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Posted on Friday, Oct. 4, 2013 — 12:59 PM
When Vanderbilt University faculty and staff review their 2014 health plan options during Open Enrollment, they will notice a feature that reflects not only how Vanderbilt is taking care of its own but also leading the transformation of health care for the region.
The foundation of each health plan option is the Vanderbilt Health Affiliated Network (VHAN) for “Tier One” coverage. This gives Vanderbilt’s employees a broader choice of high-quality providers and affiliated hospitals at the lowest out-of-pocket cost. Through Aetna, which administers the plans, they also have “Tier Two” access to Aetna’s national network of providers.
Known as VHAN for short, it is the largest provider-organized network of doctors, regional health systems and other health care providers in Tennessee and surrounding states. Network providers actively collaborate to provide patients with high-quality, efficiently coordinated and cost-effective health care services.
Growth of the network is a cornerstone of VUMC’s strategy – in collaboration with others who share its commitment to meet the needs of the community – to lead the transformation of the health care system.
As the health care system moves toward a population-based model of care, VHAN puts the leadership of care coordination in the hands of health care providers, working closely with employers and insurance companies.
“In these times of abrupt change and consolidation in health care, there is a need for innovation and Vanderbilt and its affiliate hospitals and clinicians are taking on the responsibility to lead that change,” said Mark Cianciolo, executive director of VHAN.
VHAN is working with employers like Vanderbilt to improve health care quality, access and costs and to keep employees healthy and productive through health promotion activities and individualized management of chronic disease like diabetes.
Benefits of the network include:
• Providers working together to deliver the right outcomes-based care at the right location.
• Physicians with access to critical information from all clinical interactions to better treat patients.
• Providers with access to leading-edge capabilities while providing quality care in the most appropriate setting, including community locations closer to a patient’s home or workplace.
In addition to keeping employees healthy and productive, VHAN aims to reduce employers’ costs for health care by creating new, more efficient care models and reducing variation in practice. For instance, a pilot project between VHAN and Cumberland Pediatric Alliance (CPA) improved coordination of care and saved more than 9 percent of expected cost of health care services for children in the Vanderbilt Employee Health Plan.
At a time when per capita health care costs are rising at a rapid rate, this is important for all employers, including Vanderbilt. Vanderbilt is “self-insured,” which means that it pays the actual costs for the health care services used by its employees and dependents covered through its health plan. (The health plan is only administered, but not paid for, by Aetna).
VHAN includes a rapidly growing number of like-minded regional health systems and other providers. These include Williamson Medical Center, Maury Regional Medical Center, NorthCrest Medical Center, all located along the Interstate 65 north-south corridor; Mountain States Health Alliance based in northeast Tennessee; Cookeville Regional Medical Center to the east; and West Tennessee Healthcare in Jackson, Tenn.
VHAN also is expanding programs in local communities, such as after-hours clinics in Williamson and Wilson counties, and teaming with large physician practices to expand primary care offerings. Last month, it was announced that CPA, which has 35 practices including 300 pediatricians, had joined VHAN, as has Heritage Medical Associates, a large primary care and multi-specialty group in Nashville.
All of this activity takes VHAN a step closer to its goal of building a clinically integrated network (CIN). The Federal Trade Commission defines a CIN as a group of providers who mutually choose to work together and commit to a united cause: to improve outcomes and reduce costs through the employment of evidence-based medicine and continuous process improvement.
To understand VHAN, it may also be helpful to understand its relationship with Vanderbilt.
“Vanderbilt is the organizer, the facilitator to bring together like-minded, high quality health systems and providers to collaborate on developing new technologies, aggregate and share data, and do quality reporting, all in service of improving health while reducing health care costs,” Cianciolo said.
“VHAN is the company through which we are building those capabilities and taking them across the state.”
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