Health care coverage is just part of the benefits you get through the Vanderbilt Health Affiliated Network. We offer a suite of additional services including pharmacy, health promotion, and care connection solutions. With the right people at the table, our network is truly collaborative. Employers, employees, doctors, hospitals, and insurers all work together with one simple goal: high quality patient care with sustained cost control.
We offer solutions for fully insured and self-insured employers. When you choose a health plan powered by our network, your employees get access to more than 4,000 of the region’s best physicians, hospitals, and clinics, as well as access to a national network.
Our network currently offers health plans with Aetna, one of the nation’s largest insurers. Our tiered insurance model gives your employees peace of mind through broad nationwide coverage while offering additional savings and benefits at thousands of high-quality doctors and hospitals close to home.
Our plan offers three benefit levels:
- Tier 1: This tier includes all of the doctors and hospitals who are part of our network. When your employees choose a health care provider within the network, they get the most generous level of benefits, plus additional savings. With more than 4,000 providers, plus hospitals, urgent care centers, walk-in clinics, and retail locations, your employees get convenient access to quality health care throughout Tennessee and surrounding states.
- Tier 2: This tier includes all providers in Aetna’s national PPO network. No matter where your employees travel – for business or pleasure – they have access to quality health care. Tier 2 benefits have higher out-of-pocket costs than Tier 1.
- Tier 3: Providers who are not part of our network or Aetna are called out-of-network providers. Tier 3 offers the lowest benefit level, so these providers will cost more.
Health promotion and connection
The first step toward lifelong health is finding the motivation and support to make the journey easier. We offer education and clinical support resources designed to empower employees.
- Transitions Care: Patients who have been hospitalized often suffer complications during the transition back to outpatient health care. This program matches nurse care advisors with patients before they leave the hospital to help ensure their transition is seamless, preventing complications and unnecessary hospital readmissions.
- Complex Care: Our analytics team identifies patients at risk of high medical costs; our highly trained nurse care advisors then integrate with these patients’ physicians as part of a holistic care team. The care advisor can help the patient coordinate appointments with specialists, stay on treatment plans, reduce medication costs and reduce the need for health care services by helping them stay healthy.
Pediatric Quality Programs
- Asthma Program: Research clearly shows that children with asthma have better outcomes and account for less health care costs if they receive an Asthma Control Test, complete an Asthma Action Plan, and get a flu shot every year. Our program holds practices accountable for providing these low-cost preventive services to asthma patients, reducing the risk of acute asthma episodes requiring hospital care.
- Behavioral Health Consults: Pediatricians in our network have on-demand access to a psychiatric consult service for guidance on depression, anxiety, ADHD, and other psychiatric conditions that require proactive management.
- Integrated Pharmacy Expertise: Our analytics, pharmacy, and care coordination teams work collaboratively to create solutions to improve quality and control costs. Our pharmacy experts apply deep analytics to understand and neutralize the rising pharmacy cost trends that are affecting employers across the country.
- Pharmacy Dashboard: We provide practices a dashboard to identify appropriate alternatives to high-cost drugs. This program also tracks medication adherence and empowers practices to help patients get effective medicines for their needs at reduced cost.