US Centers for Medicare & Medicaid Services Innovation Center releases rigorous evaluation, calling OneCare an “essential mechanism” for supporting providers in value-based care
FOR IMMEDIATE RELEASE: August 15, 2023
Colchester, Vt. – According to an independent analysis commissioned by the Centers for Medicare & Medicaid Services (CMS) Innovation Center, OneCare Vermont successfully drove down costs and hospitalizations over four years. In a health care environment where patients tend to see nothing but consistent cost increases, this analysis shows that OneCare is working – lowering costs, driving down the need for hospitalizations, and improving patient care.
Key Findings in the Report include:
- Reduced gross spending for Medicare beneficiaries in ACO and beneficiaries statewide over its first four years.
- Lowered hospitalizations and unplanned hospital readmissions for Medicare beneficiaries.
- Achieved key financial targets for Medicare and all-payer total cost of care, limiting growth rates well below national projections.
- Provided an important mechanism to continue collaboration and health care delivery transformation activities that preceded the model.
“OneCare’s progress is exciting and encouraging,” said Carrie Wulfman, MD, OneCare chief medical officer. “This report shows that we are advancing our mission of supporting high-quality care and reducing health care spending through an unprecedented level of connection and coordination among our many different types of providers, across diverse care settings.”
OneCare is a Vermont owned and operated ACO that gives Vermont providers in their network necessary tools to provide the best health care possible. These include data and analysis, financial incentives for health outcomes and flexibility to deliver the right care at the right time at the right place.
By providing these tools, OneCare is moving our health care system towards a higher quality, more affordable, and coordinated model that better serves patients. By supporting providers, increasing access to preventative care and paying for value and health outcomes rather than various services, such as tests and operations, this system will keep Vermonters healthier while reducing the rate of growth in health care spending. Evaluators found the ACO structure in our state was an “essential mechanism” for supporting providers in value-based care.
“OneCare is making progress towards its goals of lowering costs and improving Vermont’s health care system,” said Abe Berman, One Care’s CEO. “There are over 5,000 providers partnering with OneCare who, thanks to the tools offered by the ACO, are delivering higher quality care and more savings to over 200,000 Vermonters. While we know there is a lot more work to do, this report is a clear indication that we are making real progress.”
The report, which covered the model’s evaluation results over its first four performance years (PYs), from 2018 through 2021, also highlighted several examples that contributed to OneCare’s success, including:
- The collaborative ACO structure fostered stronger relationships among community partners, supporting coordination of services.
- OneCare’s Comprehensive Payment Reform program (see video below) for independent primary care practitioners enabled practices to hire more primary care clinicians, expand care teams to include mental health and substance use disorder providers, social workers, and care coordinators, implement practice flow transformation, and allowed practices to have a consistent revenue stream during the COVID-19 pandemic.
- Hospitals and practices relied on fixed, prospective payments that provided reliable income and supported population health management efforts.
Watch: A overview of OneCare’s Comprehensive Payment Reform Program
The National Association of Accountable Care Organizations (NAACOS), responded to the independent evaluation by applauding the success of OneCare, calling it a model that should be expanded across the nation.