Vermont Business Magazine The Department of Vermont Health Access (DVHA) today published a Request for Proposal (RFP) to contract with one or more Accountable Care Organizations (ACOs) to provide certain Medicaid services. The goal of the RFP is to continue to build an integrated health care system that improves the quality of, and access to, care for all Vermonters. The RFP furthers this goal, the DVHA said in a statement, by creating the opportunity for health care providers to get paid in a way that rewards quality, care coordination, and early intervention.
Specifically, the RFP seeks to make a regular, predictable, and prospective payment to ACOs for Medicaid services. Rather than being paid for every service, an ACO would be paid in advance for their entire population. Predictable payment should allow providers to focus on quality of care, innovation, and making long term investments in their practices.
“This is another step in the transformation of our health care system to one that pays for quality rather than quantity,” said Governor Peter Shumlin. “By moving away from the fee-for-service system to one that rewards providers for keeping patients healthy, we will keep Vermonters healthier and save them money. This is the future of health care in America, and Vermont is leading the way.”
The payment model set forth in the RFP would align Medicaid with the federal government’s cutting edge ACO innovation program, called Next Generation. The Administration has been working with the Green Mountain Care Board to determine the feasibility of creating a Next Generation payment model across all health care payers, aligning and streamlining Medicare, commercial insurers such as Blue Cross Blue Shield, and Medicaid.
The RFP does not change in any way the benefits available to Medicaid beneficiaries, which are set by federal and state law. “Medicaid’s mission is to provide the appropriate care at the right time to all its beneficiaries, including some of the most vulnerable people in our community,” said DVHA Commissioner Steven Costantino. Costantino added, “The RFP envisions a system where we partner effectively with health care providers to ensure that we provide great care for Medicaid beneficiaries while being proper stewards of the taxpayer dollars that support the program.”
The RFP was published on April 7th. Proposals are due June 8th. A projected procurement timeline is set forth in the RFP. The RFP is subject to state procurement rules and procedures. State officials are limited in what they can say in order to maintain the integrity of the bidding process. The RFP is available at http://vermontbusinessregistry.com/BidPreview.aspx?BidID=15466