ACO Insights

Measuring OneCare’s progress

Welcome to the OneCare ACO Insights dashboard. This dashboard shows metrics of our three core capabilities – network performance management, data and analytics, and payment reform – to demonstrate the value of OneCare and measure our progress. The metrics on this page will be periodically updated to reflect our progress over time.

Illustration - OneCare Core Business Area - the Statewide Care Model - showing a doctor taking care of a male patient checking his heart beat with a stethoscope. Next to the patient is a window showing Vermonters in healthy communities engaging in activities promoting healthier lifestyles.

Core Capability #1:

Network Performance Management

  • Metric #1: Patient Prioritization Support from OneCare
  • Metric #2: Achieving Outcomes for High Risk Individuals
Illustration - OneCare Core Business Area - Data Analytics. Two data analysts on the left are looking at a large whiteboard covered in infographics and statistics. Next to them is a woman sitting in front of a computer generating detailed analytics.

Core Capability #2:

Data and Analytics

  • Metric #1: Identify and Support Potential Opportunities for Change
  • Metric #2: Support Primary Care and Panel Management Efforts
Illustration - OneCare Core Business Area - Payment Reform. An accountant is looking at her computer and working with a doctor who is standing in front of a large clipboard with quality check marks on it. On the ground behind them are symbols representing money and payment.

Core Capability #3:

Payment Reform

  • Primary Metric: Fixed Payment Transformation

Metrics: Network Performance Management

Metric #1: Patient Prioritization Support from OneCare

Care coordination is the basis for improving clinical outcomes, improving the patient experience, and reducing cost of care. Resources to support care coordination efforts statewide are limited and not always interconnected. Actionable data is critical when making meaningful change. OneCare provides support to providers by supplying care coordination training and sharing prioritized lists of patients who are high risk who may benefit from care coordination.

Network Performance Management Infographic #1 - reference to accessible version below

Metric #2: Achieving Outcomes for High Risk Individuals

OneCare provides tools, funding, and care coordination expertise to support care coordination activities. Coordinating care has been shown to reduce unnecessary utilization of health care services. By tracking progress in key performance indicators including emergency department utilization, inpatient utilization, and readmission rates; OneCare can help determine if the care coordination program is having the expected effect.

Network Performance Management Infographic #2 - reference to accessible version below

Metrics: Data and Analytics

Metric #1: Identify and Support Potential Opportunities for Change

OneCare’s analysts use data and analytics to identify potential opportunities for changes in workflow or improvement in quality of care. OneCare interacted with community health services areas (HSAs) to determine where data could support improvement efforts.

Data and Analytics Infographic #1a - reference to accessible version below

The map above represents the level of engagement of participating organizations within each HSA as determined by OneCare Analytics.

Data and Analytics Infographic #1b - reference to accessible version below

Metric #2: Support Primary Care and Panel Management Efforts

OneCare works to bring focus to specific clinical priorities and provides data to track improvement in these areas.

Data and Analytics Infographic with Focus Areas - reference to accessible version below
Data and Analytics Infographic and Participating organizations - reference to accessible version below

Metrics: Payment Reform

Primary Metric: Fixed Payment Transformation

Health care providers have historically been paid on a fee-for-service basis for each visit or procedure. OneCare sought to change this by paying certain providers monthly fixed payments to care for their patients. This helps shift the focus to delivering the best care, not the most care.

OneCare Payment Reform Infographic Timeline - reference to accessible version below

Accessible version of The Transformation of OneCare’s health care spending Infographic

* OneCare works with/oversees multiple programs (e.g., Medicare, Medicaid), some of which are at the end of stage 3, and some of which are in stage 4; this placement represents an approximate combined average of where these programs currently are in this transition to value-based care. CHART SOURCE: Health Care Payment Learning Action Network Updated All Payer Model Framework

Primary Metric: Fixed Payment Transformation, continued

OneCare Vermont is leading the effort to move the health care system to a value-based financial model that rewards high-value care over volume. Part of our strategy is to also change the way providers are paid. OneCare facilitates these changes on behalf of its network providers.

The Story Behind this Chart

OneCare distributes two types of “fixed prospective payments” (FPP) to health care providers: FPP non-reconciled and FPP reconciled.

FFS represents fee-for-service dollar amounts paid directly from payers (e.g., Medicaid) to health care providers but OneCare is accountable (responsible) for these costs.

Over time, growing the total health care costs in a value-based model and moving more provider reimbursement to fixed payments will help to shift away from the fee-for-service payment structure and incentivize activities that aim to manage overall health care costs and keep populations healthier.