In the case of the patient with the wound vacuum-assisted closure, she would likely have returned to the hospital multiple times. Her wounds may have never healed, and she wouldn’t have the quality of life that she currently has right now, which is getting out of bed and participating in activities
Harnessing Waivers to Drive Innovation in Health Care Delivery
As an accountable care organization (ACO), patients seen by OneCare Vermont providers benefit from special legal permissions—known as “waivers”—granted by the Centers for Medicare & Medicaid Services (CMS) and the Department of Vermont Health Access. These waivers allow ACO participants to simplify compliance with certain federal regulations, such as those governing referrals and payments, provided the arrangements support the transition to value-based care.
Waivers are more than just regulatory flexibility—they are a strategic tool that enables providers to collaborate more effectively, reduce duplication of services, and deliver more seamless, coordinated care. OneCare Vermont leverages these waivers to improve quality, control costs, and expand access to care.
Pairing Waivers with Strategic Funding
Recognizing the transformative potential of waivers, OneCare Vermont goes a step further by offering targeted funding to support projects that utilize these permissions to innovate care delivery. One standout example that received special funding from OneCare in 2024 is the Wound Care Initiative—a project designed to address a critical and often overlooked aspect of patient recovery.
The Wound Care Initiative: A Model of Coordinated Healing
Chronic wounds can significantly hinder recovery and quality of life, especially when patients transition across multiple care settings. The Wound Care Initiative brings together Addison County Home Health and Hospice (ACHH&H), UVM Health Network Porter Medical Center, and UVM Health Network Helen Porter Rehabilitation and Nursing Facility to ensure consistent, high-quality wound care throughout the patient journey.
The funding from OneCare for this initiative supported care coordination and non-reimbursable services, including the deployment of a wound-certified clinician to the patient. This specialist provides continuity of care across settings, improving outcomes and reducing costly complications such as emergency department visits and hospital readmissions.
Real-World Impact: Healing Through Collaboration
Properly managed wound care can significantly reduce healing times—for instance, venous leg ulcers typically heal within 12 to 16 weeks with appropriate treatment, and the use of negative pressure wound therapy can accelerate healing by up to 45%. Without coordinated care, however, outcomes can worsen; nearly half of chronic wounds become infected if not properly managed.
One powerful example of the wound care initiative’s success involves a patient with severe stasis ulcers, initially considered unlikely to heal. Thanks to the expertise of a wound-certified clinician made available through the waiver and the consistent use of advanced techniques like Vacuum-Assisted Closure (wound VAC), the patient made a full recovery.
Deb Wesley, CEO of ACHH&H, reflected on the impact:
“In the case of the patient with the wound VAC, she would likely have returned to the hospital multiple times. Her wounds may have never healed, and she wouldn’t have the quality of life that she currently has right now, which is getting out of bed and participating in activities.”
Driving Down Costs While Improving Care
The need for effective wound care is growing, with over 6.5 million Americans suffering from chronic wounds and the wound care market projected to reach $22 billion by 2026. Advanced wound care products already account for 65% of this market, underscoring the importance of specialized knowledge and consistent application.
The Wound Care Initiative demonstrates how coordinated care can reduce the average cost of healing a wound—ranging from $3,415 to $13,355—by preserving patient access to expert wound care, and ensuring best practices are followed. With Medicare spending billions annually on wound care, the potential for cost savings is substantial alongside improved quality of for patients.
Conclusion: A Contribution to Value-Based Success
The Wound Care Initiative exemplifies how strategic use of waivers, paired with targeted funding and clinical expertise, can transform care delivery. By ensuring continuity across the care continuum and focusing on patient-centered outcomes, this initiative has proven to not only improve lives but also advance the goals of value-based care.
For more information:
Please contact Public Affairs at OneCare Vermont. public@onecarevt.org | 802-847-1346
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