Vermont Business Magazine - The Department of Vermont Health Access (DVHA) yesterday identified OneCare Vermont as the successful bidder in its procurement seeking an Accountable Care Organization (ACO) to provide certain Medicaid services as part of the State of Vermont’s efforts to move away from the current fee-for-service payment system to one that pays doctors and providers for keeping people healthy.
The selection means that the State will enter negotiations with OneCare Vermont; however, it does not bind the State in any way. “These negotiations are another step toward creating an integrated health care system that pays for value, not volume of services,” said Department of Vermont Health Access Commissioner Steven Costantino. “The contracting process will ensure that this potential arrangement will benefit Vermont and Vermonters.”
OneCare Vermont was selected by the Centers for Medicare and Medicaid Services (CMS) to participate in a similar Accountable Care Organization program for Medicare enrollees in Vermont. Additionally, OneCare Vermont has worked collaboratively with the State on the Vermont Medicaid Shared Savings Program (VMSSP) and the Vermont Health Care Innovation Project, sponsored by the federal State Innovation Models (SIM) testing grant.
OneCare Vermont is one of three Vermont Accountable Care Organizations, along with HealthFirst and Community Health Accountable Care. All three Vermont Accountable Care Organizations are working toward the establishment of the Vermont Care Organization, an umbrella organization that would create a unified structure to coordinate the work of Accountable Care Organizations in Vermont.
Overall, the goal of the project is to continue to build an integrated health care system that improves the quality of, and access to, care for all Vermonters. Broadly, it aims to create a structure for health care providers to get paid in a way that rewards quality, care coordination, and early intervention. Specifically, the project seeks to make a regular, predictable, and prospective payment to an Accountable Care Organization for Medicaid services. Rather than being paid for every service, the Accountable Care Organization 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.
The payment model set forth by the project would align Medicaid with the federal government’s cutting edge Accountable Care Organization innovation program, called Next Generation. The State 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. Those negotiations with the federal government are ongoing.
Source: Department of Vermont Health Access, Tuesday July 5, 2016