Findings include a reduction in Medicare costs and in hospital readmissions suggesting cost saving and care coordination improvements
Colchester, VT – The federal Centers for Medicare & Medicaid Services (CMS) released an evaluation and summary of findings of the first two performance years (2018 and 2019) of Vermont’s All-Payer Model (APM), finding promising results that indicate the APM and Vermont’s Accountable Care Organization, OneCare Vermont, are on the right track toward transforming the way health care is paid for and delivered. The evaluation of the first two years of the model was conducted by NORC at the University of Chicago, an independent research institution, and assesses the implementation and measures effects of the APM.
The five-year APM was launched on January 1, 2017 with the purpose of assessing whether an All-Payer Model to include Medicare, Medicaid, and commercial payers and implemented by a statewide Accountable Care Organization (ACO) can reduce health care spending while preserving or improving quality of care. OneCare Vermont is the statewide ACO and has worked to meet the goals outlined in the APM by aligning payments to providers with incentives that improve care and overall population health, especially for those with chronic or complex illness. The program also enhances coordination among providers, provides data to support best practices to make care more consistent, and invests in wellness and prevention through primary care.
“These findings are very encouraging validation of the critically important work our providers are doing to improve preventive care, keep costs down, and support patients with complex conditions,” said Vicki Loner, RN.C, OneCare CEO. “We have a long way to go to fully realize the vision of the APM, but we are on the right track and must continue to make steady progress for the people of Vermont.”
Key findings of the evaluation of the APM are:
- The APM achieved statistically significant Medicare gross spending reductions at both the ACO and state levels, as well as Medicare net spending reductions at the state level.
- There were statistically significant declines in acute care stays (at the ACO and state levels) and in 30-day readmissions at the state level.
- Evaluators found that stakeholders agree that the APM provides an important, unifying forum for providers, payers, and the state to engage in meaningful discussions about healthcare reform and set goals. The APM is also strengthening relationships among hospitals, community organizations, designated mental health agencies, primary care practices, and other providers.
“These findings are very encouraging validation of the critically important work our providers are doing to improve preventive care, keep costs down, and support patients with complex conditions. We have a long way to go to fully realize the vision of the APM, but we are on the right track and must continue to make steady progress for the people of Vermont.”
“This evaluation of Vermont’s All-Payer Model is another example of a successful ACO model. We know from other CMS models that ACOs are both lowering the cost of care and improving the quality of patient care,” said Clif Gaus, Sc.D., president and CEO of the National Association of ACOs (NAACOS). “This report adds to the growing body of evidence that shows if you hold providers accountable for patients’ total-cost-of-care and give them time to adjust practice patterns then positive results will follow.”
Providers participating in the OneCare Vermont ACO understand the challenge of shifting the healthcare system to one that allows providers to practice the way they were trained to deliver care—in a more patient-centered model that allows for holistic, coordinated care. “Changing the healthcare system will take time and I am pleased that the findings of this report show that we are headed in the right direction. OneCare provides the structure and tools for providers to work together across organizational lines and supports our work to improve the health of Vermonters through data and analytics and innovative payment models,” said Toby Sadkin, MD, family physician at St. Albans Primary Care, Chair of Primary Care Health Partners, and OneCare Board Manager.
Healthcare reform is an ongoing process with a continuous opportunity to build upon collective experiences and make the necessary adjustments to strengthen the APM. Several areas of opportunity identified in the report have been addressed in years three and four of the APM, including bringing more Federally Qualified Health Centers into the ACO and committing further investment and support for independent primary care.
“This report provides an informed, research-based structured analysis of our collective work in Vermont and demonstrates that the progress in the early years show value, thanks to the cooperative effort of thousands of providers who work together in the OneCare ACO,” Loner continued. “We have learned a lot in the early years and we will continue to learn and evolve as the model matures. This is hard work and we are confident that the work we are embarking on as part of our strategic plan will enable us to focus and accelerate our progress as we continue to deliver meaningful payment and healthcare reform for Vermonters.”
Alida Duncan, Marketing & Communications Manager
About OneCare Vermont:
OneCare partners with health care providers to transform the health care system to one that focuses on health goals and fosters better outcomes for all. By giving health care providers actionable data and analytics, paying for health care value, and managing ACO network performance, OneCare supports participating providers in their work to provide excellent health care to Vermonters. Through this partnership, OneCare moves Vermont toward a trusted, equitable health care system where patients and providers work together to achieve optimal health and an exceptional care experience. Learn more at onecarevt.org.
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