Vermont becomes first in nation to implement statewide accountable care organization

by Jennifer Brandt Vermont Business Magazine On Friday, officials from Fletcher Allen and Dartmouth Hitchcock Medical Center announced the creation of the nations first statewide accountable care organization (ACO), called OneCare Vermont. The group includes 13 of the states 14 hospitals, along with hundreds of primary care physicians, five rural practices and two federally qualified health centers.
Representative Peter Welch authored the provision of the Affordable Care Act that approved OneCare Vermont as a pilot program. He issued this statement about the organizations approval.
"As usual, Vermont is leading the way. Accountable care organizations like 'OneCare Vermont' will transform the health care payment system by rewarding providers for improvements in a patient's health rather than the number of procedures they perform. It is a common sense approach that I will be working to expand nationwide."
The law will affect about 42,000 of Vermonts 118,000 Medicare beneficiaries who will now be receiving benefits from OneCare. According to OneCare.org, an ACO is defined as: a group of primary care providers, specialists and/or hospitals and other health professionals who coordinate the full continuum of care and are accountable for the overall quality of care and costs for a defined population. (Medicare Payment Advisory Commission).
Governor Peter Shumlin issued this statement on the OneCare announcement.
I am glad that the federal government continues to support Vermonts efforts at statewide, comprehensive health care reform. The success of health care reform depends on transforming into a more effective, efficient health care system. We need our health care providers to lead this effort. The OneCare ACO is a great example of how health care providers can step up to the challenge, and government can support them. I look forward to OneCare achieving great results for Vermonters.
Part of the mission of One Care Vermont is to increase coordination between health care providers in Vermont. The organization also hopes that the new system will increase communication between practitioners and patients.
The old pay per service model is being replaced. The new system is aimed at ensuring no cost change for Medicare recipients and protecting practitioners from financial risk from Medicare. This is intended to ensure cost savings for individual patients over the long term. The federal Center for Medicare and Medicaid services have laid out specific ways in which this will be achieved. According to an article on vtdigger.org: "The shared savings program aims to reduce health care costs by improving provider efficiency. To try to obviate or mitigate corner cutting, CMS has laid out 33 quality measures, which range from providing access to specialists to regular screenings for cancer and other illnesses."
Vermont has already begun to work in conjunction with the federal government to help protect consumers. According to Healthcare.gov. In every State and for the first time under Federal law, insurance companies are required to publicly justify their actions if they want to raise rates by 10 percent or more. Vermont has received $4,804,045 under the new law to help fight unreasonable premium increases.