Colchester, VT, October 10, 2019 – OneCare Vermont (OneCare) is one of eight organizations chosen to participate in Advancing Integrated Models, a multi-site demonstration promoting innovative, person- centered strategies to improve care for adults and children with complex health and social needs. Made possible with support from the Robert Wood Johnson Foundation and led by CHCS, AIM will assist health system and provider organizations in designing and piloting new approaches to integrate care for people with complex needs with a focus on improving health outcomes and fostering health equity.

“As healthcare and social service programs continue to work in collaboration to improve health and wellbeing for Vermonters, integration of health and social needs information becomes even more crucial in order to support effective person-centered care. Joining this information can enhance identification of individuals that could benefit from enhanced services and supports and help inform ways to connect Vermonters in need with resources available to support them. We are very appreciative of Agency of Human Services’ leadership in looking for innovative ways to facilitate improved care and outcomes through collaborations across health and human services sectors,” said Sara Barry, OneCare’s Senior Director of Value Based Care.

This multi-site demonstration will accelerate opportunities to align best practice approaches in care delivery for children and adults with complex health and/or social needs, including: (1) complex care management; (2) trauma-informed care; (3) physical and behavioral health integration; and (4) mechanisms to address health-related social needs. While many organizations have implemented one or more of these strategies, few have adopted all and even fewer have effectively aligned these efforts internally or externally with community partners.

“There is enormous energy across the complex care field to implement various strategies to improve health and social service delivery for people with complex needs; however, these strategies are typically siloed in isolated programs,” said Allison Hamblin, MSPH, president and chief executive officer at CHCS. “Advancing Integrated Models seeks to promote greater integration of these approaches and create sustainable partnerships and financing pathways to support this work.”

OneCare was competitively selected to participate in the initiative, along with seven additional programs. Each pilot site offers clearly defined opportunities to build on existing pioneering care models and meaningfully involve consumers in improving care delivery. Sites will collaborate with Medicaid partners to identify supportive payment models for their planned approach. Additional programs are: Bread for the City, Washington D.C.; Center for the Urban Child and Healthy Family at Boston Medical Center, Boston, MA; Denver Health, Denver, CO; Hill Country Health and Wellness Center, Round Mountain and Redding, CA; Johns Hopkins HealthCare, Baltimore, MD; Maimonides Medical Center, Brooklyn, NY; and Stephen and Sandra Sheller 11th Street Family Health Services, Philadelphia, PA.

“These innovators in the field are truly at the cutting edge of person-centered care for adults and children with complex needs,” said Susan Mende, MPH, senior program officer at the Robert Wood Johnson Foundation. “AIM is providing an exciting opportunity to build on their efforts and support a vision for meaningful health system transformation to improve health outcomes.”

Over two years, each site will receive tailored technical assistance and access to national subject matter experts and participate in a peer learning collaborative to accelerate solutions across sites. Throughout the initiative, CHCS will identity and share lessons and tools from the sites’ experiences to help stakeholders across the nation increase the effectiveness of integrated care models. Look for more information at

About the Robert Wood Johnson Foundation

For more than 45 years the Robert Wood Johnson Foundation has worked to improve health and health care. We are working alongside others to build a national Culture of Health that provides everyone in America a fair and just opportunity for health and well-being. For more information, visit

About the Center for Health Care Strategies

The Center for Health Care Strategies (CHCS) is a nonprofit policy center dedicated to improving the health of low-income Americans, especially for individuals with complex, high-cost needs. CHCS works with state and federal agencies, health plans, providers, and community-based organizations to advance innovative and cost-effective models for organizing, financing, and delivering health care services. For more information, visit

About OneCare Vermont ACO

OneCare is an Accountable Care Organization (ACO) working with Medicare (Next Generation Model), Vermont Medicaid, Commercial, and Self-Funded insurance programs to improve the health of Vermonters and lower health care costs. Established as an ACO in 2013 by Dartmouth-Hitchcock and the University of Vermont Medical Center, the OneCare network in 2019 includes the communities of Bennington, Brattleboro, Burlington, Lebanon, Middlebury, Montpelier, Newport, Randolph, Rutland, Springfield, St. Albans, St. Johnsbury, and Windsor. OneCare Vermont comprises an extensive network of providers, including hospitals in Vermont and New Hampshire, hundreds of primary and specialty care physicians, skilled nursing facilities, Federally Qualified Health Centers, Home Health Agencies, Area Agencies on Aging, and Designated Agencies for Mental Health and Substance Use. Over 172,000 Vermonters receive care from a provider in the OneCare network.