OneCare providers earn $11.3 million in Medicare shared savings

Vermont Business Magazine OneCare Vermont, the state’s accountable care organization (ACO) announced today key results of their 2019 Medicare program. Participating providers earned a total of $11.3 million in Medicare shared savings from collaborative work to improve beneficiaries’ outcomes and overall health of the Medicare population. Additionally, OneCare Vermont participating providers collectively achieved a Medicare quality performance score of 91.88% for the year.

Quality scores and shared savings results for each payer program are measured and released annually as a metric for the five-year, Vermont All-Payer ACO Model.

“I want to extend congratulations to the participating providers of OneCare Vermont’s programs for their tremendous efforts,” said Vicki Loner, RN, CEO of OneCare Vermont. “Working together as a system and taking accountability is an important step toward improving care for Vermonters and stabilizing health care costs.”

For Medicare beneficiaries in 2019, OneCare’s provider community delivered all necessary healthcare services from routine primary care to complex chronic disease management, achieving high overall quality of care and spent $11.3 million less than projected for Medicare beneficiaries. The shared savings is then reinvested in programs, services and initiatives to further improve health and reduce costs.

Providers invested $8 million to support primary care Patient Centered Medical Homes, Community Health Teams, and SASH programs statewide – all initiatives that provide direct value to beneficiaries through better care coordination to keep people healthier and assist in the management of chronic illnesses such as diabetes and hypertension. The remaining $3.3 million will be distributed directly to risk-bearing providers that participate in OneCare’s Medicare program.

Participating providers are also required to meet specific quality measures. Medicare recently released the 2019 Quality Performance scorecard for its Medicare patient population and OneCare Vermont providers received an overall quality score of 91.88% and demonstrated improved care for patients with hypertension. Quality measures assess health care processes, outcomes, and patient perceptions linked to high-quality health care delivery.

Steve Gordon, President and CEO of Brattleboro Memorial Hospital has been a part of OneCare since 2018 and reflected on the results and their work with OneCare Vermont.

“When providers of all types work together to care for the whole person, including mental and physical health, overall health and quality of life improves, costs decrease, and the providers themselves thrive, so it’s a victory all the way around,” said Gordon. “The journey to better health and lower costs takes time, and we are working together to not only transform health care but to reform the way we pay for that care. We are assuming risk, which can be daunting, but we appreciate the support from OneCare Vermont and the partnerships we have across the health care system.”

The innovative way healthcare is delivered and paid for in Vermont is central to the ACO and the All-Payer Model and providers that choose to be in OneCare receive financial incentives for their participation in value-based payment reform programs.

In September, it is estimated that hospitals and primary care practices who participated in the Vermont Medicare All-Payer ACO Model for performance year 2018 received individual lump sum incentive bonuses totaling $2.24 million across these provider organizations, which they can use to fund health system improvements.

These incentive payments are paid directly to providers from the Centers for Medicare and Medicaid Services (CMS) for the care they delivered in 2018.

Loner concluded, “I hope our provider partners will take a moment to acknowledge and celebrate their hard work. We cannot let up and instead must keep working together to make an even greater impact for the people of Vermont.”

To learn more about OneCare’s quality activities and results, visit our Results page.

For the latest on our work to support Vermont’s provider community delivering high-quality and cost-effective care, read our 2019 Annual Report.

Please visit our blog post about OneCare Medicare results.

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 10.7.2020