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Health Services

 
Health Services is a comprehensive approach proven to contain health plan costs while delivering the highest quality of care on a consistent basis, from prevention through the ongoing maintenance of at-risk patients through partnerships with treating physicians.

Our Health Services programs include:
  • BeneFIT: A custom suite of health education and wellness programs for employers
  • Disease Management / Health Support: Prevention education, ongoing maintenance and motivational health coaching for at-risk patients.
  • Case Management: Personalized health care strategies and monitoring.
  • Utilization Review: Current usage compared to the best, most cost-effective medical care.
  • And more
Clinical Integration
Clinical Integration benchmarks and assesses methods to optimize our members’ health; addresses potential problems while they are still treatable; and promotes, measures and monitors healthier lifestyles. Through Clinical Integration, we enable our doctors to provide better patient care, help our members to achieve better health, and reduce costs by containing many serious health circumstances.

Coordination of Care Across the Continuum: Valley Preferred promotes and facilitates the sharing of data among caregivers to assure quality and efficiency in wellness, prevention, acute care, chronic care, advanced complex illness support and more.Clinical Integration

Physician Engagement: Primary and Specialty Care Physicians refer patients for enrollment in disease management, participate in patient care committees, develop and distribute protocols and utilize tools to assess and ultimately improve their clinical performance.  
 
Quality Improvement: A robust quality improvement program identifies opportunities for system enhancements. Examples of QI measurements include: member satisfaction, physician participation in quality improvement initiatives and physician engagement in disease management.

Data: Data is collected, monitored, and bench marked to assure quality care, identify patients who would benefit from disease management and measure the health of all patients engaged in the Valley Preferred-Physician relationship.

Pay-for-Performance: The Performance Based Incentive Plan is rooted in quality and efficiency initiatives, which may include the Physician Self-Audit and performance on clinical indicators. Year-end reports are generated for each participating physician.