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
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.
Collaborative Medi-Cal Partnerships
We partner with our Medi-Cal providers to deliver community-focused services that support better health outcomes.
Initial Health Assessment
For information on Initial Health Appointments (IHA), please visit Santa Clara Family Health Plan.
Medi-Cal Preventive Care Incentives
Help your patients get rewarded- no forms, no attestations; submit a simple electronic claim with the correct codes through December 31, 2025. You must be enrolled in SCFHP during service; other eligibility and terms may apply. Access the 2025 Member Incentives using the links below:
- Well-Child Visits (0–15 months): $50 reward for completing six PCP visits by 15 months.
Why it matters: These visits track growth, provide vaccinations, and screen for developmental issues early when interventions are most effective.
Learn more: Wellness Rewards | Santa Clara Family Health Plan
- Well-Child Visits (15–30 months): $30 reward for completing two PCP visits by 30 months.
Why it matters: These check-ins ensure continued developmental progress and build lifelong health habits.
Learn more: Wellness Rewards | Santa Clara Family Health Plan
- Flu Vaccine (age 2): $10 reward for one dose of flu vaccine by the second birthday.
Why it matters: Young children are highly vulnerable to flu complications—vaccination protects them and their community.
Learn more: Wellness Rewards | Santa Clara Family Health Plan
- Lead Screening (by age 2): $10 reward for completing venous or capillary blood lead test.
Why it matters: Lead exposure can harm brain development; early detection can prevent long-term health and learning problems.
Learn more: Wellness Rewards | Santa Clara Family Health Plan
- Baby Shower (Pregnant Members 17+): Free diaper bag for attending an SCFHP Baby Shower.
Why it matters: Members receive education, resources, and support for a healthy pregnancy and postpartum period.
Learn more: Healthy Moms, Healthy Babies | Santa Clara Family Health Plan
- Postpartum Class (New Parents 17+): Attending “The Fourth Trimester” class will earn you a free Welcome Baby Kit.
Why it matters: Postpartum education helps reduce health risks and supports the mental well-being of new parents.
Learn more: 50658E HE_Car Seat Class Flyer_RG0124 PRINT
- Car Seat Safety Class: Free convertible car seat for attending “Buckle Up with SCFHP.”
Why it matters: Proper car seat use drastically reduces injury risk in accidents for children under age 5.
Learn more: 50658E HE_Car Seat Class Flyer_RG0124 PRINT
- Member Orientation: $25 reward for attending SCFHP Member Orientation for the first time.
Why it matters: Orientation empowers members to understand and use their benefits, improving care outcomes.
Learn more: SCFHP Member Orientations | Santa Clara Family Health Plan
The links below contain hospital quality and patient safety data from recognized national and state sources.
Alta Bates Summit Medical Center- Alta Bates Campus
Alta Bates Summit Medical Center (Hawthorne)
Community Hospital of the Monterey Peninsula
El Camino Hospital Mountain view
George L Mee Memorial Hospital
Good Samaritan Hospital San Jose
Hazel Hawkins Memorial Hospital
Lucile Packard Children’s Hospital
Mills-Peninsula Medical Center
Santa Clara Valley Medical Center
Sutter Maternity and Surgery Center of Santa Cruz
Sutter Santa Rosa Regional Hospital
Sutter Tracy Community Hospital
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.
| Issuer | QHP 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.
| Issuer | NCQA'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.