1. Access to Healthcare Network A membership based, non-profit medical discount plan for under and uninsured Nevada residents.

2. Access to Healthcare Network Mission Access to Healthcare Network’s mission is to increase access to primary and specialty health care services for the under and uninsured, working poor, Nevada residents, through shared responsibility and community wide partnerships.

3. AHN History Developed through Healthy Community Access Program (HCAP) grant. AHN received 501(C)3 status in August of 2007 AHN is registered with the Nevada Division of Insurance

4. AHN – Target Population The estimated 400,000 under and uninsured Nevada residents between 100% and 250% of the Federal Poverty Level The working poor Children Single mothers Self-Employed Part-time workers Recently Unemployed receiving unemployment benefits

5. Shared Responsibility Model PROGRAM STRUCTURE Hospitals Healthcare Providers Members Community

6. Hospitals In Patient Rate: $400 per day $3000 cap Out Patient Rate: 35% of Medicaid or 50% of Medicare $13,000 hernia surgery AHN Rate: $350 $19,000 ankle surgery AHN Rate: $320 $20,000 hysterectomy AHN Rate: $700

7. Healthcare Providers A Network of over 700 healthcare providers: Primary Specialty Ancillary Dentists Optometrists Pharmacists All providing services at greatly reduced rates.

8. AHN Members Must not be insured or eligible for Medicaid, Medicare, or S-CHIP Earned income within 100% and 250% of the Federal Poverty Level Must Pay Cash at the time of service

9. Membership Fee Time Frame 3 Months6 Months1 year Individual$120$180$288 Individual + 1 child $195$300$530 Entire Family $270$420$770

10. Employer Based Membership Small Business owners Employers with part-time workers Employers who cannot afford high premiums Employer pays half the cost of membership for the member

11. AHN Program Benefits Integrated Healthcare Delivery System Primary Care Physician (Medical Home) Access to Specialty, Ancillary, Dental, Vision and Pharmacy Discounted Rates Care Coordination Patient Care Fund

12. Patient Care Fund State and Local Governments subsidize cost of AHN membership Foundations designate funds for specific illness or population of people

13. Susan G. Komen for the Cure Health Service Primary Care Visit Oncologist Consult Mammogram Biopsy Mastectomy Chemotherapy Radiation Therapy Actual Cost AHN Rate $80$40 $130$65 $296$75 $1650$96 $5000$400 $137,000$6700 $87,000$4200

14. AHN Programs Statewide Help Line – 1.877.385.2345 Covering Kids and Families State of Nevada Health Insurance Program State of Nevada Health Assistance Program Maternal Care Program Health Savings Program

15. AHN Health Savings Program Charles Schwab Bank Federal Home Loan Bank of San Francisco AHEAD Grant Wells Fargo Bank Pilot Project of 40 AHN Members

16. Health Savings Program For AHN members wanting to save for their healthcare needs. Must attend 3 -2 hour Financial Education Sessions and 1-1hour Credit Report Review Session Two Financial Education Workshops during course of the saving period AHN Program Orientation

17. Health Savings Program Must save a minimum of $25 per month Can only be used for health related costs Savings will be matched dollar for dollar up to $500 Deposits are made at AHN Savings are monitored by Care Coordinator Members will receive a monthly statement

18. Shared Responsibility Model Hospitals  Seed money for network startup  Reduced fee for service Hospitals  Seed money for network startup  Reduced fee for service Members  Pay cash at the time services are provided  Pay monthly membership fee (individual and family) Members  Pay cash at the time services are provided  Pay monthly membership fee (individual and family) Providers Primary Care Providers, Specialists, Hospitals, Pharmacy, Mental Health and Ancillary Services  Offer services for a reduced fee Providers Primary Care Providers, Specialists, Hospitals, Pharmacy, Mental Health and Ancillary Services  Offer services for a reduced fee Employers  Pay monthly fee for uninsured employees and family members to access reduced fee Network  Receive tax incentive  Employee pays portion of monthly membership fee Employers  Pay monthly fee for uninsured employees and family members to access reduced fee Network  Receive tax incentive  Employee pays portion of monthly membership fee Insurance Industry  First Membership based, Non Profit Medical Discount Plan in Nevada registered with the Division of Insurance  Partnering with Brokers  Marketing to employers Transition our members into Insurance products Insurance Industry  First Membership based, Non Profit Medical Discount Plan in Nevada registered with the Division of Insurance  Partnering with Brokers  Marketing to employers Transition our members into Insurance products Banking Industry  Funding for development of AHN- Health Savings Program  Funding for match portion of Health Savings Program  Community Reinvestment Act activity Banking Industry  Funding for development of AHN- Health Savings Program  Funding for match portion of Health Savings Program  Community Reinvestment Act activity Government County and State  Grant funding for operating costs  Tax incentives for employers  Annual contribution for network sustainability funding and Patient Care Fund Government County and State  Grant funding for operating costs  Tax incentives for employers  Annual contribution for network sustainability funding and Patient Care Fund Administration Providing services Statewide Sustainability Funding Annual operation budget AHN services offered : Washoe County Northern Nevada Southern Nevada (Las Vegas) Administration Providing services Statewide Sustainability Funding Annual operation budget AHN services offered : Washoe County Northern Nevada Southern Nevada (Las Vegas) Patient Care Fund Funding provided by local Foundations to provide financial assistance to AHN members for specific illnesses or member populations. Patient Care Fund Funding provided by local Foundations to provide financial assistance to AHN members for specific illnesses or member populations. Community  Medical Society  Foundations, corporations, businesses, individual donations  Supports Network sustainability and Patient Care Fund Community  Medical Society  Foundations, corporations, businesses, individual donations  Supports Network sustainability and Patient Care Fund

19. Why it Works HOSPITALS/PROVIDERS Reduced rate of ER usage among the uninsured Receive payment for services up front AHN puts a structure to a structure-less population

20. Why it Works MEMBERS Have access to affordable healthcare Have a Primary Care (Medical Home) Have access to Specialty Care Have access to Dental and Vision Have assistance navigating the healthcare system

21. Why It Works Community State and local government hands that are ordinarily tied can use AHN to provide services allowing their budgets to go farther Local Foundations can serve a designated illness or population and their contributions go three times farther

22. Why It Works AHN’s shared responsibility, integrated health care delivery model, can work anywhere: – Small rural area of 50,000 or less (Northern Nevada) – Midsize Urban area of 500,000 (Washoe County – Reno/Sparks, Nevada) – Large Urban area of 2,000,000 + (Las Vegas, Nevada)

23. Beyond 2014 AHN model prompted Congress to include non-profits in the Insurance Exchange AHN model will be implemented within 10 states AHN will be there for those in need of access to healthcare