NBC National Network NBC National Network Initiative:Initiative:

Update and DiscussionUpdate and Discussion

San DiegoSan DiegoSeptember, 2007September, 2007

Contributing OrganizationsContributing Organizations

PsychiatristsPsychiatristsDoctorate Doctorate

Level Level PsychologistsPsychologists

Masters Level Masters Level CliniciansClinicians

Clinical Nurse Clinical Nurse SpecialistsSpecialists TotalTotal

4,3614,361 4,0284,028 13,87713,877 2,4872,487 24,75324,753

Total Count of Providers in the NBC Total Count of Providers in the NBC NetworkNetwork

NBC NATIONAL NETWORK

STATESTATE FACILITY FACILITY COUNTCOUNT

STATESTATE FACILITY FACILITY COUNTCOUNT

ArkansasArkansas 1313 North DakotaNorth Dakota 55

CaliforniaCalifornia 99 NebraskaNebraska 99

ColoradoColorado 22 New JerseyNew Jersey 22

FloridaFlorida 22 New YorkNew York 55

GeorgiaGeorgia 44 OhioOhio 1515

IowaIowa 1010 OklahomaOklahoma 66

IllinoisIllinois 76*76* OregonOregon 55

IndianaIndiana 1212 PennsylvaniaPennsylvania 99

KansasKansas 88 Rhode IslandRhode Island 22

LouisianaLouisiana 88 South DakotaSouth Dakota 22

MassachusettsMassachusetts 33 TennesseeTennessee 1212

MichiganMichigan 11 TexasTexas 1010

MinnesotaMinnesota 23*23* VirginiaVirginia 22

MissouriMissouri 1010 WashingtonWashington 44

MississippiMississippi 11 WisconsinWisconsin 1313

North CarolinaNorth Carolina 50*50*

TOTALTOTAL 333333

* We are doing further research to identify how many reported facilities are inpatient or residential units vs. outpatient services.

Count of Facilities by State

StateState TotalTotal StateState TotalTotal StateState TotalTotal

AKAK 22 DEDE 77 KYKY 117117

ALAL 797797 FLFL 5,9115,911 LALA 195195

ARAR 119119 GAGA 246246 MAMA 161161

AZAZ 681681 HIHI 7 7 MDMD 179179

CACA 2,7882,788 IAIA 290290 MEME 2222

CNCN 11 IDID 250250 MIMI 101101

COCO 151151 ILIL 911911 MNMN 148148

CTCT 4949 ININ 137137 MOMO 1,5611,561

DCDC 1111 KSKS 1,1481,148 MSMS 5050

Count of Providers by Count of Providers by StateState

StateState TotalTotal StateState TotalTotal StateState TotalTotal

MTMT 1818 OHOH 635635 TXTX 1,0161,016

NCNC 1,8171,817 OKOK 104104 UTUT 134134

NDND 6464 VAVA 192192

NENE 128128 OROR 867867 VTVT 66

NHNH 2828 PAPA 184184 WAWA 285285

NJNJ 144144 RIRI 1010 WIWI 129129

NMNM 1,0631,063 SCSC 1,2951,295 WVWV 4040

NVNV 1616 SDSD 2424 WYWY 2929

NYNY 226226 TNTN 220220 TOTALTOTAL

24,7124,7144

Count of Providers by Count of Providers by StateState

DisciplineDiscipline CPT CodeCPT Code

9080190801CPT CodeCPT Code

9080690806CPT CodeCPT Code

9086290862CPT CodeCPT Code

9923399233

PsychiatristPsychiatrist $65-$234$65-$234

Mean of $123Mean of $123N/AN/A $45-$80$45-$80

Mean of $58Mean of $58

$65-$128$65-$128

Mean of $89Mean of $89

Doctorate Doctorate Level Level PsychologistPsychologist

$60-$182$60-$182

Mean of $91Mean of $91$60-$85$60-$85

Mean of $76Mean of $76N/AN/A N/AN/A

Masters Level Masters Level ClinicianClinician

$55-$134$55-$134

Mean of $80Mean of $80$55-$86$55-$86

Mean of $67Mean of $67N/AN/A N/AN/A

Clinical Nurse Clinical Nurse SpecialistSpecialist

$55-$150$55-$150

Mean of $105Mean of $105$55-$125$55-$125

Mean of $66Mean of $66$30-$117$30-$117

Mean of $66Mean of $66N/AN/A

Ranges and Mean of NBC Fees by CPT CodeRanges and Mean of NBC Fees by CPT Code

DefinitionsDefinitions

► ““Contributing Members” are NBC Members (or associated Contributing Members” are NBC Members (or associated non-NBC members) who agree to the use of their provider non-NBC members) who agree to the use of their provider network to create a national networknetwork to create a national network

► ““Participating Members” are NBC Members who use the NBC Participating Members” are NBC Members who use the NBC

network under terms and conditions established by NBC’s network under terms and conditions established by NBC’s Contributing MembersContributing Members

Questions & Issues for DiscussionQuestions & Issues for Discussion

ContractualContractual

► How does NBC best protect the interests of How does NBC best protect the interests of Contributing Members?Contributing Members? Non-solicitationNon-solicitation Competitive issuesCompetitive issues ConfidentialityConfidentiality

► Does the Contributing Member’s provider contract Does the Contributing Member’s provider contract allow for network rental?allow for network rental?If not, what are the options?If not, what are the options? Amending existing contracts that don’t allow for network rentalAmending existing contracts that don’t allow for network rental Other optionsOther options

► What kinds of contracts are needed between What kinds of contracts are needed between Contributing and Participating Members to support an Contributing and Participating Members to support an NBC Network?NBC Network? Create a network of inter-Member agreements Create a network of inter-Member agreements Develop a single Member-NBC network usage agreementDevelop a single Member-NBC network usage agreement

Questions & Issues for DiscussionQuestions & Issues for Discussion

OperationalOperational

► How do we establish a single source (master provider How do we establish a single source (master provider file) for the network?file) for the network? NBC out sources to a “neutral” vendor and share the costsNBC out sources to a “neutral” vendor and share the costs NBC out sources to an NBC member company and shares the NBC out sources to an NBC member company and shares the

costs (should be minimal)costs (should be minimal)

► How is the NBC network maintained?How is the NBC network maintained? Updates by each Contributing Member to NBC on a quarterly Updates by each Contributing Member to NBC on a quarterly

basisbasis

► Who handles what kinds of provider issues?Who handles what kinds of provider issues? Problems with a provider – Contributing or Participating Member?Problems with a provider – Contributing or Participating Member? Problems with claims/authorizations – Participating MemberProblems with claims/authorizations – Participating Member

Questions & Issues for DiscussionQuestions & Issues for Discussion

OperationalOperational

► We will need to create a standardized set of definitions We will need to create a standardized set of definitions so that we can accurately describe the networkso that we can accurately describe the network

► How do we show specializations for outpatient How do we show specializations for outpatient providers and facilities?providers and facilities?

► How do we insure compliance to accreditation How do we insure compliance to accreditation standards for credentialing?standards for credentialing?

► Each Participating Member must load the network and Each Participating Member must load the network and associated rates into their own claims payment system associated rates into their own claims payment system from the master provider filefrom the master provider file

Questions and Issues for DiscussionQuestions and Issues for Discussion

FinancialFinancial

► Who gets paid for what and how much?Who gets paid for what and how much?

ASO rates are around 0.70 PMPM to 1.00 PMPM ASO rates are around 0.70 PMPM to 1.00 PMPM Even 0.10 PMPM will make any of us non-competitive on priceEven 0.10 PMPM will make any of us non-competitive on price

► Contributing to the network involves minimal cost Contributing to the network involves minimal cost while significantly expanding opportunities for revenuewhile significantly expanding opportunities for revenue

Whatever we charge for our networks will be charged back to us Whatever we charge for our networks will be charged back to us by othersby others

Turning Gold into LeadTurning Gold into Lead

► Excessive legal review and risk management Excessive legal review and risk management

► Charging too much for network rentalCharging too much for network rental

► Over thinking legal and operational issuesOver thinking legal and operational issues

QUESTIONS?QUESTIONS?

Level of interest?Level of interest?

Where do we go from here?Where do we go from here?Next steps?Next steps?

StateState PsychiatristPsychiatrist Ph.D. Ph.D. PsychologistPsychologist

Masters Level Masters Level ClinicianClinician

CNS/ARNPCNS/ARNP TotalTotal

AKAK 00 00 22 00 22

ALAL 162162 194194 441441 00 797797

ARAR 1414 1515 909909 00 119119

AZAZ 8383 127127 443443 2828 681681

CACA 371371 625625 17881788 44 27882788

CNCN 00 00 11 00 11

COCO 11 2121 129129 00 151151

CTCT 00 77 4242 00 4949

DCDC 11 22 88 00 1111

DEDE 00 11 66 00 77

FLFL 18341834 595595 12041204 22782278 59115911

GAGA 2222 3737 187187 00 246246

Count of Providers by Discipline and State

Count of Providers by Discipline and State

StateState PsychiatristPsychiatrist Ph.D. Ph.D. PsychologistPsychologist

Masters Level Masters Level ClinicianClinician

CNS/CNS/

ARNPARNPTotalTotal

HIHI 00 33 44 00 77

IAIA 3333 5454 203203 00 290290

IDID 1111 5757 179179 33 250250

ILIL 9898 110110 703703 00 911911

ININ 1313 2727 9797 00 137137

KSKS 186186 203203 759759 00 11481148

KYKY 1616 1515 8080 66 117117

LALA 2727 2424 144144 00 195195

MAMA 1212 3737 112112 00 161161

MDMD 44 2323 152152 00 179179

MEME 00 44 1818 00 2222

StateState PsychiatristPsychiatrist Ph.D. PsychologistPh.D. Psychologist Masters Level Masters Level ClinicianClinician

CNS/ARNPCNS/ARNP TotalTotal

MIMI 44 1919 7878 00 101101

MNMN 1010 3333 105105 00 148148

MOMO 278278 260260 10231023 00 15611561

MSMS 11 66 4141 22 5050

MTMT 00 44 1414 00 1818

NCNC 363363 360360 10661066 2828 18171817

NDND 1616 1313 3535 00 6464

NENE 1616 3030 8282 00 128128

NHNH 00 88 2020 00 2828

NJNJ 1313 1717 114114 00 144144

NMNM 113113 183183 729729 3838 10631063

NVNV 11 33 1212 00 1616

NYNY 66 3535 185185 00 226226

OHOH 147147 4545 424424 1919 635635

Count of Providers by Discipline and State

Count of Providers by Discipline and State

StateState PsychiatristPsychiatrist Ph.D. PsychologistPh.D. Psychologist Masters Level Masters Level ClinicianClinician

CNS/CNS/

ARNPARNPTotalTotal

OKOK 44 2222 7878 00 104104

ONON 00 11 2323 00 2424

OROR 140140 276276 402402 4949 867867

PAPA 66 2626 152152 00 184184

RIRI 11 00 99 00 1010

SCSC 196196 164164 917917 1818 12951295

SDSD 33 11 2020 00 2424

TNTN 4343 3737 140140 00 220220

StateState PsychiatristPsychiatrist Ph.D. Ph.D. PsychologistPsychologist

Masters Level Masters Level ClinicianClinician

CNS/CNS/

ARNPARNPTotalTotal

TXTX 7474 148148 792792 22 10161016

UTUT 33 3030 100100 11 134134

VAVA 66 1414 172172 00 192192

VTVT 22 11 33 00 66

WAWA 1010 6262 203203 1010 285285

WIWI 1515 4141 7373 00 129129

WVWV 22 44 3434 00 4040

WYWY 00 44 2525 00 2929

AB-AB-CANADACANADA

00 00 22 00 22

BC-BC-CANADACANADA

00 00 11 11 22

QC-QC-CANADACANADA

00 00 11 00 11

QU-QU-CANADACANADA

00 00 33 00 33

SK-SK-CANADACANADA

00 00 77 00 77

TOTALTOTAL 436436 40284028 1387713877 24872487 2475324753

Count of Providers by Discipline and State