Results – Archive
View our results prior to this year.
2021
2021 Results for Shared Savings by Payer Program
Medicare
Participating providers earned a total of $10.0 million in Medicare shared savings from collaborative work to improve beneficiaries’ outcomes and overall health of the Medicare population. Of the $10.0 million, OneCare paid $8.8 million of advanced shared savings throughout 2021 to fund the Patient Centered Medical Home, Community Health Team, and SASH population health management payments. The remaining $1.2 million will be distributed directly to providers, with $1.0 million going to primary care and the remaining $200k going to the risk bearing hospitals.
Medicaid
Participating providers earned a total of $4.3 million in Medicaid shared savings. Upon receipt of the payment from Medicaid, $1.5 million will be paid to primary care practices and $2.8 million will be paid to the risk bearing hospitals. Additionally, providers accepting a fixed payment were able to operate in a manner that generated $2.8 million of savings relative to the fixed payment amount
BlueCross BlueShield of Vermont
The 2021 programs continued with risk protections linked to the pandemic. In sum, the result of the performance year is a requirement for OneCare invest $110k in continued improvement activities
MVP QHP
The MVP program was structured as an upside-only program in 2021, and no shared savings were earned.
Combined Shared Savings and Losses for Performance Year 2021
| Medicare | ||
|---|---|---|
| Settlement Payment* | $10,026,241 | |
| % of TCOC | 2% | |
| Fixed Payment Performance | $0 | |
| Combined Result** | $10,026,241 | |
| Medicaid | ||
|---|---|---|
| Settlement Payment* | $4,333,465 | |
| % of TCOC | 1.6% | |
| Fixed Payment Performance | $2,790,821 | |
| Combined Result | $7,124,287 | |
| BlueCross BlueShield of Vermont QHP | ||
|---|---|---|
| Settlement Payment* | ($50,000) | |
| % of TCOC | 0.04% | |
| Fixed Payment Performance | No fixed payment | |
| Combined Result | ($50,000) | |
| BlueCross BlueShield of Vermont Primary | ||
|---|---|---|
| Settlement Payment* | ($60,000) | |
| % of TCOC | 0.02% | |
| Fixed Payment Performance | No fixed payment | |
| Combined Result | ($60,000) | |
| MVP QHP | ||
|---|---|---|
| Settlement Payment* | $0 | |
| % of TCOC | 0% | |
| Fixed Payment Performance | No fixed payment | |
| Combined Result | $0 | |
* Settlement payment amounts incorporate any applicable risk corridor constraints and/or sharing factors per contract terms.
** (Note on Medicare Combined Result) OneCare was paid $8.8 million of advanced shared savings throughout 2021. These dollars supplied OneCare with the cash flow for the Patient Centered Medical Home, Community Health Team, and SASH population health management payments. 100% of Shared Savings were distributed to Initiative Participants and Preferred Providers.
2020
2020 Results for Shared Savings by Payer Program
Medicare
Participating providers earned a total of $16.3 million in Medicare shared savings from collaborative work to improve beneficiaries’ outcomes and overall health of the Medicare population.
Of the $16.3 million, OneCare paid over $8.4 million of advanced shared savings throughout 2020 to fund the Patient Centered Medical Home, Community Health Team, and SASH population health management payments.
The remaining $7.9 million will be distributed directly to risk-bearing providers that participate in OneCare’s Medicare program and reinvested in additional programs, services and initiatives to further improve health and reduce costs.
Medicaid
OneCare Vermont earned shared savings for the 2020 program year, $11.6 million of which was in a settlement payment to the OneCare Vermont ACO.
BlueCross BlueShield of Vermont
For 2020, BCBSVT paid OneCare a $125,000 settlement payment.
MVP QHP
For 2020, MVP paid OneCare a $1,063,182 settlement payment.
Combined Shared Savings and Losses for Performance Year 2020
| Medicare | ||
|---|---|---|
| Settlement Payment* | $16,313,471 | |
| % of TCOC | 4% | |
| Fixed Payment Performance | $0 | |
| Combined Result** | $16,313,471 | |
| Medicaid | ||
|---|---|---|
| Settlement Payment* | $11,621,236 | |
| % of TCOC | 3.6% | |
| Fixed Payment Performance | $43,738,036 | |
| Combined Result | $55,359,272 | |
| BlueCross BlueShield of Vermont QHP | ||
|---|---|---|
| Settlement Payment* | $50,000 | |
| % of TCOC | 0.04% | |
| Fixed Payment Performance | No fixed payment. | |
| Combined Result | $50,000 | |
| BlueCross BlueShield of Vermont Primary | ||
|---|---|---|
| Settlement Payment* | $75,000 | |
| % of TCOC | 0.04% | |
| Fixed Payment Performance | No fixed payment. | |
| Combined Result | $75,000 | |
| MVP QHP | ||
|---|---|---|
| Settlement Payment* | $1,063,182 | |
| % of TCOC | 2.3% | |
| Fixed Payment Performance | No fixed payment. | |
| Combined Result | $1,063,182 | |
* Settlement payment amounts incorporate any applicable risk corridor constraints and/or sharing factors per contract terms.
** OneCare was paid $8.4 million of advanced shared savings throughout 2020. These dollars supplied OneCare with the cash flow for the Patient Centered Medical Home, Community Health Team, and SASH population health management payments. 100% of Shared Savings were distributed to Initiative Participants and Preferred Providers.
2019
2019 Results for Shared Savings by Payer Program
Medicare
Participating providers earned a total of $11.3 million in Medicare shared savings from collaborative work to improve beneficiaries’ outcomes and overall health of the Medicare population.
Of the $11.3 million, OneCare paid $8 million of advanced shared savings throughout 2019 to fund the Patient Centered Medical Home, Community Health Team, and SASH population health management payments.
The remaining $3.3 million will be distributed directly to risk-bearing providers that participate in OneCare’s Medicare program and reinvested in additional programs, services and initiatives to further improve health and reduce costs.
Medicaid
OneCare Vermont went over the budget target for Medicaid and the year-end reconciling payment represents providers accepting accountability for cost and quality of care.
OneCare paid Department of Vermont Health Access $6.7 million for the 2019 performance year.
BlueCross BlueShield of Vermont
For 2019, OneCare participated in the BCBSVT program as upside risk only. The ACO did not receive shared savings or losses.
Combined Shared Savings and Losses for Performance Year 2019
| Medicare | ||
|---|---|---|
| Settlement Payment* | $11,059,786 | |
| % of TCOC | 2.2% | |
| Fixed Payment Performance | $0 | |
| Combined Result** | $11,059,786 | |
| Medicaid | ||
|---|---|---|
| Settlement Payment* | ($6,505,293) | |
| % of TCOC | (3.2%) | |
| Fixed Payment Performance | $8,245,865 | |
| Combined Result | $1,740,572 | |
| BlueCross BlueShield of Vermont | ||
|---|---|---|
| Settlement Payment* | $0 | |
| % of TCOC | 0% | |
| Fixed Payment Performance | $0 | |
| Combined Result*** | $0 | |
* Settlement payment amounts incorporate any applicable risk corridor constraints and/or sharing factors per contract terms.
** OneCare was paid $8,021,268 of advanced shared savings throughout 2019. These dollars supplied OneCare with the cash flow for the Patient Centered Medical Home, Community Health Team, and SASH population health management payments. 100% of Shared Savings were distributed to Initiative Participants and Preferred Providers.
*** While no settlement payment was owed to BCBSVT, OneCare was required to reinvest $10k in its network as a result of program performance.
2018
Despite the strong start, OneCare does not expect this outcome each year. The goal is to live on a steady growth rate. To achieve that goal, OneCare will receive funding in the settlement process some years and will owe money in the process other years.
Medicare: $13,345,337 savings (OneCare was paid $7,776,760 of advanced shared savings throughout 2018. These dollars supplied OneCare with funding for the Patient-Centered Medical Home, Community Health Team, and Support and Services At Home population health management payments.)
Medicaid: OneCare Vermont was within approximately 1% of the budget target for Medicaid and the year-end reconciling payment represents providers accepting accountability for cost and quality of care. OneCare paid Department of Vermont Health Access the difference between the Actual Total Cost of Care and the Expected Total Cost of Care, totaling approximately $1.5 million for the 2018 performance year.
BlueCross BlueShield of Vermont: OneCare was within .05% of the budget target and the BCBSVT QHP (Health Exchange) and paid BCBSVT $645,574.