At Vaya Health, we believe quality is everyone’s responsibility. We know we can achieve our quality goals only when we partner with you—our network providers—to strengthen our capacity and maintain measurable improvements in member outcomes and internal operations.
How does Vaya measure the quality of my performance?
In addition to conducting monitoring and various provider performance reviews, Vaya measures performance through a combination of oversight activities and quality indicators, including, but not limited to:
- Cooperation with Vaya’s quality improvement (QI) activities and quality strategy to improve quality of care, services, and member experience
- Collection and evaluation of data
- Timeliness of and access to care
- Quality of care, including the extent to which you improve desired health outcomes for members
- Quality and appropriateness of services, including that they are delivered safely, effectively, efficiently, equitably, and person-centered
- System performance
- Member experience and satisfaction with services rendered
How can I support quality improvement?
We depend on our providers for involvement and input in QI processes to improve the quality of care and services and member experience. For providers, this includes:
- Developing internal QI processes
- Participating with Vaya on QI initiatives, including collection of performance measurement data and participating in our clinical and service measurement QI programs
- Serving on the Vaya Quality Improvement Committee (QIC)
- Completing and submitting provider satisfaction surveys
- Ensuring information provided for inclusion in our practitioner and provider directories is accurate and up to date
We plan to strengthen QI-related partnerships with network providers to improve performance in key areas such as access to care, development, and review of clinical practice guidelines, improved member experience, follow-up after discharge, well-child visits, childhood immunizations, cervical cancer screenings, plan all-cause readmissions, depression screening, initiation and engagement in substance use treatment, and other performance measures as indicated or prescribed.
Quality improvement
Vaya seeks input from and collaborates with providers to actively improve outcomes and the quality of services provided to members. Vaya maintains a QIC, which includes network providers and is designed to increase our ability to continually improve member outcomes and operational efficiencies. Vaya produces an annual Quality Management and Improvement Program (QMIP). The QMIP promotes reduction or elimination of health disparities, rewards providers for advancing quality goals and health outcomes, aligns with North Carolina’s Medicaid Managed Care Quality Strategy and provides the framework for Vaya’s QI activities and quality improvement focus areas.
This framework provides a comprehensive plan for delivering high-quality, accessible, timely care to members, including:
- Better care delivery: Make health care more person-centered, coordinated, and accessible. Vaya seeks to continuously improve the quality and appropriateness of behavioral health, I/DD, TBI, physical health, pharmacy, and other services and supports delivered to members by Vaya network providers while addressing key drivers of health.
- Healthier People, Healthier Communities: Improve the health of North Carolinians through prevention, better treatment of chronic conditions, and better behavioral health care, and working collaboratively with community partners. We collaborate with our community partners to achieve this aim.
- Smarter spending: Vaya incorporates strategies to pay for high-value, appropriate care rather than volume of care. We also seek ways to incentivize excellence and innovation by network providers.