Performance Standards
Overview
As a VHAN member, you participate in value-based contracts that reward high-quality, efficient care.
This page explains the performance standards tied to those contracts, so you know what’s expected, how your work supports better patient outcomes and where there may be opportunities to qualify for shared savings. Any rewards earned collectively through meeting contract standards are distributed based on individual modifier performance.
Keeping Your Practice Information Up to Date
Up-to-date information is about more than communication. This information allows for accurate reports and incentives. To make the most of your membership and ensure we provide appropriate support and accurate insights, set a reminder to complete the following activities on a regular basis.
Quality and Contract Performance
How can I optimize performance?
Each practice participates in specific value-based contracts. Understanding which contracts you participate in is the first step to meeting requirements and improving performance.
Which contracts can members participate in?
- Aetna
- Meritain (Aetna)
- Aetna Medicare Advantage
- Cigna Collaborative Accountable Care (CAC)
- HealthSpring Medicare Advantage
- United Healthcare
- United Healthcare MA
Questions About Contracts?
To confirm your current contracts or ask about joining a new one, contact your VHAN network representative or email info@vhan.com.
Understand Contract Expectations
Collective Network Rewards
Your success in VHAN value-based contracts contributes to shared savings across the network. VHAN offers resources to help you understand requirements and track performance, including:
Contract Payor Profiles
Overview of payor-specific goals and expectations
Quality Measure Guides
Details on required quality measures and reporting
Quick Reference Guide
Summary of key contract elements
Understand VHAN Modifiers
Individual Reward Distribution
In addition to payor requirements, VHAN applies network-wide quality standards that help determine how shared savings are distributed to individual practices. These standards are called modifiers.
- Most members will follow the Primary Care Modifer formula unless the practice has a pediatric focus.
- Specialists may earn points for the citizenship portion of the modifier.
Learn more about how each modifier works:
Coding
Accurate coding supports both quality performance and reimbursement by ensuring a patient’s health conditions are fully and correctly documented. This information is used to assess patient risk and account for the complexity and needs of the patient population when setting benchmarks and measuring performance. VHAN’s coding tools offer practical guidance and detailed support to help members strengthen coding practices.
Make the Most of Your Membership
VHAN assists members through clinical programs, care management services, practical resources and a dedicated support team—all designed to help enhance your practice performance. The pages below highlight tools and services that support performance improvement and success in value-based contracts.