OneCare’s work provides a common approach to serve all participating providers. OneCare facilitates improved provider network performance on cost and quality.
OneCare’s Core Capabilities
Core Capability #1:
Network Performance Management
There are over 5,000 participating health care providers who make up OneCare’s network of providers. Through network performance management, OneCare establishes value-based care contracts with insurance payers (Medicaid, Medicare, and commercial insurers) on behalf of participating providers and supports success under those contracts through primary prevention efforts, care coordination infrastructure, and quality improvement metrics.
Core Capability #2:
Data and Analytics
OneCare brings data together from different parts of health care—health care services, insurance claims, medical records, pharmacies, and hospital visits—and analyzes the data to measure health care cost, quality, and utilization. Providers who participate in OneCare benefit from OneCare’s data about not just their practice, but also their region, the state, and how they compare. Insights gleaned from these data help providers identify which Vermonters need outreach and which areas of care delivery to improve.
Core Capability #3:
OneCare pays fixed monthly amounts to providers to care for their patients—helping shift away from the fee-for service model that rewards for more care, to focusing on delivering the best care through a value-based model. When providers are reimbursed for value instead of volume, over time, they can change the way they deliver health care and invest in activities that are designed to lead to better health outcomes—primary care, health prevention, early identification of disease, and the right treatment at the right time.