VHAN recently received Cigna CAC performance results for PY21, and we are happy to announce that the network performed remarkably well compared to market and national rates across key measures. According to representatives from Cigna CAC, VHAN’s efforts to identify and list actions for preventive care initiatives and improvements, along with quality measure reports, patient outreach and best practice-sharing contributed to the favorable results. Read the article for a full list of VHAN’s achievements.

As we approach the last quarter of the year, it’s essential to focus on triple-weighted measures on your Medicare Advantage (MA) contracts. These measures—related mainly to medication adherence, diabetes control, blood pressure control—count more towards your performance than single weighted measures in the Centers for Medicare and Medicaid Service’s (CMS) pay-for-performance Star Ratings system. Triple-weighted measures play a critical role in a health plan’s ability to earn four or more Stars, the threshold at which practices can achieve a higher proportion of shared savings dollars and quality bonuses. Learn more about how VHAN can help members succeed in these important areas.

In her job as a VHAN social worker, Amber Colbert has helped countless patients make the transition from hospital to a skilled nursing facility. Typically, Colbert works with Medicare patients 65 or older, monitoring their health care journey and helping them find the right facility when needed. That experience served her well in her care for an Alzheimer’s patient and his caregiver wife. Read the full story to learn how VHAN social workers help patients and their families at every stage of life.

While VHAN Social Worker Mary Brooks has worked on dozens of memorable cases, a recent experience with one particular patient stuck with her. The patient was discharged from the hospital with an open wound and a significant recovery ahead. Unfortunately, when she arrived home, she found that her air conditioning was no longer working in the middle of a heat wave in West Tennessee. Read the full story to learn how Mary found a way to get the air conditioning fixed and built trust with her patient.

While caregivers make a significant difference in the lives of patients, the hard work and dedication of caregiving can take a serious toll. The many-pronged tensions of caregiving are illustrated by a young parent who recently gave birth to a female with Down syndrome. Read the full article to learn how VHAN’s Care Management team worked with the parent to ease her anxiety and connect her to childcare resources.

Several of VHAN’s contracts include triple-weighted measures, which have a larger impact on quality results. Medication adherence is particularly important, as it is triple weighted across all Medicare Advantage (MA) contracts. Additionally, medication adherence provides an opportunity for year-round focus and impact, unlike other measures that may be addressed at certain times throughout the year. VHAN’s Pharmacy Team offers tools to help your patients with medication adherence.

Returning to school can cause some children and teens anxiety, stress and depression. As young patients return to school next month, be prepared to offer them and their caregivers behavioral health support should the need arise. Read the full article for a complete list of resources VHAN offers members, patients and their caregivers.

CMS announced 395 new ICD-10-CM codes, set to take effect on October 1, 2023. The new codes must be used for discharges occurring from October 1, 2023 through September 30, 2024 and for patient encounters occurring from October 1, 2023 through September 30, 2024. Read the full article for some key codes your staff should be aware of.

In the future, social determinants of health are expected to play a more prominent role in healthcare payer models as the industry continues to recognize their impact on patient outcomes and overall healthcare costs. What do you need to know about the social determinants that affect your patients?