Regional Medical Center Now Available to VHP Members
Regional Medical Center (RMC) is now part of Valley Health Plan’s network. The County of Santa Clara purchased the hospital on April 1, 2025. It is now the fourth hospital in the County’s health system, called Santa Clara Valley Healthcare (SCVH).
RMC treats many emergency and advanced health issues. Some of their specialty departments include care for cardiovascular, neurological, and orthopedic issues, as well as general surgery. Now VHP members can access high quality care close to home if it is needed.
In recent years, people in the community were concerned because some services were cut at the 258-bed hospital. This included the Level II trauma center, stroke care, certain heart care services called STEMI (ST Elevation Myocardial Infarction), and labor and delivery.
Santa Clara Valley Healthcare brought back the trauma center, stroke care, and heart care services (STEMI) on April 1.
There are also plans to bring back labor and delivery services soon, along with new health services. About 40% of San Jose’s population lives within five miles of Regional Medical Center, so these services are critical to many people.
SCVH also expanded Epic’s Electronic Health Record system, known as HealthLink, to RMC. This helps doctors and nurses share important health information and provide better, safer care. Valley Health Plan also uses Epic’s system, which makes it easier for RMC and VHP to share data and coordinate care.
SCVH says more than 98% of Regional Medical Center employees chose to stay on during the transition. They are now County employees. VHP is happy to welcome Regional Medical Center and its staff to the County of Santa Clara.
Virta Weight Loss and Diabetes Reversal
Valley Health Plan has partnered with Virta Health to provide a weight loss and diabetes reversal program at no additional cost to VHP members with type 2 diabetes and prediabetes.
Virta's program has shown impressive results, with members losing an average of 18 pounds in 10 weeks. And 87% of participants were able to reduce or safely quit their medications. The program focuses on personalized nutrition plans designed to promote weight loss, lower blood sugar, and potentially reverse type 2 diabetes.
Key features include:
• On-demand support from expert health coaches
• A dedicated medical provider to safely reduce medications
• Access to nutrition resources and recipes
• A digital weight scale and meter
Valley Health Plan covers the full cost of Virta (over $3,000) for members and eligible family members with type 2 diabetes or prediabetes. The program is available to those ages 18+ who are enrolled in a qualifying VHP health plan.
“The most surprising thing about Virta is how much I enjoy my new way of eating. I’ve lost 30 pounds and have been able to maintain it, and my life no longer revolves around my diabetes meds.”
-Ricardo, Virta member
For more information or to apply, visit: www.virtahealth.com/join/valleyhealthplan.
Virta also provides free language services for nonEnglish speakers. For assistance, contact Virta at 1-844-847-8216 or support@virtahealth.com
Visit www.virtahealth.com/ join/valleyhealthplan or scan the QR code to get started!
Cancer Awareness and Free Online Assessment
Cancer affects 1 out of 3 people in the United States. You or someone you know may have been impacted by cancer. Your body is made of trillions of cells that grow and divide. Normally, when cells become old or damaged, they die. Cancer starts when this process goes wrong, and cells keep making new ones while old or faulty cells do not die.
Cancer can develop in any part of the body and is named for where it starts. For example, cancer that begins in the breast is called breast cancer, even if it spreads elsewhere.
Breast Cancer Awareness
Breast cancer is the second most common cancer in women, just after skin cancer. It happens when breast cells grow uncontrollably. This can cause cancer cells to take up space that should be filled by healthy cells, making it harder for the body to function properly. Thanks to advances in medical science and early screenings, many people with breast cancer can get treated and go on to live full, healthy lives.
Risk Factors
The main risk factors for breast cancer are being a woman and getting older. Most breast cancers are found in women ages 50 and older. Other risk factors include a personal history of breast cancer or certain noncancerous breast diseases and a family history of breast or ovarian cancer.
Screenings and Exam Types
Breast cancer screening is a way to find the disease before symptoms appear. While some women may notice symptoms, many do not show signs, so regular screenings are important. Early detection can improve the chances of successful treatment.
Breast cancer screening cannot prevent the disease, but it can help detect it early. It is recommended that you discuss which screenings are right for you and the timing with your doctor.
Some common exams to check for breast cancer include:
• Mammogram: This is an x-ray of the breast that can find small tumors that you cannot feel. For many women, mammograms are the best way to detect breast cancer early when it is easier to treat. Talk to your doctor about when to have this exam.
• Clinical Breast Exam: A doctor or healthcare professional will examine your breasts and underarms for lumps or irregularities.
• Breast Self-Exams: You can also check your breasts yourself for lumps or changes. If you find anything unusual, talk to your doctor.
Early screening for breast cancer saves lives. Call your doctor’s office to schedule an appointment or to learn more about cancer screening exams.
Colorectal Cancer Awareness
Colorectal cancer is the third most common non-skin cancer in both men and women. It is the second leading cause of cancer death in the United States, after lung cancer. Colorectal cancer is most common in adults aged 65 to 74.
This type of cancer starts in the colon or rectum. Depending on where it begins, it can be called colon or rectal cancer. These two types are often grouped together because they share many features.
Colorectal cancer happens when cells in the colon or rectum grow uncontrollably, forming tumors. Most of these cancers begin as growths called polyps on the inner lining of the colon or rectum. While some polyps can turn into cancer, not all are cancerous.
Risk Factors
Many factors can affect your risk, including a personal or family history of colorectal cancer or certain types of polyps. Talk to your doctor to learn more about risk factors.
Screening and Test Types
Screening exams are important for finding polyps before they turn into cancer and for catching colorectal cancer early when treatment is most successful. According to the American Cancer Society, people with an average risk for colorectal cancer should begin regular screening at age 45. People at a higher risk should start screening before age 45 and have more frequent exams.
Tests that can check for polyps and colorectal cancer include:
• Stool Test: This test looks for tiny amounts of blood in your stool that you cannot see. For example, the Cologuard test is an easy at-home screening test. If your Cologuard result is negative, the
American Cancer Society recommends getting screened again in three years.
• Sigmoidoscopy: A flexible tube with a light and camera examines the rectum and lower colon and can remove tissue if needed.
• Colonoscopy: This test is like a sigmoidoscopy but checks the entire colon and can also remove tissue if necessary.
Talk to your doctor about your screening options. Your doctor can help you understand the tests available so you can make an informed decision.
Early screening for colorectal cancer saves lives. Call your doctor’s office to schedule an appointment or to learn more about cancer screening exams.
Take Charge of Your HealthFree Cancer Risk Assessment!
Valley Health Plan is teaming up with the American Cancer Society to help more people prevent, detect, treat, and survive cancer.
One simple way to get started is by using the CancerRisk360™ assessment. It is a free, easy online quiz that helps you learn about your personal cancer risk. It takes just 5–10 minutes, and you will get custom tips on how to stay healthy and lower your risk. You must be 18+ years to take it.
Take the easy assessment now and start your journey toward better health: https://acscancerrisk360.cancer.org/.
If you or someone you know has been diagnosed with cancer, we are here for you. The American Cancer Society has helpful information, support, and tools. Learn more at www.cancer.org or call the 24/7 Cancer Helpline at 1-800-227-2345.
Heart Health
High Blood Pressure: What You Need to Know
What is High Blood Pressure?
High blood pressure, also called hypertension, happens when your blood pressure is consistently higher than normal. This pressure can change throughout the day and can make your heart work too hard. Try to keep your blood pressure below 120/80 mmHg. Talk to your doctor about what your specific goals should be.
Signs and Symptoms
High blood pressure usually has no symptoms, which is why checking it regularly is important. A doctor must confirm the diagnosis. High blood pressure increases your risk of serious health problems, such as heart disease and strokes.
Causes and Risks
Common causes of high blood pressure include being inactive, eating too much salt, smoking, and drinking too much alcohol. Over time, high blood pressure can harm your heart, brain, kidneys, and eyes.
Controlling Blood Pressure
• Maintain a healthy weight. Losing weight can help lower your blood pressure.
• Eat healthier. Focus on fruits, vegetables, and low-fat dairy, reducing saturated fats.
• Reduce sodium. Aim for less than 1,500 mg of sodium per day.
• Get active. Try to get at least 30 minutes of exercise every day, such as taking a walk.
• Limit alcohol. Women should drink no more than one drink per day and men no more than two drinks per day.
High Blood Pressure and Smoking
Smoking raises your blood sugar, blood pressure, and cholesterol. Quitting smoking can significantly lower your risk of heart attack, stroke, and diseases affecting your nerves, kidneys, and mouth.
VHP is committed to supporting members who want to stop smoking or using tobacco products. Members can join VHP’s Tobacco Cessation Support program, where they can learn how to manage and cope when trying to quit. See the next section for more information on this free program.
Monitor Your Blood Pressure at Home
If you have high blood pressure or are at risk, consider checking your blood pressure at home. Speak with your doctor to learn how to do this safely.
Talk With Your Doctor
Staying healthy is important. Schedule your yearly health exam and remember to ask about your blood pressure. Understanding your results is important. And remember to be patient and flexible as you work toward your health goals.
You can reverse many health problems by making lifestyle changes if you catch them early. Learning more about your health helps you make better choices.
To learn about VHP's Health and Wellness programs and how to enroll, visit www.valleyhealthplan. org/members/health-and-wellness.
If you have any questions, contact VHP's Health Education Department at 408-970-2299 or healtheducation@vhp.sccgov.org.
Help to Quit Smoking and Tobacco
Smoking and Tobacco Use
Tobacco use is the leading cause of preventable disease, disability, and death in the United States. Smoking and use of tobacco products, including e-cigarettes, cigars, smokeless tobacco, or other nicotinecontaining products, cause or worsen numerous diseases and conditions.
Health Impacts of Tobacco Use
The health risks associated with tobacco use include cancer, heart disease, and respiratory problems. Smoking affects every part of your body including your ears, nose, lungs, stomach, blood, brain, eyes, mouth, heart, and bones. If you smoke, you are 10 times more likely to get cancer than a person who never smoked.
Health Benefits of Quitting Smoking
Quitting smoking will improve your health and can add up to 10 years to your life. As soon as you quit smoking, your body begins to repair the damage caused by smoking and continues to repair itself for many years.
VHP Tobacco Cessation Program
Valley Health Plan offers a tobacco cessation
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program to help members quit smoking or using tobacco products. This program consists of two sessions (available online or in person). We provide sessions in English, Spanish, and Vietnamese. Other languages are also available upon request.
After you finish both sessions, you will receive a certificate to celebrate your success and mark the start of your journey to stop using tobacco. Our goal is to help you quit smoking, even if you have tried before. This program is available at no cost to all VHP members.
VHP’s Tobacco Certified Health Education Specialists will help you with:
• Understanding your smoking history and habits
• Learning the benefits of quitting and ways to do it
• Managing withdrawal symptoms
• Identifying what triggers your smoking
• Discussing options for nicotine replacement therapy (NRT) with your primary care provider
• Recognizing the importance of selecting a “quit date”
To learn about VHP's Tobacco Cessation program and how to enroll, visit www. valleyhealthplan.org/tobacco-cessation. If you have any questions, contact VHP's Health Education Department at 408-9702299 or healtheducation@vhp.sccgov.org.
Childhood Vaccines
The health and well-being of our children is a priority. One of the most effective ways to protect children from serious illnesses and diseases is through vaccines.
Vaccines protect infants and young children.
Vaccines protect children from sickness that can cause long-term health problems. These health problems can include blindness, hearing loss, brain damage, and even death. It is especially easy for infants and young children to get very sick from certain diseases, including the flu. Getting very sick can cause health issues in the future. Children under 5 years of age who get the flu are much more likely than adults to have to go to the hospital.
Vaccines protect children.
There is a vaccine schedule that maps out which vaccine your child needs and when. The schedule is based on how your child’s immune system responds to vaccines at different ages. It is also based on how likely your child will be exposed to a certain disease. Getting your child vaccinated at the right time helps reduce the risk of severe illness.
Vaccines protect others.
Children who are not vaccinated can spread
diseases to others, like newborns, older adults, and people with chronic health issues. Keeping your child’s vaccinations up to date protects not only your child but also those around them.
Vaccines can prevent lost wages from being sick.
When a child gets sick, parents and guardians may have to take time off work to care for them. Time off work can lead to lost income and stress on the family. Older children may also miss out on school, sports, and other activities because they cannot be around other people.
Talk to your children’s doctor about which vaccines they need. Maintaining your children’s vaccines helps protect them as they grow and keeps them healthy.
Vaccine Schedule
By age two, your baby should be up to date with the following vaccines:
• Hepatitis B (HepB)
• Rotavirus (RV)
• Diphtheria, tetanus, and whooping cough (pertussis) (DTaP)
• Haemophilus influenzae type b (Hib)
• Pneumococcal Disease (PCV)
• Polio (IPV)
• COVID-19
• Influenza (Flu)
• Measles, Mumps, Rubella (MMR)
• Chickenpox (Varicella)
• Hepatitis A (HepA)
Vaccination rates have decreased since the start of COVID-19, and this is concerning. To help keep our community healthy, we encourage you to get vaccinated. Vaccines not only protect you but also help prevent the spread of illness.
At Valley Health Plan, our focus is on the well-being of our members. That starts with helping our members have the information and access to care they need to be the healthiest they can be.
To download a copy of the CDC’s recommended child vaccine schedule or to learn more about each vaccine and how it protects your child, visit www.cdc.gov/vaccines.
If you have any questions, please contact VHP’s Health Education Department at healtheducation@vhp.sccgov.org or 408-970-2299.
Initial Health Appointment
The Initial Health Appointment (IHA) is a complete evaluation of your health status during your first visit with your Primary Care Provider (PCP).
This appointment helps build a partnership with your PCP. To prepare, gather your medical history and write down any questions or concerns you have. Good communication and trust are important to prioritize your health and well-being.
If you are a new member of Valley Health Plan, your PCP may complete your IHA within 120 days of joining. The IHA will be provided in a way that respects your cultural and language needs.
Completing an IHA can help you:
• Communicate better. Talk openly with your doctor about your health to build a stronger relationship.
• Identify health issues. Help your doctor find and focus on your main health problems and goals.
• Understand your health. Give your doctor a clear picture of your current health so they can help improve it.
• Increase awareness. Learn about behaviors that affect your health or chronic conditions.
• Get extra support. Find issues that may require referrals to other resources.
What an IHA includes:
• Health history: This covers your physical and mental health, including your current and past medical conditions, your social situation, and your behaviors.
• Risk assessment: Identifies risks based on your age, behaviors, and family health history.
• Preventative care needs: Assesses what preventive screenings or services you need and helps ensure you get them on time.
• Health education: Receive guidance based on your age, risk factors, or any health conditions you have.
• Diagnosis and treatment plan: Get a diagnosis for any health issues and a treatment plan to address them.
Valley Health Plan covers the cost of the Initial Health Appointment. To schedule one, contact your doctor’s office.
Mental Health and Wellness Screenings
Mental health is just as important as physical health. Mental health conditions are very common, and they can have negative effects on our lives. For instance, people with mental health conditions can miss work or school, misuse substances, and isolate themselves from friends and family. Kids experience mental health issues just like adults do and should be screened by their pediatricians.
It is commonly known that physical check-ups are important preventive care, while mental health screenings are often overlooked. Just like checking for signs of cancer leads to early intervention, screening for mental health concerns can also identify issues before they become severe.
Consider these key benefits of regular mental health screenings:
• Early detection. Mental health screening can help identify issues such as depression and anxiety early on before they become more severe. Early diagnosis leads to earlier treatment, which improves outcomes.
• Prevention of progression. Catching
mental health issues early prevents the worsening of symptoms. It also makes early intervention possible.
• Improved functioning. Poor mental health can negatively impact a person’s ability to function at work, school, community activities, or in relationships. Early screening can help improve family and work relationships, attendance at work or school, and symptoms such as irritability, anxiety, and low mood.
• Stigma reduction. Including mental health screening as part of regular doctor visits reduces stigma and sends the message that mental health is just as important as physical health.
• Better quality of life. Good mental health allows people to process emotions, manage stress, and get support during difficult times, all of which contribute to overall well-being and a fulfilling life.
Screening is a powerful tool to assess a person’s mental health before symptoms appear. VHP encourages you to talk to your doctor to get screened as part of your overall health and wellness.
Adapted from www.learntolive.com
More Important Resources and Information
At VHP, we know that keeping up on how to get the most out of your health plan is important to you. So, we have made it easy. To find all your health information in one place, access our member portal, VHP Connect, at www.vhpconnect.org.
For information on the following subjects, visit: www.valleyhealthplan.org/members/formsand-resources or www.valleyhealthplan.org
>Members Tab > Benefits Handbooks. The Benefits Handbooks are also known as the Evidence of Coverage (EOC). This information is also available through alternative media upon request.
Advance Health Care Directive
Affirmative Statement About Financial Incentives
Autism Care Management Program
Change of Address
Choosing and Changing Your Primary Care Practitioner (PCP)
Chronic Condition Management Program / Care Management
Combined Evidence of Coverage, including information such as:
• Benefits and services included and excluded from coverage
• Pharmacy management and general coverage
• Copayments and other cost sharing responsibilities
• Benefits and limitations to services outside the service area
• How to submit a claim for covered services
• How to obtain specialty care, behavioral healthcare services, and hospital services
• How to obtain care outside the service area
• How to obtain care after normal business hours
• Authorization and denial of services
(Independent Medical Review eligibility and process)
Coordination of Benefits
Emergency and Urgent Care Services
Evaluation and coverage of new and existing technologies
Grievance and Appeals Process
Language Assistance
Lock-In Provision
Member Rights and Responsibilities
Non-Discrimination
Protected Health Information
Provider Directory / Search
Self-Refer Services (Direct Access)
Timely Access
Waste, Fraud, and Abuse
Teletypewriter and Telecommunications Device for the Deaf services are available for the hearing and speech impaired. Call the California Relay Service (CRS) by dialing 711 or the 800 CRS number of your modality.
The VHP Member Services Department has staff available Monday through Friday, 8 a.m. to 5 p.m. to assist with:
• utilization management issues
• authorizations
• claims
• benefits
• coverage
• general inquiries
Messages received after normal business hours are returned on the next business day, and messages received after midnight on Monday through Friday are responded to on the same day. If you need assistance, please contact VHP Member Services at 1-888-421-8444 (toll-free) or memberservices@vhp.sccgov.org
Sources
Whole-Food Plant-Based Hummus Recipe
Ingredients
• 15 Ounce Can Garbanzo beans, drained and rinsed
• 3 Tbsp Lemon juice
• 2 Cloves Garlic, crushed
• 1-2 Tbsp Water
• 1 Tbsp Tahini (optional)
• Dash Sea salt
Directions
Place all ingredients in a food processor and process until very smooth.
Add more ingredients to this basic hummus for flavor and variety: 1. 1/2 cup roasted red peppers plus 1/2 teaspoon ground cumin. 2. 1/2 cup chopped parsley or cilantro. 3. 1-2 teaspoons chopped jalapeno peppers.