|
Most Recent
Back to Announcements
Notification of Service Start for Project HERO Contract Specialty Care Provider Network
Announcement Date: 1/23/2008
Project HERO Contract Availability
Contracted services are now available through Project HERO (Healthcare Effectiveness through Resource Optimization). VA has contracted with specialty care provider networks to better manage Fee care provided directly to enrolled veterans.
- Contracted services for medical/surgical, mental health, diagnostics, and dialysis are available through Humana Veterans Healthcare Services (HVHS) in VISNs 8, 16, 20, and 23
- Contracted services for dental care are available through Delta Dental Federal Services (Delta Dental) in VISNs 8, 16, 20, and 23
All Project HERO contracted provider networks and care facilities are required to meet accreditation standards and VA-specified quality standards. Contractors will provide a centralized VHA coordinated referral and appointment process and submit clinical information after care is provided. VA expects cost savings through utilization of these contracts.
Contract Overview and Evaluation
Project HERO contracts were awarded on October 1, 2007 for a period of one year, followed by four option years.
Under Project HERO, VA is partnering with HVHS and Delta Dental to complement the VA system of care and ensure that community providers meet quality standards. To ensure that the specialty care provider networks meet VA standards, Project HERO will measure cost, volume, and type of care; quality of care; patient satisfaction; and the impact of Project HERO on Academic Affiliates. Monthly, quarterly, and annual reports documenting the results of the evaluation will be distributed to internal and external stakeholders.
Project HERO Awards Contracts for a Specialty Care Provider Network
Announcement Date: 10/01/2007
Specialty Care Provider Network
Through Project HERO, VA will contract with specialty care provider networks to better manage Fee care and optimize the care provided directly to enrolled veterans. VA will purchase medical/surgical, mental health, diagnostic, dialysis, and dental services in VISNs 8, 16, 20, and 23. VA will purchase these services only when VA facilities and providers cannot provide the service.
Contract Award Results
- VA received a total of seven proposals in response to the Request for Proposals for a Specialty Care Provider Network
- Project HERO Contracts were awarded to Humana and Delta Dental
- Humana will provide medical/surgical, diagnostics, dialysis, and mental health services in VISNs 8, 16, 20, and 23
- Delta Dental will provide dental services in VISNs 8, 16, 20, and 23
- Contracts have a base year and four options years, each twelve months in length
| VISN |
Medical / Surgical |
Diagnostic Imaging |
Mental Health |
Dialysis |
Dental |
| 8 |
Humana |
Humana |
Humana |
Humana |
Delta |
| 16 |
Humana |
Humana |
Humana |
Humana |
Delta |
| 20 |
Humana |
Humana |
Humana |
Humana |
Delta |
| 23 |
Humana |
Humana |
Humana |
Humana |
Delta |
Expected Benefits
All contracted provider networks and care facilities are required to meet accreditation standards and VA-specified quality standards. In addition, awardees will be required to provide a centralized VHA coordinated referral and appointment process and to submit clinical information after care is provided. VA expects cost savings as a result of contract award.
Evaluation Criteria
To ensure that the specialty care provider networks meet VA standards, Project HERO will measure the following: cost, volume, and type of care; quality of care; patient satisfaction; and the impact of Project HERO on Academic Affiliates. The PMO will also track spending against the established contract minimum and maximum and will report on the results of the claim audits. Monthly, quarterly, and annual reports documenting the results of the evaluation will be distributed to internal and external stakeholders to ensure that they are updated and informed of Project HERO Demonstration activities.
|
