The Virginia Health Network (VHN) is a for-profit Preferred Provider Organization (PPO) which began operations in September of 1988. The Company was created by a consortium of nine hospitals in the Richmond and Hampton Roads areas of Virginia. VHN is separately incorporated from its sponsoring organizations.
VHN is a provider owned, wholesale model preferred provider organization. VHN’s mission is to organize and manage networks of quality health care providers, lease those networks, and provide other value-added services to payors that wish to contain health care costs while meeting the highest standards for quality of care. The Company’s staff works cooperatively with participating providers, participating payors and their members, and other types of organizations such as utilization management companies to foster the team approach that will enable all participants to achieve their goals.
PRODUCTS AND SERVICES
VHN’s primary products are its open access PPO networks which support group health plans and workers’ compensation products offered by contracting payors. In addition to these open panel networks, VHN offers healthcare manager networks to be utilized in gatekeeper and point of service plans. Claims repricing services are also available.
VHN’s service areas include 92% of the population of the state of Virginia, including Hampton Roads, the Greater Richmond area, Northern Virginia, Charlottesville, Fredericksburg, and Southwest Virginia.
VHN does not take insurance risk or pay claims. We believe that our objectives of community cost containment and enhancing patient flow to contracting providers can best be accomplished by working with multiple payors of health claims. This is accomplished by contracting with these payors, mostly health insurance companies and self-insured employers, to utilize VHN hospitals and physicians as the exclusive providers in their managed care plans. The agreements further stipulate that direct benefit incentives must be in place to direct insureds to network providers (e.g. 90% for in-network and 70% for out-of-network).