Health Plan Contracting

Network-Based Contracting

A key benefit of HVPA membership is being a part of a network that carries the collective representation of over 400 physicians. Network-based contracting consists of HVPA entering into binding health plan provider agreements on behalf of its members. By signing the HVPA Participating Provider Agreement (PPA), you agree to participate in all plans deemed mandatory by the HVPA Board of Directors. The Board believes that network-based contracting is an important element in achieving clinical integration among independent physicians.

Benefits of Network-Based Contracting

• Improves delivery of patient care
• Improves the ability of its members to provide input on payers’ risk-based contracts regarding the amount of risk that is taken and whether the reward offered is commensurate
• Increases efficiencies and reduces costs
• Enhances HVPA’s ability to create contracting opportunities for smaller medical groups and sole practitioners
• Allows members and their medical groups to have direct input in the risk contracting process through specialty representatives

HVPA Network Contracts

• Blue Care Network (BCN)
• Blue Care Network Advantage
• Priority Health HMO
• Priority Health PPO
• Priority Health Medicare Advantage

Messenger Model Contracting

HVPA offers contracts with some health plans through a messenger model arrangement. This means HVPA will facilitate credentialing and participation with the plan the same as with our network contracts, however participation is not mandatory.

HVPA Messenger Model Contracts

• Blue Cross Complete (Medicaid)
• HAP HMO
• HAP PPO
• HAP Senior Plus
• Meridian Health Plan (Medicaid)
• Molina Health Plan (Medicaid)