Vermont Business Magazine The Green Mountain Care Board (GMCB) takes action to ensure accountability and transparency from OneCare Vermont about the use of primary care funds paid to hospital-owned primary care providers. The GMCB also requires OneCare to reduce the total compensation to be paid to its top executives for FY2023.
The action comes after Blue Cross & Blue Shield of Vermont withdrew from participation with OneCare at the end of 2022 and after State Auditor Doug Hoffer questioned the overall cost effectiveness of the accountable care organization program in a scathing 2021 report.
“Accessing primary care is a challenge for many Vermonters,” said Owen Foster, GMCB Chair. “It’s vitally important that OneCare funds dedicated to support primary care are used for their intended purpose of bolstering primary care.”
OneCare’s primary care incentive funds include approximately $8.7 million expected to be paid to hospital-owned primary care and $5 million expected to be paid to independent primary care practices in FY2023.
GMCB approved a motion to require OneCare to obtain attestations from hospitals describing how the primary care incentive funds were used historically, and to confirm prospectively that they will be utilized as intended, after learning that OneCare could not verify whether these funds had been used entirely for their intended purposes.
Additionally, the GMCB ordered OneCare to reduce the total compensation paid to its top executives and instead use the funds toward population health activities to benefit Vermonters.
GMCB members cited the reduction in the number of Vermonters OneCare is serving, due to BlueCross BlueShield of Vermont’s withdrawal, benchmarking data that compares OneCare’s performance to other accountable care organizations, and the concerns regarding how primary care funds were being utilized.
GMCB will issue an Order with these conditions, with an October 1, 2023, deadline for the attestations and accounting of the primary care funds.
Blue Cross to halt relationship with OneCare Vermont in 2023
Auditor report OneCare: All-Payer ACO Model costing more than it's saving
About: The Green Mountain Care Board (GMCB) is a 5-member, independent Board with a vision of a sustainable and equitable health care system that promotes better health outcomes for Vermonters. The GMCB was created in 2011 with an ambitious mission to drive system-wide improvements in access, affordability, and quality of health care to improve the health of Vermonters. Through public meetings, the GMCB ensures a transparent approach to health care regulation and a voice for stakeholders, including health care organizations, clinicians, and members of the public. With a holistic, data driven approach, the GMCB carries out its regulatory duties, supports innovation in health care delivery and payment reform, and serves as an important resource for independent, transparent analyses of Vermont’s health care system performance.
Source: 6.16.2023. Montpelier, VT – Green Mountain Care Board
