Performance and Quality

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 post-payment reviews, Vaya measures indicators in the following domains:

  • Cooperation with Vaya’s quality improvement (QI) activities to improve quality of care and services and member experience
  • Collection and evaluation of data
  • 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, 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
  • Completing and submitting provider satisfaction surveys
  • Ensuring information provided to include 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, initiation and engagement in substance use treatment and other performance measures as indicated or prescribed.

Quality Improvement Committee

Vaya maintains a Quality Improvement Committee (QIC), which includes network providers, designed to increase our ability to continually improve member outcomes and operational efficiencies. Vaya produces a Quality Management Annual Report that contains three distinct documents: Program Description, Program Evaluation and Quality Management Workplan. These documents outline and review Vaya’s improvement strategies, plus QI initiatives and focus areas for the coming year.

Provider Satisfaction Survey

The Provider Satisfaction Survey is conducted annually on behalf of NC Medicaid. The survey assesses provider perceptions of their interactions with LME/MCOs such as Vaya, training and support provided by LME/MCOs and materials provided by LME/MCOs to help strengthen their practice. Survey responses are used to help focus Vaya’s ongoing QI efforts to improve services provided to our network.