The Vanderbilt Health Affiliated Network (VHAN) is celebrating its 10-year anniversary and the innovations along the way that have transformed health care and strengthened communities in Tennessee and surrounding states.
The health care industry endured a period of rapid change 10 years ago, with the Affordable Care Act taking full effect and a swell of mergers and acquisitions dominating industry news. While many concepts for improving health outcomes and lowering health care spending were percolating, no one could predict which big idea would be successful. Clinically integrated networks (CINs) were among the ideas being increasingly tested at the time.
Over the last decade, results for CINs and their sister model, Accountable Care Organizations (ACOs), have been mixed. Some have produced modest savings while many folded after failing to produce the promised value.
Vanderbilt Health Affiliated Network (VHAN), on the other hand, discovered the formula for CIN success, expanding its reach even during the COVID-19 pandemic and continuing to deliver on the values and vision its founders imagined 10 years ago.
“We knew that to produce the best patient outcomes and navigate the increasingly complex world of health care, we must constantly share with each other,” said C. Wright Pinson, MBA, MD, Deputy Chief Executive Officer and Chief Health System Officer for VUMC. “We founded VHAN believing that by making work possible to place the patient first would create business benefits for network members. Ten years later, patient outcomes and reduced costs are proving that hypothesis.”
An Auspicious Beginning
VHAN launched in December 2012 with four members: Vanderbilt University Medical Center (VUMC), Maury Regional Medical Center, NorthCrest Medical Center and Williamson Medical Center. The founders collaborated on a goal: to create a value-based alliance of health care providers across Middle Tennessee that would voluntarily share and adopt best practices, collectively reshaping the business of health care and improving the patient experience.
After establishing VHAN, board members began hearing from peer organizations in other parts of the state and region who were interested in participating in the effort. The vision for VHAN then expanded to becoming a statewide, high-performing network that could increase the quality of care and lower the cost of care for patients, employers and insurance companies across a broader geography.
“When you think about developing a clinical program for the entire state of Tennessee, you can’t even begin unless you listen. You have to be willing to open yourself to understand the uniqueness of each of the regions,” said Cindy Powell, MD, Chief Medical Officer of VHAN and Senior Vice President of Population Health at VUMC. “One of VHAN’s values is we pause. We listen. We want to foster a culture of shared learning. We don’t have all the answers and don’t pretend to.”
Since its founding, VHAN has grown to include approximately 6,850 providers, 73 hospitals, 13 health systems and hundreds of physician practices and clinics in Tennessee and neighboring states — all working together to create healthier communities.
“Being part of VHAN has been a big part of our success — from providing coding to financial information to examples on which we based our protocols,” said Jennifer Marchisio, CMA, assistant manager of compliance, communications and quality improvements for Rainbow Kids Clinic. “We used VHAN resources to create our protocols for COVID-19 preparedness and response. When no one else had the information, VHAN did.”
VHAN is focused on creating, deploying and scaling clinical resources and programs to benefit the network members and their patients. For example, VHAN’s pediatric behavioral health consult line, which connects network practices across the state to pediatric mental health specialists and licensed social workers, has proven to be especially vital for providers serving patients in rural settings where specialists are hard to find.
The line has fielded nearly 2,500 calls from VHAN member practices since its debut in 2018, filling a crucial role for children and their families amid a national shortage of pediatric behavioral health resources. Provider members from across the region connect directly with experts from Vanderbilt Psychiatric Hospital to help customize care plans for their patients and navigate community resources. With the success of the line for the pediatric population, VHAN expanded to open an adult behavioral health consult line earlier this year.
“The VHAN consult line has helped me greatly, especially with accessing behavioral health care,” said Michael Ladd, MD, of Green Hills Pediatric Associates. “The consult line has also been very helpful when I need to speak with a psychiatrist about the less-straightforward cases we see.”
VHAN’s Care Management program, which uses clinician referrals and claims data to identify patients at high risk for major health issues, is another industry-leading care model. VHAN has reached out to thousands of these patients on behalf of individual practices — easing the burden of practice staff – and offers clinician support to help with transitions of care, chronic health conditions, medication management and other complex issues.
The network also aggregates members’ care insights and outcomes to create datasets large enough to draw reliable and actionable conclusions. These insights can show if a treatment is performing differently than its publicly reported outcomes, indicate how a particular type of patient may respond to a common treatment, or help clinicians compare and choose treatment pathways.
VHAN also broadly shares network best practices, regulatory updates and health care trends via a monthly newsletter; a dedicated podcast, miniVHAN; and online resources such as VHAN Hub. The Hub offers an extensive library of webinar recordings, care toolkits, patient resources, informational videos and more to give members instant access to insights and collaborative learning opportunities.
“I’m amazed at how VHAN really wants to hear from me and is willing to listen to our region’s unique needs,” said Ernie Buchanan, MD, internal medicine physician at Upper Cumberland Family Physicians and VHAN Regional Medical Director. “VHAN is the first time we’ve ever had a network besides our own friends in town and been able to benefit from their expertise. It allows us to all come together and be our best, and individual practices and providers can maintain their independence with new resources we didn’t have access to before.”
Surpassing Health Care Quality Targets
Tennessee is among the 10 unhealthiest states in the nation and home to some of the highest rates of rural hospital closures in the nation. VHAN’s engagement and support help members combat these dire statistics and surpass quality performance targets. In the last year, members have achieved better-than-average rates on hospital readmissions, well care, emergency room visits and quality metrics. Equally remarkable, not a single VHAN member hospital has closed its doors in the organization’s history.
“What makes people really excited is when they see how VHAN has significantly changed a health outcome across the population of patients we care for,” said David Posch, Executive Director of VHAN. “We’ve decreased the number of people who have to go to the emergency room because we’re spending more time in ambulatory care to keep them healthy. Those are the real wins.”
VHAN also works to improve member organizations from within, providing members with easy access to clinical and operational knowledge to maintain and increase care quality. For example, VHAN’s Clinical Performance Committee, a subcommittee of the VHAN Board, is a physician-led committee focused on ensuring that VHAN’s clinical priorities and strategic imperatives are patient-centered, quality-driven, and in the pursuit of health, value and equity.
“To better integrate patient care across multiple providers, and to be accountable for improving quality and cost outcomes for various populations, provider members of the network knew we were going to have to put forth dedicated effort,” Posch said. “VHAN’s health care professionals are putting in that effort improving care for their patients and collectively improving health care across Tennessee with proven results.”
To learn more about the Vanderbilt Health Affiliated Network and its history, visit VHAN.com/10th.
