Sentara Health Plans and Virginia Children’s Care Network, a clinically integrated network run by community pediatricians across the region and supported by Children’s Hospital of Richmond at VCU, announced a new value-based care partnership focusing on comprehensive care coordination for Medicaid members and reducing avoidable healthcare events. The partnership expects to drive better childhood health outcomes, particularly with childhood immunizations and wellness visits.

“This innovative partnership is a recognition of both organizations’ commitment to advancing value-based care and shifting reimbursement models to those focused on quality and outcomes instead of volume of services performed,” said Robert Krebbs, vice president of network management and value based care for Sentara Health Plans. “From increasing immunization rates to removing barriers to well-child visits for pediatric patients, this reimbursement model aims to ensure Sentara Health Plans Medicaid members have access to the right care, at the right time and in the right place.”

The value-based care arrangement aligns the quality improvement goals of SHP and VCCN with those of the Virginia Department of Medical Assistance Services (DMAS), the state agency which oversees Virginia Medicaid. DMAS establishes quality improvement priorities and performance expectations for managed care plans across the Commonwealth and Sentara Health Plans worked with VCCN to directly tie those performance measures into the value-based partnership.

“Quality underpins all that we do at CHoR,” said Elias Neujahr, president, CHoR. “Connecting our community colleagues through VCCN and its value-based partnerships enables us to bolster the health of children across the Commonwealth. From improving vaccination rates to stemming the rising tide of childhood obesity – we are unconditionally committed to partnering with our community to improve children’s health outcomes.” 

Under the value-based partnership, VCCN will receive monthly funding from SHP to support population health activities, with the opportunity to receive additional funds on an annual basis based on quality outcomes. When VCCN’s efforts effectively bend the cost curve and produce high quality results at a lower cost of care, SHP will share in those savings with VCCN.

“In addition to focusing on quality outcomes through structured goals and value-based contracts, VCCN strengthens the relationship between independent community pediatric practices and CHoR, leveraging the best of both private and academic models for patients and their families,” said Liv Gorla, M.D., VCCN chair.

SHP and VCCN share a commitment to quality improvement and delivering exceptional service and care to the Medicaid population in Virginia. “Quality is the foundation of everything we do at Sentara Health Plans,” said Sunil Sinha, M.D., medical director, value based partnerships for SHP. “From our call centers to our clinical staff, to our executive leadership, our focus is always on our mission – to improve health every day. This collaborative effort with a partner like VCCN, who shares that same core value, is a testament to what we can achieve by aligning incentives and coordinating our efforts to serve this population.

Learn more about Virginia Children's Care Network.