the dispute shall be resolved promptly, either by mutual
      written agreement of the parties or by a final court judgment or order.
      Any court action brought by a party to this Agreement shall be brought and
      maintained in a court of competent jurisdiction in Davidson County, in the
      State of Tennessee, and the parties hereto hereby consent to the
      jurisdiction of such courts.

            7.4 Interest After Dispute Settled. If a purported termination
      occurs following a Change in Control and during the term of this
      Agreement, and such termination is disputed in accordance with Section 7.3
      hereof, then if such dispute is resolved by payment to the Executive of
      any cash payment, the Company shall in addition pay the Executive interest
      at 10% per annum on all such cash ultimately paid to the Executive as a
      result of settlement of any such dispute from the Date of Termination.

      8. No Mitigation. The Company agrees that, if the Executive's employment
by the Company is terminated during the term of this Agreement, the Executive is
not required to seek other employment or to attempt in any way to reduce any
amounts payable to the Executive by the Company pursuant to Section 6. Further,
the amount of any payment or benefit provided for in Section 6 (other than
Section 6.1(b)) shall not be reduced by any compensation earned by the Executive
as the result of employment by another employer, by retirement benefits, by
offset against any amount claimed to be owed by the Executive to the Company, or
otherwise.

      9. Successors; Binding Agreement.

            9.1 In addition to any obligations imposed by law upon any successor
      to the Company, the Company will require any successor (whether direct or
      indirect, by purchase, merger, consolidation or otherwise) to all or
      substantially all of the business and/or assets of the Company (the
      "SUCCESSOR") to expressly assume and agree to perform this Agreement in
      the same manner and to the same extent that the Company would be required
      to perform it if no such succession had taken place; provided if the
      Company is acquired by merger with a subsidiary of a Person, then such
      Person shall be the Successor unless such Person principally does its
      hospital management business in such subsidiary or in another subsidiary
      of such Person in which case the subsidiary principally doing the hospital
      management company business of the Person shall be the Successor. Failure
      of the Company to obtain such assumption and agreement prior to the
      effectiveness of any such succession, after notice by the Executive to the
      Company and, if practicable, a reasonable opportunity to cure such
      failure, shall be a breach of this Agreement and shall entitle the
      Executive to compensation from the Company in the same amount and on the
      same terms as the Executive would be entitled to hereunder if the
      Executive were to terminate the Executive's employment for Good Reason
      after a Change in Control, except that, for purposes of implementing the
      foregoing, the date on which any such succession becomes effective shall
      be deemed the Date of Termination.

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            9.2 This Agreement shall inure to the benefit of and be enforceable
      by the Executive's personal or legal representatives, executors,
      administrators, successors, heirs, distributees, devisees and legatees. If
      the Executive shall die while any amount would still be payable to the
      Executive hereunder if the Executive had continued to live, all such
      amounts, unless otherwise provided herein, shall be paid in accordance
      with the terms of this Agreement to the executors, personal
      representatives or administrators of the Executive's estate.

      10. Notices. For the purpose of this Agreement, notices and all other
communications provided for in the Agreement shall be in writing and shall be
deemed to have been duly given when personally delivered or when mailed by
United States certified mail, return receipt requested, postage prepaid,
addressed to the respective addresses set forth below, or to such other address
as either party may have furnished to the other in writing in accordance
herewith, except that notice of change of address shall be effective only upon
actual receipt:

                  To the Company:

                  Vanguard Health Systems, Inc.
                  20 Burton Hills Boulevard
                  Suite 100
                  Nashville, TN 37215
                  Attention: Chief Executive Officer

                  with a copy to:

                  VHS Holdings LLC
                  c/o Blackstone Management Associates IV LLC
                  345 Park Avenue
                  New York, NY 10154
                  Attention: Neil Simpkins
                  and a copy to:

                  Simpson Thacher & Bartlett LLP
                  425 Lexington Avenue
                  New York, NY 10017-3954
                  Attention: Brian Robbins

                  To the Executive:

                  [NAME]
                  [ADDRESS]

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      11. Miscellaneous. No provision of this Agreement may be modified, waived
or discharged (collectively a "WAIVER") unless the Waiver is agreed to in
writing and signed by the Executive and an officer of the Company and sets forth
in reasonable detail the facts and circumstances which are the subject of the
Waiver. No waiver by either party hereto at any time of any breach by the other
party hereto of, or compliance with, any condition or provision of this
Agreement to be performed by such other party shall be deemed a waiver of
similar or dissimilar provisions or conditions at the same or at any prior or
subsequent time. No agreements or representations, oral or otherwise, express or
implied, with respect to the subject matter hereof have been made by either
party which are not expressly set forth in this Agreement. The validity,
interpretation, construction and performance of this Agreement shall be governed
by the laws of the State of Tennessee, without regard to such state's conflict
of laws rules. All references to sections of the Exchange Act or the Code shall
be deemed also to refer to any successor provisions to such sections. Any
payments provided for hereunder shall be paid net of any applicable withholding
required under federal, state or local law and any additional withholding to
which the Executive has agreed. The obligations of the Company and the Executive
under Sections 6 and 7 shall survive the expiration of the term of this
Agreement.

      12. Validity. The invalidity or unenforceability or any provision of this
Agreement shall not affect the validity or enforceability of any other provision
of this Agreement, which shall remain in full force and effect.

      13. Counterparts. This Agreement may be executed in several counterparts,
each of which shall be deemed to be an original but all of which together will
constitute one and the same instrument.

      14. Definitions. For purposes of this Agreement, the following terms shall
have the meanings indicated below:

            14.1 "BENEFICIAL OWNER" shall have the meaning defined in Rule 13d-3
      under the Exchange Act.

            14.2 "CAUSE" for termination by the Company of the Executive's
      employment, after any Change in Control, shall mean (i) the conviction of
      the Executive, by a court of competent jurisdiction and following the
      exhaustion of all possible appeals, of a criminal act classified as a
      felony or involving moral turpitude, (ii) the willful and continued
      failure by the Executive to substantially perform the Executive's duties
      with the Company (other than any such failure resulting from the
      Executive's incapacity due to physical or mental illness or any such
      actual or anticipated failure after the issuance of a Notice of
      Termination for Good Reason by the Executive pursuant to Section 7.1)
      after a written demand for substantial performance is delivered to the
      Executive by the Company, which demand specifically identifies the manner
      in which the Company believes that the Executive has not substantially
      performed the Executive's duties, or (iii) the willful engaging by the
      Executive in conduct which is demonstrably and materially injurious to the
      Company or its subsidiaries, monetarily or otherwise. For purposes of
      clauses (ii) and (iii) of this definition, no act, or failure to act, on
      the Executive's part shall be deemed "willful" unless done, or omitted to
      be done, by the Executive not in

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      good faith and without reasonable belief that the Executive's act, or
      failure to act, was in the best interest of the Company.

            14.3 "BOARD" shall mean the Board of Directors of the Company.

            14.4 A "CHANGE IN CONTROL" shall be deemed to have occurred if the
      conditions set forth in any one of the following paragraphs shall have
      been satisfied:

                  (a) any Person is or becomes the Beneficial Owner, directly or
            indirectly, of securities of the Company representing more than 50%
            of the combined voting power of the Company's then outstanding
            voting securities; or

                  (b) during any period of not more than two consecutive years
            (not including any period prior to the execution of this Agreement),
            individuals who at the beginning of such period constitute the
            Board, and any new director (other than a director designated by a
            Person who has entered into an agreement with the Company to effect
            a transaction described in clause (a), (c) or (d) of this paragraph)
            whose election by the Board or nomination for election by the
            Company's shareholders was approved by a vote of at least two-thirds
            (2/3) of the directors then still in office who either were
            directors at the beginning of the period or whose election or
            nomination for election was previously so approved, cease for any
            reason to constitute at least a majority thereof; or

                  (c) the shareholders of the Company approve a merger or
            consolidation of the Company with any other corporation, other than
            both (A) (i) a merger or consolidation which would result in the
            voting securities of the Company outstanding immediately prior
            thereto continuing, directly or indirectly, to represent (either by
            remaining outstanding or by being converted into voting securities
            of the surviving or parent entity), 50% or more of the combined
            voting power of the voting securities of the Company or such
            surviving or parent entity outstanding immediately after such merger
            or consolidation, or (ii) a merger or consolidation in which no
            Person acquires 50% or more of the combined voting power of the
            Company's then outstanding securities; and (B) immediately after the
            consummation of such merger or consolidation described in clause
            (A)(i) or (A)(ii) above (and for at least 180 days thereafter) any
            one of the Company's Chief Executive Officer, Chief Operating
            Officer and Chief Financial Officer do not change from the people
            occupying such positions immediately prior to such merger or
            consolidation except as a result of their death or Disability and
            none of such officers shall have changed prior to such merger or
            consolidation at the direction of a Person who has entered into an
            agreement with the Company the consummation of which will constitute
            a Change in Control or who has caused a Potential Change in Control
            to occur; or

                  (d) the shareholders of the Company approve (A) a plan of
            complete liquidation of the Company or (B) an agreement for the sale
            or disposition by the

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            Company of all or substantially all the Company's assets (or other
            transaction having a similar effect); or

                  (e) any Potential Change in Control occurs and the Company
            within one (1) year thereafter gives notice to the Executive not to
            extend this Agreement as provided in Section 2.

      For purposes of Section 14.4(a), 14.4(c), and 14.4(d)(B) of this Agreement
      only, the "Company" shall mean any of Vanguard Health Systems, Inc.,
      Vanguard Health Holding Company I, LLC, or Vanguard Health Holding Company
      II, LLC; provided that, any reorganization involving solely the "Company"
      and its subsidiaries shall not constitute a change in control under this
      agreement. Notwithstanding any provision under Section 14.4 of this
      Agreement, a Change in Control shall not include (A) any transaction where
      (i) all of the Company's Chief Executive Officer, Chief Operating Officer
      and Chief Financial Officer do not change both immediately after the
      Change in Control and for at least 180 days thereafter except as a result
      of their death or Disability and (ii) none of such officers shall have
      changed prior to the Change in Control at the direction of a Person who
      has entered into an agreement with the Company the consummation of which
      will constitute a Change in Control or who has caused a Potential Change
      in Control to occur; or (B) the transactions contemplated by the Merger
      Agreement.

            14.5 "CODE" shall mean the Internal Revenue Code of 1986, as amended
      from time to time.

            14.6 "COMPANY" shall mean Vanguard Health Systems, Inc. and any
      successor to its business and/or assets which assumes and agrees to
      perform this Agreement by operation of law, or otherwise including,
      without limitation, any Person required to assume this Agreement as the
      Successor pursuant to Section 9.1 (except in determining, under Section
      14.4 hereof, whether or not any Change in Control of the Company has
      occurred in connection with such succession).

            14.7 "DATE OF TERMINATION" shall have the meaning stated in Section
      7.2 hereof.

            14.8 "DISABILITY" shall be deemed the reason for the termination by
      the Company of the Executive's employment, if, as a result of the
      Executive's incapacity due to physical or mental illness, the Executive
      shall have been absent from the full-time performance of the Executive's
      duties with the Company for a period of six (6) consecutive months, the
      Company shall have given the Executive a Notice of Termination for
      Disability, and, within thirty (30) days after such Notice of Termination
      is given, the Executive shall not have returned to the full-time
      performance of the Executive's duties.

            14.9 "EXCHANGE ACT" shall mean the Securities Exchange Act of 1934,
      as amended from time to time.

                                      -11-
<PAGE>

            14.10 "EXECUTIVE" shall mean the individual named in the first
      paragraph of this Agreement.

            14.11 "GOOD REASON" for termination by the Executive of the
      Executive's employment shall mean the occurrence (without the Executive's
      express written consent) of any one of the following acts by the Company,
      or failures by the Company to act, unless, in the case of any act or
      failure to act described below, such act or failure to act is corrected
      prior to the Date of Termination specified in the Notice of Termination
      given in respect thereof:

                  (a) any change in the Executive's title, authorities,
            responsibilities (including reporting responsibilities) which, in
            the Executive's reasonable judgment, represents an adverse change
            from his status, title, position or responsibilities (including
            reporting responsibilities) which were in effect immediately prior
            to the Change in Control or from his status, title, position, or
            responsibilities (including reporting responsibilities) which were
            in effect following a Change in Control pursuant to the Executive's
            consent to accept any such change; the assignment to him of any
            duties or work responsibilities which, in his reasonable judgment,
            are inconsistent with such status, title, position or work
            responsibilities; or any removal of the Executive from, or failure
            to reappoint or reelect him to any of such positions, except if any
            such changes are because of Disability, Retirement, death or Cause;

                  (b) a reduction by the Company in the Executive's annual base
            salary as in effect on the date hereof or as the same may be
            increased from time to time except for across-the-board salary
            reductions similarly affecting all senior executives of the Company
            and all senior executives of any Person in control of the Company;

                  (c) the relocation of the Executive's office at which he is to
            perform his duties, to a location more than thirty (30) miles from
            the location at which the Executive performed his duties prior to
            the Change in Control, except for required travel on the Company's
            business to an extent substantially consistent with his business
            travel obligations prior to the Change in Control;

                  (d) if the Executive had been based at the Company's principal
            executive offices immediately prior to the Change in Control, the
            relocation of the Company's principal executive offices to a
            location more than 30 miles from the location of such offices
            immediately prior to the Change in Control;

                  (e) the failure by the Company, without the Executive's
            consent, to pay to the Executive any portion of the Executive's
            current compensation, or to pay to the Executive any portion of an
            installment of deferred compensation under any deferred compensation
            program of the Company, within seven (7) days of the date such
            compensation is due;

                                      -12-
<PAGE>

                  (f) the failure by the Company to continue in effect any
            stock-based and/or cash annual or long-term incentive compensation
            plan in which the Executive participates immediately prior to the
            Change in Control, unless the Executive participates after the
            Change in Control in other comparable plans generally available to
            senior executives of the Company and senior executives of any Person
            in control of the Company;

                  (g) the failure by the Company to continue to provide the
            Executive with benefits substantially similar in value to the
            Executive in the aggregate to those enjoyed by the Executive under
            any of the Company's pension, life insurance, medical, health and
            accident, or disability plans in which the Executive was
            participating immediately prior to the Change in Control, unless the
            Executive participates after the Change in Control in other
            comparable benefit plans generally available to senior executives of
            the Company and senior executives of any Person in control of the
            Company;

                  (h) the adverse and substantial alteration of the nature and
            quality of the office space within which the Executive performed his
            duties prior to a Change in Control as well as in the secretarial
            and administrative support provided to the Executive; provided,
            however, that a reasonable alteration of the secretarial or
            administrative support provided to the Executive as a result of
            reasonable measures implemented by the Company to effectuate a
            cost-reduction or consolidation program shall not constitute Good
            Reason hereunder;

                  (i) any material breach by the Company of any provision of
            this Agreement; or

                  (j) any purported termination of the Executive's employment
            which is not effected pursuant to a Notice of Termination satisfying
            the requirements of Section 7.1; for purposes of this Agreement, no
            such purported termination shall be effective.

      The Executive's right to terminate the Executive's employment for Good
      Reason shall not be affected by the Executive's incapacity due to physical
      or mental illness, unless Executive shall have incurred a Disability;
      provided, that the temporary assignment of the Executive's
      responsibilities to another employee of the Company during the period of
      the Executive's incapacity shall not itself constitute Good Reason. The
      Executive's continued employment shall not constitute consent to, or a
      waiver of rights with respect to, any act or failure to act constituting
      Good Reason hereunder.

            14.12 "NOTICE OF TERMINATION" shall have the meaning stated in
      Section 7.1 hereof.

                                      -13-
<PAGE>

            14.13 "PERSON" shall have the meaning given in Section 3(a)(9) of
      the Exchange Act, as modified and used in Section 13(d) and 14(d) thereof;
      however, a Person shall not include (i) the Company or any of its
      subsidiaries, (ii) any trustee or other fiduciary holding securities under
      an employee benefit plan of the Company or any of its subsidiaries, (iii)
      an underwriter temporarily holding securities pursuant to an offering of
      such securities, (iv) any entity owned, directly or indirectly, by the
      stockholders of the Company in substantially the same proportions as their
      ownership of the Company's common stock, (v) any person or entity that is
      a stockholder of the Company as of the date hereof and any affiliates of
      such person or entity, or (vi) Blackstone (as defined in the Company's
      2004 Stock Incentive Plan) or its affiliates.

            14.14 "POTENTIAL CHANGE IN CONTROL" shall be deemed to have occurred
      if the conditions set forth in any one of the following paragraphs shall
      have been satisfied:

                  (a) the Company enters into an agreement, the consummation of
            which would result in the occurrence of a Change in Control;

                  (b) the Company or any Person publicly announces an intention
            to take or to consider taking actions which, if consummated, would
            constitute a Change in Control;

                  (c) any Person who is or becomes the Beneficial Owner,
            directly or indirectly, of securities of the Company representing
            10% or more of the combined voting power of the Company's then
            outstanding securities increases such Person's beneficial ownership
            of such securities by 5% or more of the combined voting power of the
            Company's then outstanding securities (not including in the
            securities beneficially owned by such Person any securities acquired
            directly from the Company); or

                  (d) the Board adopts a resolution to the effect that, for
            purposes of this Agreement, a Potential Change in Control has
            occurred.

            14.15 "RETIREMENT" shall be deemed the reason for the termination by
      the Company or the Executive of the Executive's employment if such
      employment is terminated in accordance with the Company's retirement
      policy or qualified retirement plan, not including early retirement,
      generally applicable to its salaried employees, as in effect immediately
      prior to the Change in Control, or in accordance with any retirement
      arrangement established with the Executive's consent with respect to the
      Executive.

            14.16 "SEVERANCE PAYMENTS" shall mean those payments described in
      Section 6.1 hereof.

            14.17 "SUCCESSOR" is defined in Section 9.1.

                                      -14-
<PAGE>

            14.18 "TOTAL PAYMENTS" shall mean those payments described in
      Section 6.2 hereof.

            14.19 "WAIVER" is defined in Section 11.

               [REMAINDER OF THIS PAGE INTENTIONALLY LEFT BLANK.]

                                      -15-
<PAGE>

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

                                    VANGUARD HEALTH SYSTEMS, INC.

                                    By: _____________________________
                                        Ronald P. Soltman
                                        Executive Vice President

                                    EXECUTIVE:
                                    _________________________________
                                    Name:
                                    Title:

               [Signature Page to Severance Protection Agreement]<PAGE>

                                                                   EXHIBIT 10.22

           ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM ADMINISTRATION
                        DIVISION OF BUSINESS AND FINANCE
                               CONTRACT AMENDMENT
                                                    Page 1 of 3 Plus Attachments

================================================================================
1.  AMENDMENT NO.: 2. CONTRACT NO.: 3. Effective Date of Amendment:  4. Program:
       07              YH04-0001-06         April 1, 2004               DBF-TPL
--------------------------------------------------------------------------------
5. CONTRACTOR/PROVIDER NAME AND ADDRESS:

                   Phoenix Health Plan / Community Connection
                              1209 South 7th Avenue
                             Phoenix, Arizona 85007
------------------------------------------------------------------------------
6. PURPOSE: To add Credit Balance Review services to assist in cost efficiency
            for the health plans.
==============================================================================

7. The above referenced contract is hereby amended as follows:

      A.    Pursuant to the agreement on page 79, Contract Clauses, paragraph #
            30, Changes; this contract is being modified to include the Credit
            Balance Review Project. This service is being made available under
            the AHCCCS contract with Public Consulting Group (PCG). The details
            of this program are provided on page 2 of this amendment.

      B.    This pilot program shall be reviewed at the close of one full cycle
            to determine the effectiveness of the program. At that time a
            determination shall be made whether to continue the program. In the
            event it is decided to continue the program, it cannot continue
            beyond the statutory term of the governing contract that ends March
            2008.

      C.    Credit balance refund payments will be forwarded to PCG who will
            identify and verify the balance. PCG will forward all collected
            monies to AHCCCS. AHCCCS will in turn, disburse 10% of the funds
            collected to PCG in accordance with the Pricing Schedule in the
            AHCCCS contract. The remainder of the funds (90%) will be disbursed
            by AHCCCS to the participating health plans and program contractors.
            There will be no additional fees assessed for these services.

NOTE: Please sign, date                 Gary L.  Callahan, Contract Management
and return both originals to:           Supervisor
                                        AHCCCS Contracts and Purchasing
                                        701 E. Jefferson, 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. NAME OF CONTRACTOR:               10. ARIZONA HEALTH CARE COST CONTAINMENT
PHOENIX HEALTH PLAN/COMMUNITY        SYSTEM
CONNECTION

--------------------------------------------------------------------------------
SIGNATURE OF AUTHORIZED INDIVIDUAL:  SIGNATURE:
              /s/ NANCY NOVICK                    /s/ MICHAEL VEIT
--------------------------------------------------------------------------------
TYPED NAME:                          TYPED NAME:
              NANCY NOVICK                        MICHAEL VEIT
--------------------------------------------------------------------------------
TITLE:                               TITLE:
           CHIEF EXEUTIVE OFFICER    CONTRACTS AND PURCHASING
                                     ADMINISTRATOR
--------------------------------------------------------------------------------
DATE                                 DATE:
                   4/21/04                          APR 28 2004
================================================================================
<PAGE>

                                                                     PAGE 2 of 3

                          CREDIT BALANCE REVIEW PROJECT

I. PURPOSE:

The purpose of this amendment is to implement a credit balance review pilot
program by Public Consulting Group, Inc. (PCG) on behalf of Phoenix Health Plan
(Health Plan/Program Contractor) through PCG's contract with the Arizona Health
Care Cost Containment System (AHCCCS).

II. DEFINITIONS:

CREDIT BALANCE REVIEW is the process used to identify and recover any Medicare
or Third Party resource overpayment retained by a provider for a Medicaid
member.

ONE FULL CYCLE is defined as the time necessary to mail letters, follow up, and
response time for participants; along with time to follow up on non-responses;
review and process responses and payments and any final reporting to confirm
cost effectiveness of the project. This would also include time for the on-site
reviews. It is anticipated that one full cycle would run approximately six (6)
months.

III. PROCESS:

PCG's credit balance program is comprised of two parts, which when used in
conjunction, have proven to be effective recovery tools. The process begins when
AHCCCS notifies the selected provider by mail requesting they conduct a
self-audit for credit balances. This will be accompanied by the AHCCCS Health
Plan/Program Contractor third party resource refund worksheet (Attachment A).
Instructions in this letter allow a provider to return overpayments, which may
exclude them from an on-site review. After sufficient time has been allowed for
all to respond, the next step is to select providers for on-site reviews of the
provider's credit balance process. Providers are selected for this review based
upon their comparative returns of credit balances in the self-audit, AHCCCS and
the Health Plan/Program Contractor preference, and the likelihood of credit
balances existing. AHCCCS will generate a second letter to the provider
notifying them of the on-site review, explaining the scope, and including a list
of accounts that have been targeted for review. This list will be identified
through a series of data analysis programs designed to create a profile of a
member/patient with a potential credit balance. To perform this function, PCG
will use a combination of data files including paid claims history, encounter
data, and eligibility files. In addition, provider accounting procedures are
verified to ensure the proper posting of contractual allowances, etc. PCG will
schedule these reviews approximately thirty (30) days after the provider
receives the notification.

Any credit balance accounts under current review or previously identified by the
Health Plan/Program Contractors shall be reported to AHCCCS prior to PCG's
scheduled review. These accounts should be reported on the AHCCCS Health
Plan/Program Contractor credit balance accounts under review worksheet
(Attachment B) with supporting documentation. This worksheet shall be forwarded
to Public Consulting Group, Inc. (PCG) to the address sited on the bottom of the
worksheet. There will be no recovery fee associated to these accounts.

The letter from AHCCCS instructs providers to send refund balances to PCG. PCG
will receive and identify these refunds. AHCCCS will require PCG to process
these refunds in the same manner as currently required by our contract with PCG.
AHCCCS will require PCG to research the refunds and to provide a monthly
disbursement report of the refund amounts due to the health plans and program
contractors. AHCCCS will disburse a payment in the amount due to the health
plans and program contractors. In the event Reinsurance is included in the
credit balance, AHCCCS will be reimbursed up to the amount of the reinsurance
payment pursuant to Section D, Program Requirements, Paragraph 57, Reinsurance
of this contract and the Health Plan/Program Contractor will retain the residual
balance. The Health Plan/Program Contractor will not be required to adjust their
encounters related to past reinsurance claims as a result of any findings.

                                                                     PAGE 3 of 3

<PAGE>

An electronic report of all claims identified as credit balances where
reimbursement is received from the provider, will be generated for the Health
Plan/Program Contractor and for AHCCCS to ensure proper adjustment of the claims
on PMMIS. Any credit balance discovered in either the self-audit or the on-site
audit shall be paid to PCG. PCG will research and verify cases needing
adjustments as a result of the credit balance. Once a full cycle has been
completed, the project will be evaluated to determine cost effectiveness and if
the program should be continued. Depending on the pilot program's success, this
program may be implemented quarterly, semi-annually or annually.

<PAGE>

                                  ATTACHMENT A
                      Third Party Resource Refund Worksheet

AHCCCS  Provider Name: _______________________  Page:________ of ________
                                                Completed By:___________________
AHCCCS Provider ID Number: ___________________  Date:________/________/_________

<TABLE>
<CAPTION>
                                                                                   TOTAL
                                                                                AMOUNT PAID
                 MEMBER/     DATE OF                                  TOTAL      BY THIRD     THIRD PARTY
                 PATIENT     SERVICE            CLAIM       TOTAL     AMOUNT       PARTY     RESOURCE/        REFUND        REASON
MEMBER/PATIENT   AHCCCS      PERIOD           REFERENCE     BILLED   PAID BY     RESOURCE/   INSURANCE        AMOUNT         FOR
     NAME         ID      FROM     TO       NUMBER (CRN)   CHARGES    AHCCCS     INSURANCE     NAME             DUE         REFUND
------------------------------------------------------------------------------------------------------------------------------------
<S>              <C>      <C>      <C>      <C>            <C>       <C>         <C>         <C>              <C>           <C>
------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------
</TABLE>

      This is to certify that the information contained in this report is true,
accurate and complete, to the best of my knowledge. I understand that AHCCCS
will rely on this certification at the time

      AHCCCS certifies its expenditures to the Centers for Medicare and Medicaid
Services on Form CMS-64.

      Authorized Signature _______________________________ Date:________________

      Forward worksheet to Public Consulting Group,        Attention:
      Inc. P.O. Box 4049 Tallahassee, Fl 32315             Catherine Cox

<PAGE>

                                  ATTACHMENT B
                    AHCCCS Health Plan and Program Contractor
                 Credit Balance Accounts Under Review Worksheet

Health Plan/Program Contractor Name: ___________________  Page: ______ of ______

Health Plan/Program Contractor ID Number: ______________  Completed By: ________

                                                            Date:____/____/____

<TABLE>
<CAPTION>
                AHCCCS                 MEMBER/     DATE OF     ENCOUNTER/
 AHCCCS        PROVIDER   MEMBER/     PATIENT     SERVICE        CLAIM            TOTAL             THIRD PARTY
PROVIDER         ID       PATIENT     AHCCCS       PERIOD      REFERENCE         BILLED        RESOURCE/INSURANCE
  NAME         NUMBER      NAM          ID       FROM    TO    NUMBER (CRN)     CHARGES                NAME
------------------------------------------------------------------------------------------------------------------------------------
<S>            <C>        <C>         <C>        <C>     <C>   <C>              <C>            <C>
------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------
</TABLE>

This is to certify that the information contained in this report is true,
accurate and complete, to the best of my knowledge. I understand that AHCCCS
will rely on this certification at the time

AHCCCS certifies its expenditures to the Centers for Medicare and Medicaid
Services on Form CMS-64.

<PAGE>

Authorized Signature _______________________________   Date:_______________

Forward worksheet to Public Consulting Group, Inc.     Attention: Catherine Cox
P.O. Box 4049 Tallahassee, Fl 32315

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