Blue Cross Vermont and OneCare Vermont enroll 24,000

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Blue Cross Vermont and OneCare Vermont enroll 24,000

Mon, 02/18/2019 - 5:54am -- tim

Vermont Business Magazine Blue Cross and Blue Shield of Vermont (BCBSVT) has announced a continued partnership with OneCare Vermont providing its individual and small employer members access to state health care reform programs. BCBSVT and OneCare will engage with providers through programs focused on improving quality, increasing access to care, and ensuring efficient and cost-effective delivery of health care services. This arrangement covers approximately 24,000 BCBSVT members with primary care physicians in the OneCare network. BCBSVT is the only commercial health insurance company to participate in the State’s All Payer Model and the OneCare Vermont Accountable Care Organization (ACO) delivery program.

Since inception of this program eight years ago, BCBSVT has facilitated state payment reform, supported delivery system transformation, and the integration of medical management in Vermont.  “BCBSVT is committed to state health care reform that improves the quality of care and ultimately yields affordable premiums for Vermonters. This contract continues to build on our health reform initiatives and public-private partnerships.” says Don George, CEO and president of BCBSVT.  

“Reaching this agreement is an important step in achieving the broad goals of the All Payer Model,” said Kevin Stone, interim CEO of OneCare Vermont. “We appreciate the spirit of collaboration and hard work that led to this milestone and hope this will be a key building block to ongoing collaboration.”

BCBSVT and OneCare will share in financial savings and risk of up to 6 percent of the total cost of care for individual and small employer members attributed to the program.  BCBSVT will pay OneCare $3.25 per member per month to support care coordination programs.  This total cost of care is directly linked to the health insurance premiums and the Accountable Care Organization (ACO) budget target approved by the Green Mountain Care Board.

The contract also includes quality measures—including member satisfaction and outcomes of care coordination – that align with the All Payer Model, Vermont Medicaid, and BCBSVT’s goals for improving the member experience and health outcomes. Don George, CEO and president of BCBSVT shares, “We are working closely with OneCare providers to support their work in care coordination on behalf of our members. 

BCBSVT and OneCare serving as leaders in payment reform efforts here in Vermont will focus on impacting medical spending through reform efforts as opposed to blanket premium or budget reductions.  Collaboration and sharing of risk with providers will move the state forward in health care reform by focusing on population health strategies and the integration of provider systems. 

About Blue Cross and Blue Shield of Vermont:  Blue Cross and Blue Shield of Vermont (BCBSVT) is the only health and wellness company based in Vermont. As a nonprofit organization and the state’s oldest and largest health insurer, BCBSVT provides coverage for thousands of Vermonters through group and individual health plans. More information is available at www.bcbsvt.com. Blue Cross and Blue Shield of Vermont is an independent corporation operating under a license with the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans.

About OneCare Vermont ACO OneCare is an Accountable Care Organization (ACO) working with Medicare (Next Generation Model), Vermont Medicaid, Commercial, and Self-Funded insurance programs to improve the health of Vermonters and lower health care costs. Established as an ACO in 2013 by Dartmouth-Hitchcock and the University of Vermont Medical Center, the OneCare network in 2019 includes the communities of Bennington, Brattleboro, Burlington, Lebanon, Middlebury, Montpelier, Newport, Randolph, Rutland, Springfield, St. Albans, St. Johnsbury, and Windsor. OneCare Vermont comprises an extensive network of providers, including hospitals in Vermont and New Hampshire, hundreds of primary and specialty care physicians, skilled nursing facilities, Federally Qualified Health Centers, Home Health Agencies, Area Agencies on Aging, and Designated Agencies for Mental Health and Substance Use. Over 172,000 Vermonters receive care from a provider in the OneCare network.

Source: Berlin, VT – Blue Cross and Blue Shield of Vermont