OneCare Vermont is pleased to welcome Josiah Mueller as the Director of Value Based Care, overseeing the organization’s population health model statewide. In this role, Mueller will lead innovations and promote data-driven approaches to improving cost, utilization, and quality of care.
My patient care and teaching experience inspired me to want to do better for patients, providers, and society as a whole, leading me to graduate studies in healthcare economics and a career pivot into value-based care. While working at the Center for Medicare and Medicaid Innovation (CMMI), I learned about an exciting healthcare reform effort in Vermont – the All-Payer Model. Years later, the opportunity to join OneCare was far too exciting to pass up. I’m honored to join the OneCare team and to be part of advancing Vermont’s whole health care system into a value-based model.
Most recently Mueller served as the Director of Healthcare Analytics for clinical operations at Mount Sinai Health System. Mueller started his career in healthcare during nursing school, working as a nursing assistant in neurological inpatient and ICU settings. Additionally, Mueller worked as a pediatric emergency room nurse at John’s Hopkins Hospital, taught hospital-based clinical coursework to nursing students, worked in clinical informatics, and guided strategy for quality improvement efforts. Mueller earned a master’s degree in health economics and went on to work at the Center for Medicare and Medicaid Innovation (CMMI) in the Patient Care Models Group as a Nurse Consultant. In this role, Mueller worked on mandatory episodes of care payment models as the economic impact analysis lead and subject matter expert for national stakeholders.
Moving here from New York City, Mueller is excited to raise his two daughters in Vermont and learn cross-country skiing next winter. Mueller is a triathlete, having participated in dozens of running, cycling, and triathlon races, and looks forward to being active outside in Vermont’s natural environment year-round.
What does it mean to improve cost, utilization, and quality of care?
OneCare focuses on compiling and analyzing health data providers need. OneCare brings data together from different parts of health care: health care visits, insurance claims, medical records, pharmacies, and hospital visits. Then, OneCare helps providers use the insights gleaned from the data to quickly adapt to and meet evolving health needs in their communities.
Data also help providers examine a critical aspect of health care: cost. OneCare supports health care for all Vermonters by making investments in preventive care: checkups, screenings, and community health initiatives. Using these data, we can help lower costs for care that is both unnecessary and expensive by avoiding duplicate tests, or waiving a requirement that patients spend days in the hospital before transitioning to skilled nursing care when the hospital stay is not needed.
Examples of this value-based care in action:
- Quality measures ensure providers are monitoring, and striving to improve, health outcomes. For example, the Controlling High Blood Pressure quality measure looks at OneCare’s unique dataset of patients within a specific age cohort with an active diagnosis of hypertension based on insurance claims billed using specific diagnostic coding. With this information, providers can target patients in their care with a course of action to adhere to a blood pressure plan, manage medication, routinely monitor blood pressure, reduce of sodium in diet, and increase physical activity.
- Health care organizations with high scores on standardized measures of quality earn funding for innovative programs and health promotion efforts. Because organizations participating in OneCare had excellent quality measure scores, they earned $6.3 million in quality payments in 2019. Participating organizations showed improvement in key quality measures, including controlling high blood pressure