Common use of Windfall Situations and Changes in the Environment Clause in Contracts

Windfall Situations and Changes in the Environment. In the event that there is a Force Majeure Event, a material change in the environment in which the Eligible Medical Groups are operating their revenue cycles, or a material change in the laws and regulations that apply to Ascension Health, Supplier, or an individual Eligible Medical Group which significantly impacts the economics of one or more of the Parties or frustrates the ability of a Party to perform its obligations hereunder, through no fault of its own, the applicable Party shall have the right to request that the other Party consider a fair and appropriate adjustment to the Operating Metrics Scorecard. Upon such request, Supplier and Ascension Health will discuss the impact associated with the change in circumstance, with the outcome to equitably reflect the impact on the Operating Metrics Scorecard. Examples of material matters that could affect one or more metrics on the Operating Metrics Scorecard performance include, but are not limited to, the following: • Payor bankruptcies. • A pattern of services to patients for whom an Eligible Medical Group is not certified by a payor to xxxx for such services and thus not entitled to reimbursement. • Changes in Self-Pay Discounts and/or changes in Charity Policy. • Material growth or decline in self pay population or patient residual balance after insurance. • Changes in accounts receivable write-off policies or Medicaid Pending aging policies • Implementation of new systems outside the control of Supplier (e.g., new patient accounting system). • Regulatory changes, including changes to the ICD nomenclature (e.g., ICD-11) or changes to the status of Medicaid Expansion in a given state. R1 RCM AND ASCENSION HEALTH CONFIDENTIAL Exhibit 3 Page 33 [**] Indicates that text has been omitted which is the subject of a confidential treatment request. The text has been separately filed with the Securities and Exchange Commission. APPENDIX A – Operating Metrics Calculation Methods Set forth below are the details of each of the Operating Metrics.

Windfall Situations and Changes in the Environment. In the event that there is a Force Majeure Event, a material change in the environment in which the Eligible Medical Groups are operating their revenue cycles, or a material change in the laws and regulations that apply to Ascension HealthAscension, Supplier, or an individual Eligible Medical Group which significantly impacts the economics of one or more of the Parties or frustrates the ability of a Party to perform its obligations hereunder, through no fault of its own, the applicable Party shall have the right to request that the other Party consider a fair and appropriate adjustment to the Operating Metrics Scorecard. Upon such request, Supplier and Ascension Health will discuss the impact associated with the change in circumstance, with the outcome to equitably reflect the impact on the Operating Metrics Scorecard. Examples of material matters that could affect one or more metrics on the Operating Metrics Scorecard performance include, but are not limited to, the following: • Payor bankruptcies. • A pattern of services to patients for whom an a Eligible Medical Group is not certified by a payor to xxxx bill for such services and thus not entitled to reimbursement. • Changes in Self-Pay Discounts and/or changes in Charity Policy. • Material growth or decline in self pay population or patient residual balance after insurance. • Changes in accounts receivable write-off policies or Medicaid Pending aging policies • Implementation of new systems outside the control of Supplier (e.g., new patient accounting system). • Regulatory changes, including changes to the ICD nomenclature (e.g., ICD-11) or changes to the status of Medicaid Expansion in a given state. R1 RCM AND ASCENSION HEALTH CONFIDENTIAL Exhibit 3 Page 33 .- 41 - [*****] Indicates that text Text omitted for confidential treatment. The redacted information has been omitted which excluded because it is the subject of a confidential treatment request. The text has been separately filed with the Securities both (i) not material and Exchange Commission. APPENDIX A – Operating Metrics Calculation Methods Set forth below are the details of each of the Operating Metrics.(ii) would be competitively harmful if publicly disclosed

Windfall Situations and Changes in the Environment. In the event that there is a Force Majeure Event, a material change in the environment in which the Eligible Medical Groups Recipients are operating their revenue cycles, or a material change in the laws and regulations that apply to Ascension Health, Supplier, or an individual Eligible Medical Group Recipient which significantly impacts the economics of one or more of the Parties or frustrates the ability of a Party to perform its obligations hereunder, through no fault of its own, the applicable Party shall have the right to request that the other Party or Parties consider a fair and appropriate adjustment to the Operating Metrics Scorecard. Upon such request, Supplier and Ascension Health will discuss the impact associated with the change in circumstance, with the outcome to equitably reflect the impact on the Operating Metrics Scorecard. Examples of material matters that could affect one or more metrics on the Operating Metrics Scorecard performance include, but are not limited to, the following: • Payor bankruptcies. • Delayed implementation of agreed to rates between insurance company and Eligible Recipient. • Xxxxx initiated take backs and/or retrospective changes to previously adjudicated claims. • A pattern of services to patients for whom an Eligible Medical Group Recipient is not certified by a payor to xxxx bill for such services and thus not entitled to reimbursement. • Changes in accounting treatment (e.g., changes in netting policies on individual open patient accounts receivable balances). • Changes in Self-Pay Discounts and/or changes in Charity Policy. • Material shifts in gross charge pricing. • Material growth or decline in self pay population or patient residual balance after insurance. • Changes in accounts receivable write-off policies or Medicaid Pending aging policies • Changes in calculation method for bad debt reserve modeling. • Implementation of new systems outside the control of Supplier (e.g., new patient accounting system). • Regulatory changes, including changes to the ICD nomenclature (e.g., ICD-11) or changes to the status of Medicaid Expansion in a given stateICD-10). R1 RCM AND ASCENSION HEALTH CONFIDENTIAL Exhibit 3 Page 33 [*****] Indicates that text has been omitted which is the subject of a confidential treatment request. The text has been separately filed with the Securities and Exchange Commission. APPENDIX A – Operating Metrics Calculation Methods Set forth below are the details of each of the Operating Metrics.163368663.3

Windfall Situations and Changes in the Environment. In the event that there is a Force Majeure Event, a material change in the environment in which the Eligible Medical Groups Recipients are operating their revenue cycles, or a material change in the laws and regulations that apply to Ascension Health, Supplier, or an individual Eligible Medical Group Recipient which significantly impacts the economics of one or more of the Parties or frustrates the ability of a Party party to perform its obligations hereunder, through no fault of its own, the applicable Party shall have the right to request that the other Party or Parties consider a fair and appropriate adjustment to the Operating Metrics RCA Scorecard. Upon such request, Supplier the Parties will sit down and Ascension Health will discuss the impact associated with the change in circumstance, with the outcome to equitably reflect the impact on the Operating Metrics RCA Scorecard. Examples of material matters that could affect one or more metrics on the Operating Metrics RCA Scorecard performance include, but are not limited to, the following: • Payor bankruptcies. • Delayed implementation of agreed to rates between insurance company and Eligible Recipient. • Payor initiated take backs and/or retrospective changes to previously adjudicated claims. • A pattern of services to patients for whom an Eligible Medical Group Recipient is not certified by a payor to xxxx for such services and thus not entitled to reimbursement. • Changes in accounting treatment (e.g., changes in netting policies on individual open patient accounts receivable balances). • Changes in Self-Pay Discounts and/or changes in Charity Policy. • Material shifts in gross charge pricing. • Material growth or decline in self pay population or patient residual balance after insurance. • Changes in accounts receivable write-off policies or Medicaid Pending aging policies • Changes in calculation method for bad debt reserve modeling. • Implementation of new systems outside the control of Supplier (e.g., new patient accounting system). • Regulatory changes, including changes to the ICD nomenclature (e.g., ICD-11) or changes to the status of Medicaid Expansion in a given state. R1 RCM AND ASCENSION HEALTH CONFIDENTIAL Exhibit 3 4-B Page 33 [**] Indicates that text has been omitted which is the subject of a confidential treatment request. The text has been separately filed with the Securities and Exchange Commission. APPENDIX A – Operating Metrics Calculation Methods Set forth below are the details of each of the Operating Metrics.9