For Patients

Health Care Reform for All Vermonters

OneCare joins providers and communities together to improve the health of Vermonters and lower health care costs. OneCare gives doctors access to resources to help coordinate your care and to provide services within your community. By sharing information and working together, providers can do more to make sure you get the best possible care.

Will being in OneCare cost me money?

Being part of the ACO is completely free to patients. OneCare and your insurance company pay your provider for health services you receive. You will never receive a bill from OneCare.

If my doctor is in an ACO, will my health insurance benefits change?

If your doctor is part of OneCare, your health benefits and which providers you can see will not change in any way. You can still see any provider you choose, as allowed by your health plan.

How do I know if I'm part of the ACO?

If you are part of the ACO, you will receive a member notification letter from OneCare or from your insurance company. This letter contains information about how OneCare works, as well as how to opt out of sharing information with the ACO. If you have questions about the notification letter, please contact us.

How will you personally benefit from OneCare?

1. Connection with Your Doctor

OneCare works with your provider to help you stay healthy, avoid trips to the emergency room, and in some cases, support your health goals with a care coordination team. Your doctor also focuses on wellness and check-ups to improve your health and to help prevent you from becoming ill.

2. Health in Your Community

Our prevention programs, such as RiseVT, partner with your community to make the healthy choice the easy choice, by working on issues like affordable housing, walkable towns, and access to healthy food.

Overall, how will Vermonters benefit from OneCare?

A very diverse group of people of varying ages, genders, and backgrounds

OneCare lowers health care costs by helping providers identify Vermonters whose health may be at risk. This is part of population health management. Providers can reach out to people who could benefit from coordination of care. Providers work together to help patients find resources and services that support their health goals.

Here’s a real example of how this works.

Tom’s Story:

  • Tom* is a Vermonter with complex, chronic medical needs. Tom was making multiple trips to the emergency department for health needs that could have been managed through coordinated care.
  • OneCare data analysis identified Tom as a high risk individual and shared this information with his health care providers. They asked Tom if he would like some additional support to help him manage his care. Tom agreed, and now his care coordination team includes a primary care doctor, a cardiologist, a counselor, and a social worker.
  • The team reached out to Tom to set health goals and create a plan to help meet his needs.
  • Care coordination makes sure all Tom’s providers are talking to each other and looking at many things that impact Tom’s health like housing, transportation, and access to healthy food. This cuts down on duplication of expensive tests and connects Tom with important services in his community.
  • Tom’s care team used OneCare’s nationally recognized care coordination model. OneCare provides training for care teams throughout the state and tools to help providers talk to each other about Tom’s health goals.

*Name changed to protect privacy.

Illustration of health care providers taking care of Tom, a Vermonter with multiple chronic issues

Tom’s Results after One Year of Care Coordination

An illustration of Tom laying in a hospital bed attended to by health care providers

Tom’s visits to emergency department visits decreased from six to zero.

An illustration of Tom having a conversation with a health care provider about his chronic conditions and management

Tom saw his doctor more. Primary care physician visits increased from zero to five.

An illustration of a downward sloping arrow over a pile of money - representing decreasing health care costs for Tom

Health care costs for Tom significantly decreased, by 60%, from $63K to $25K

What if I have more questions?

If you have more questions about the ACO, please contact us.

Beneficiary Rights and Responsibilities

OneCare and its network fully supports and complies with all applicable state and federal laws regarding member rights.

See your Beneficiary Rights and Responsibilities.