OneCare’s Dedication To Transparency
OneCare Vermont is committed to make information about the work we do easily available to everyone in a clear, reliable, and easy to understand manner. Below is a list of “common interest” items and frequently asked questions.
We also welcome specific ideas for additional information to include on this page. Please contact us if you have suggestions.
What is OneCare?
OneCare is a cooperative effort of providers who have pooled their resources and expertise to keep people healthy and well with a focus on increasing access to primary care, reducing deaths from suicide and drug overdose, and supporting Vermonters with chronic illnesses. This focus on keeping people healthy and well and containing costs is key to the agreement the state signed with the federal government and the providers of OneCare are central to this effort.
How is OneCare changing care?
Our work is in breaking down silos in care and enabling coordination, building care teams, and bringing providers together in new and different ways. We do this by providing caregivers with data, funding and best practices across the state so that our family, friends and fellow Vermonters, no matter where they live, get better care. To learn more about what this means for Vermonters and their providers, check out this two part series by WCAX:
2020 Budget Overview
OneCare’s 2020 budget was approved by the Green Mountain Care Board on December 18, 2019. The 2020 budget includes support for primary care and community-based services, investments in programs that help Vermont meet the goals of the All-Payer Model, and continues Medicare funding for Blueprint and SASH (Supports and Services at Home). Secretary Smith and Commissioner Gustafson have presented to the House Appropriations Committee in late December 2019, and included their thoughts on the 2020 budget in their testimony. You can find OneCare’s full budget materials and budget presentation on the GMCB website.
PricewaterhouseCoopers (PwC) conducted an audit of OneCare’s financials for 2017 and 2018, and OneCare Vermont was given a clean audit for both years.
Results of financial audits from 2017 and 2018 are available on our ACO results page.
2018 Quality Results
The quality scores that OneCare achieved for 2018 are 85% for Medicaid, 86% BCBSVT QHP (Health Exchange), and 100% Medicare (Medicare was reporting only for 2018). Quality scores are posted on the ACO Results page. Please note that it is too early in the model to make year over year comparisons of the quality results due to the growth of the population, but we are working on ways to represent progress year-to-year.
2018 Shared Savings
Each year, OneCare sets a budget with payers for the cost of health care of a population. If the cost of healthcare for that population exceeds the set amount, OneCare pays the overage back to the payer. If the cost of healthcare is lower than the budgeted amount, the savings stay with OneCare. This provides for predictability and stability in health care spending.
OneCare does not keep savings. All of the funds are reinvested in the provider community to both offset investments already made and continue to develop and enhance population health programs and some is set aside to offset risk.
Despite the strong start, OneCare does not expect this outcome each year. The goal is to live on a steady growth rate, and to achieve that goal means sometimes OneCare will receive funding in the settlement process, and sometimes OneCare will owe money. You can find shared savings results on the ACO results page.
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 SASH 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 DVHA 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.
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