Organizational Structure and Key Leadership

ACO Participants:

ACO Participants	Joint Venture Participant (Yes/No)	Types of ACO Participants, or Combinations of Participants, That Formed the ACO
COLUMBIA BASIN HEALTH ASSOCIATION	No	Federally Qualified Health Center
COLUMBIA VALLEY COMMUNITY HEALTH	No	Federally Qualified Health Center
INTERNATIONAL COMMUNITY HEALTH SERVICES	No	Federally Qualified Health Center
MARIPOSA COMMUNITY HEALTH CENTER, INC	No	Federally Qualified Health Center
SEA-MAR COMMUNITY HEALTH CENTER	No	Federally Qualified Health Center

ACO Governing Body:

First Name Last Name	Title/Position	Voting Power (%)	Membership Type	ACO Participant Legal Business Name, if applicable
Amy Taylor	CEO of Mariposa Community Health Center	16.667%	ACO Participant Representative	MARIPOSA COMMUNITY HEALTH CENTER, INC
Deborah Buss	Beneficiary Representative	16.666%	Medicare Beneficiary Representative	N/A
Felipe Gutierrez	Chief Medical Officer	0%	ACO Participant Representative	COLUMBIA VALLEY COMMUNITY HEALTH
Hermes Shahbazian	CFO International Community Health Services	16.666%	ACO Participant Representative	INTERNATIONAL COMMUNITY HEALTH SERVICES
Manuel Navarro	CEO of Columbia Valley Community Health	16.667%	ACO Participant Representative	COLUMBIA VALLEY COMMUNITY HEALTH
Nicholas Ramirez	Senior Vice President	16.667%	ACO Participant Representative	SEA-MAR COMMUNITY HEALTH CENTER
Nieves Gomez	CEO of Columbia Basin Health Association	16.667%	ACO Representative	COLUMBIA BASIN HEALTH ASSOCIATION

Key ACO Clinical and Administrative Leadership:

CCCN ACO LLC

Benjamin Potter

ACO Executive

CCCN ACO LLC

Dr. Felipe Gutierrez

Medical Director

CCCN ACO LLC

Benjamin Potter

Compliance Officer

Associated Committees and Committee Leadership:

Committee Name	Committee Leader	Name and Position
Operations Committee	Benjamin Potter	ACO Operations Director
Compliance Committee	Benjamin Potter	ACO Compliance Officer