OneCare Vermont submits 2021 budget, reports increased participation

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OneCare Vermont submits 2021 budget, reports increased participation

Fri, 10/02/2020 - 3:30pm -- tim

Vermont Business Magazine OneCare Vermont, Vermont’s Accountable Care Organization (ACO) on Thursday filed their 2021 budget with the Green Mountain Care Board (GMCB) as part of their annual budget review process. The budget supports the cooperative effort of thousands of providers across Vermont to stabilize health care costs and improve health for Vermonters.

Highlights of the budget include:
• An additional 28,000 Vermonters will receive care from providers participating in OneCare and this new participation will contribute to meeting the scale targets.
• There is increased and more in-depth hospital and provider participation in OneCare payer programs from last year.
• Primary care providers in OneCare are projected to receive over $18 million dollars in investments to primary care, a focus of Vermont’s All-Payer ACO model, in addition to payments received for care delivery.
• Of the total OneCare budget, 1.1% is designated for operating costs.

“The pandemic has made it clear that fee-for-service is unsustainable, and we’re fully committed to value-based care as the solution to stabilizing Vermont’s increasing health care costs,” said Rutland Regional Medical Center President and CEO Claudio Fort. “We’re excited to be joining the Medicare program with OneCare for the first time this year. OneCare’s approach provides the best opportunity to achieve meaningful health care payment and delivery reform here in Vermont.”

Primary Care Health Partners signed up for the OneCare Comprehensive Payment Reform program (CPR), which pays providers for better health outcomes instead of for each visit to the doctor’s office. Independent primary care practices that participate in CPR can earn 49% more during patient visits. Jon Asselin is COO of the group.

At Governor Scott's press briefing Friday, Human Services Secretary Mike Smith said that the state is working to "re-boot" the All-Payer model, which has worked well during the pandemic.

Smith, and the governor echoed, that the system would work better with more people enrolled. He will be meeting with the state employees union later this month and he said will reach out to the teacher's union also in an effort to increase the rolls to increase scale and make the system more efficient.

“We are appreciative to have the opportunity to continue our participation in the Comprehensive Payment Reform program in 2021,” said Asselin. “This program has provided relief to the challenges facing our independent primary care practices since the program’s formation in 2018. This program has enabled us to sustain and expand the delivery of primary care services throughout Vermont. Of special note is how the CPR’s fixed payments limited our revenue losses when COVID-19 hit. Had we not been in CPR and relied solely on fee-for-service, we would have seen greater losses during the state of emergency given the reduction in the number of in-person office visits. The fixed payments helped provide a safety net during these extraordinarily difficult times.”

“We have long expressed the virtues of moving away from fee-for-service care, and COVID-19 may be the single most dramatic example of why this transition is so important for our future,” said Vicki Loner, CEO at OneCare Vermont. “Providers are working as hard as they ever have in very challenging circumstances. It’s rewarding to be part of the team that is helping them achieve greater satisfaction, increase collaboration, and ensure payments that are predictable and tied to health care outcomes, not tests and procedures. Our work together will improve the lives of Vermonters.”

To learn more about OneCare’s network and initiatives, please visit onecarevt.org.

About OneCare Vermont
OneCare Vermont is a provider-led Accountable Care Organization working to improve the health of Vermonters and lower health care costs. OneCare partners with health insurance companies, hospitals, independent medical practices, and community collaborators to offer programs that pay for positive outcomes and health care activities. OneCare gives doctors and other providers access to data, resources, and tools to improve patient health. Health care providers participating in OneCare pool resources and expertise to help Vermonters become healthier and stay healthier, and focus on improving access to primary care, reducing deaths from suicide and drug overdose, and managing chronic illnesses. By sharing information and working together, providers can do even more to deliver the best care to patients.

Source: Colchester, VT – OneCare Vermont 10.2.2020