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Quality and performance improvement

The Valley Health Plan Primary Care Value-Based Payment (VBP) Program is designed to support quality improvement and population health management for VHP members. The program includes financial incentives for providers who achieve population-level quality outcomes facilitated through data sharing, technical assistance, and operational process improvement opportunities

Primary Care Value-Based Payment Program Guide for 2024

Primary Care Value-Based Payment Program Guide for 2023

Primary Care Value-Based Payment Program Code List 2023

The VHP Quality & Strategic Improvement mission is to support the well-being of our members through a commitment to accessible, high-quality, equitable health services and community-focused, local care.

Quality Management and Strategic Improvement Program Updates

For information on Initial Health Appointments (IHA), please follow this link to Santa Clara Family Health Plan's website: Initial Health Appointment | Santa Clara Family Health Plan ( 

Information coming soon.

2023 Report Year (2022 Measurement Year) - Healthcare Effectiveness Data and Information Set (HEDIS)

HEDIS (Healthcare Effectiveness Data and Information Set) is a set of standardized performance measures designed to ensure that healthcare consumers have access to reliable information to better compare the performance of health plans.  More than 90% of America’s health plans use these standardized measures to evaluate plan performance.  When health plans participate in the Marketplace Exchange, also known as Covered California, they are required to submit an annual HEDIS report to regulatory agencies such as the National Committee for Quality Assurance (NCQA), and the Centers for Medicare and Medicaid Services (CMS) detailing how they have performed in the standardized measures.  Public reporting of HEDIS measures for all lines of business might also be required for accreditation by NCQA.

For the HEDIS Measurement Year 2022 (MY2022- January 1, 2022 to December 31, 2022), also known as the report year 2023 (RY2023), Valley Health Plan was awarded a global rating of three stars by Covered California’s Quality Rating System.  The star rating for “Getting the Right Care” category is directly attributed to the plan’s HEDIS scores.  

IssuerQHP Clinical Quality Management
Valley Health Plan HMO★★★

For the HEDIS Measurement Year 2021 (MY2021- January 1, 2021 to December 31, 2021), also known as report year 2022 (RY2022), Valley Health Plan was awarded three stars for its commercial line of business by NCQA’s Health Plan Rating (HPR).  The HPR star rating is comprised of a plan’s HEDIS and CAHPS scores, with the higher weight attributed to HEDIS. 

IssuerNCQA's Health Plan Ratings 2022
Valley Health Plan HMO★★★

VHP monitors and tracks HEDIS scores for its Covered California and Commercial lines of business to evaluate performance of clinical quality measures and other important aspects of care and services provided by network providers.  HEDIS measures relate to many significant public health issues such as cancer, heart disease, asthma, and diabetes.  VHP continues to work to improve HEDIS measures in MY2022, for more information on HEDIS Measurement Year 2022 (RY2023) click here.

As Valley Health Plan works to improve 2023 HEDIS measures, we ask our members to make sure they are scheduling and completing preventive screening services as this is one of the most important steps, they can take to stay healthy.  Preventive care can identify early health issues.  Some of the most important preventive HEDIS measures are cancer screenings like breast cancer, cervical cancer, and colon cancer.  Another important way to improve our members’ health outcomes is by encouraging members to receive their immunizations, especially flu and COVID vaccines, to stay healthy. Parents are also encouraged to have their children receive their childhood immunizations and well-child visits. VHP offers programs to help diabetic members manage their diabetes through wellness programs and chronic condition case management.  For continuing diabetes care, it is important for members to visit their doctor, have their blood checked (the A1c level reflects the average blood glucose level over three months), and to get a diabetic eye exam.  These activities can improve member outcomes.  Our commitment to improving HEDIS scores is reflective not just of Valley Health Plan’s focus on quality management, but also on a commitment to member wellness and population health.

IHA AMP coming soon.


Information coming soon.

Information coming soon.

Information coming soon.

Information coming soon.