The pandemic has made it clear that fee-for-service is unsustainable, and we’re fully committed to value-based care as the solution to stabilizing Vermont’s increasing health care costs. We’re excited to be joining the Medicare program with OneCare for the first time this year. OneCare’s approach provides the best opportunity to achieve meaningful health care payment and delivery reform here in Vermont.
Submission of the 2021 Budget
OneCare Vermont, Vermont’s Accountable Care Organization (ACO) filed their 2021 budget last week on October 1, 2020 with the Green Mountain Care Board (GMCB) as part of their annual budget review process. The budget supports the cooperative effort of thousands of providers across Vermont to stabilize health care costs and improve health for Vermonters.
Highlights of the budget include:
- An additional 28,000 Vermonters will receive care from providers participating in OneCare and this new participation will contribute to meeting the scale targets.
- There is increased and more in-depth hospital and provider participation in OneCare payer programs from last year.
- Primary care providers in OneCare are projected to receive over $18 million dollars in investments to primary care, a focus of Vermont’s All-Payer ACO model, in addition to payments received for care delivery.
- Of the total OneCare budget, 1.1% is designated for operating costs.
“The pandemic has made it clear that fee-for-service is unsustainable, and we’re fully committed to value-based care as the solution to stabilizing Vermont’s increasing health care costs,” said Rutland Regional Medical Center President and CEO Claudio Fort. “We’re excited to be joining the Medicare program with OneCare for the first time this year. OneCare’s approach provides the best opportunity to achieve meaningful health care payment and delivery reform here in Vermont.”
Primary Care Health Partners benefits from CPR program
Primary Care Health Partners signed up for the OneCare Comprehensive Payment Reform program (CPR), which pays providers for better health outcomes instead of for each visit to the doctor’s office. Independent primary care practices that participate in CPR can earn 49% more during patient visits. Jon Asselin is COO of the group.
“We are appreciative to have the opportunity to continue our participation in the Comprehensive Payment Reform program in 2021,” said Asselin. “This program has provided relief to the challenges facing our independent primary care practices since the program’s formation in 2018. This program has enabled us to sustain and expand the delivery of primary care services throughout Vermont. Of special note is how the CPR’s fixed payments limited our revenue losses when COVID-19 hit. Had we not been in CPR and relied solely on fee-for-service, we would have seen greater losses during the state of emergency given the reduction in the number of in-person office visits. The fixed payments helped provide a safety net during these extraordinarily difficult times.”
A Message from OneCare’s CEO Vicki Loner
“We have long expressed the virtues of moving away from fee-for-service care, and COVID-19 may be the single most dramatic example of why this transition is so important for our future,” said OneCare CEO Vicki Loner. “Providers are working as hard as they ever have in very challenging circumstances. It’s rewarding to be part of the team that is helping them achieve greater satisfaction, increase collaboration, and ensure payments that are predictable and tied to health care outcomes, not tests and procedures. Our work together will improve the lives of Vermonters.”