Vermont Business Magazine OneCare Vermont and Heidi Health have announced a partnership aimed at reducing the administrative burden for medical practitioners and improving quality of care for patients across the rural state of Vermont. As part of the agreement, OneCare Vermont will give many of its independent provider practices across the state 12-month subscriptions to Heidi Health’s AI medical scribe. Heidi’s AI scribe automates an average of over two hours of daily administrative work, transcribing and processing clinician-patient conversations, producing clinical notes and follow-up materials so clinicians can focus on delivering quality care to their patients.
OneCare Vermont, a pioneering accountable care organization (ACO) dedicated to improving Vermont’s healthcare system, announced in November 2024 plans to wind down its operations at the conclusion of 2025.
OneCare sent a memo (see below) to the Vermont Agency of Human Services last June that provided a detailed catalogue of its duties and the progress it had made in serving the health care system over the last 10 years and urged the state to find a way to maintain those gains.
According to the 2020 Census, 65% of Vermont residents live in rural areas, making it one of the most rural states in the United States. Between 2019 and 2024, rural America lost nearly 2,500 independent physicians, and an estimated 3,300 rural medical practices shut down, according to a recent report. This shift has caused devastating effects on provider availability, quality of care for patients, and provider wellbeing in states like Vermont.
“The partnership with OneCare Vermont could not come at a more urgent time,” said Dr. Thomas Kelly, CEO and co-founder of Heidi Health. “Rural health systems and practitioners are currently experiencing unprecedented strain. Our tools help reduce some of that burden by returning time and wellbeing to those on the front lines of care.”
Built by doctors, Heidi Health adds a modern, AI-powered tool that works with primary care providers’ existing EHR systems, resulting in no rigid rebuilds or lost functionality. Heidi automates clinical documentation for doctors in a truly personalized way—by learning how the doctor likes to take notes and adapting outputs to meet that style. As a result, clinicians spend less time on time-intensive administrative tasks, which reduces the cognitive load on providers and ultimately means less burnout. Heidi currently supports nearly 2 million patient interactions every week and has been adopted across more than 50 countries in over 200 specialties, and over 110 languages in just a few years.
“Heidi’s AI scribe tool is going to restore precious time back to our clinicians, allowing them to spend more time with patients and less time on tedious documentation,” said Dr. Carrie Weigand, Chief Medical Officer of OneCare Vermont. “The partnership signifies much more than a healthcare organization adapting to the times; it’s a true representation of our collective commitment to preserving the heart of Vermont’s healthcare system.”
Six practices in Vermont have started to use Heidi’s AI scribe through the partnership: Lakeside Pediatrics, Mountain View Natural Medicine, Thomas Chittenden Health Center, Richmond Family Practice, Primary Care Health Partners, and White River Family Practice. An additional 13-15 Federally Qualified Health Centers (FQHCs) and independent practices are beginning to use Heidi’s AI scribe in the second phase of the implementation.
“This collaboration was made possible through a $320,000 investment by OneCare Vermont Accountable Care Organization (ACO) to support independent primary care practices in adopting AI scribe tools,” explained Linda Cohen, OneCare Vermont, Counsel for Contracting and Innovation. “The OneCare Board of Managers authorized this funding as part of its broader strategy to support independent primary care practices during the final programmatic year of the ACO model and equipping them for future success.”
This initiative is made possible through the strategic use of fraud and abuse waivers granted under the Vermont All-Payer ACO Model. These waivers, provided by the Centers for Medicare & Medicaid Services (CMS) and the Department of Vermont Health Access, allow OneCare to implement innovative care delivery models that might otherwise be restricted under traditional regulatory frameworks. “By invoking these waivers, OneCare can fund arrangements that are directly tied to improving care coordination, quality, and efficiency—core goals of the ACO and pay for the Heidi product,” added Cohen.
OneCare Vermont is deeply committed to supporting independent primary care practices and FQHCs, which are essential to maintaining access to high-quality, community-based care across Vermont. By investing in tools like Heidi Health’s AI scribe, OneCare is helping to reduce clinician burnout, improve patient outcomes, and preserve the sustainability of independent practices—especially in rural areas where they are most needed. This investment reflects OneCare’s mission to improve the health and wellbeing of all Vermonters by connecting providers and communities through innovative, value-based care solutions.
“Retaining the Capabilities of Certified ACOs”
A memo sent to Vermont’s Agency of Human Services (AHS) and other healthcare stakeholders
In response to recent legislation and to support the evolution of healthcare initiatives in Vermont, this memo catalogues some of work OneCare currently performs on behalf of providers and the patients they serve, explaining components of OneCare’s work and the value it brings to our healthcare system. The intent of the memo is to be constructive and support all stakeholders through this transition. OneCare is available to field questions and help others explore opportunities to sustain this important work beyond the wind down of OneCare operations at the end of 2025.
To: Jenney Samuelson, Secretary, AHS; Brendan Krause, Director of Health Care Reform, AHS
From: OneCare Vermont
CC: DVHA; GMCB; OneCare Board of Managers; Provider Organizations; Legislators; General Public
Date: June 23, 2025
Subject: Retaining the Capabilities of Certified ACOs
As articulated in recent legislation, the Agency of Human Services is tasked with exploring opportunities to sustain the benefits of certified accountable care organizations (ACOs). Additionally, other state and private entities have requested information to help guide future initiatives they may pursue. In support of these aims, we write to highlight some of the functions OneCare Vermont, a certified ACO, currently performs on behalf of patients and providers. With hope, some, if not all, of this work can be recreated in the future.
While the loss of funding in 2026 is more obvious and quantifiable, it is important that healthcare participants, payers, and government entities are aware of other supports OneCare provides that may be less visible. The purpose of this letter is to enhance readiness for all parties and to advocate for future solutions as this work is valuable to our healthcare system and the patients they serve.
As you may know, if this work cannot be replicated, the statewide progress being made to enhance patient care efficiency and outcomes will suffer. For example:
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Patients will lose the benefit of waivers that enable more efficient care pathways.
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Patients with high medical and/or social risks will not be as reliably prioritized without provider access to data and reports on their patient panels.
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Patients will experience a less flexible and customized care model as providers are forced to revert to fee-for-service (FFS), resulting in operations focused on volume rather than innovative team-based care approaches.
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Providers will face greater administrative burden as they independently negotiate and manage value-based initiatives, potentially adding to provider burnout.
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Vermonters will lose the benefits of population health strategies and interventions that impact their health outcomes in the absence of coordinated statewide quality improvement activities.
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Patients will experience less coordination across their providers, leading to a frustrating patient experience, reduced access, and/or worsened health outcomes as cross-organizational care coordination activities dissolve.
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Patients are at risk of experiencing less valuable care to meet their needs as providers lose access to funding that supports team-based care, integrated mental health services, and other best practices in high-value care that is unreimbursed, or under-reimbursed, by FFS.
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Vermonters will face greater financial pressures as overall accountability for healthcare costs and outcomes dissipate.
OneCare’s Core Functions and Capabilities
The following list catalogues bodies of work OneCare currently manages in support of our healthcare system and the patients they serve. Some of this work can be facilitated through different means, and these explanations will help Vermont pick up where OneCare left off. Not included are the many business functions necessary to operate the company and make these benefits possible.
Quality Improvement and Accountability:
OneCare negotiates and ensures alignment of quality measures across payers, providers, and the state, and promotes and facilitates quality improvement initiatives across its provider network. This aligns focus on specific quality measures, standardizes financial incentives, creates space for provider input, enables micro- and macro-level monitoring of quality improvement, and drives statewide improvement.
Key Tasks: Negotiation and alignment of quality measures; standardizing benchmarks; establishing provider quality targets; quality analysis and assessment; program design; incentive funding; quality reporting; education and support.
Quality Reporting:
OneCare manages quality data collection, chart abstraction, patient surveys, and reporting to payers on behalf of participating providers.
Key Tasks: Data aggregation; chart abstraction; claims validation and analysis; unified payer reporting; blending results across payers; provider education and technical support; monitoring quality trends.
Regional Clinical Representative (RCR) Model and Practice Support:
OneCare supports participants to improve population health quality outcomes and meet targets through monthly meetings, data sharing, and facilitation of the RCR model.
Key Tasks: Data review meetings; workflow support; strategy development; progress monitoring; sharing best practices.
Waiver Management:
OneCare researches, educates, and champions the use of benefit enhancement and fraud, waste, and abuse waivers to facilitate patient care.
Key Tasks: Researching waiver opportunities; provider education and training; initiative development; utilization monitoring; impact analysis; payer reporting.
Innovation and Evolution:
OneCare identifies opportunities and supports initiatives designed to enhance patient care.
Key Tasks: Initiative development; pilot projects; funding; data support; results monitoring; program adjustments; expansion of successful pilots.
Provider Collaborations:
OneCare facilitates cross-organizational collaborations, data review, and relationship building.
Key Tasks: Clinical collaborations; joint advocacy; information sharing; partnerships; provider education; networking.
Data Aggregation, Sharing, and Analysis:
OneCare aggregates, validates, and warehouses cost, medical risk, and social risk data, making it available through analytics platforms.
Key Tasks: Data warehousing; quality control; infrastructure management; dashboard development; reporting; opportunity analysis.
Payment Processing:
OneCare manages funds flow between payers and providers to improve care coordination.
Key Tasks: Collecting investments; aligning payment models; pass-through funding management; shared savings distribution; accounting.
Payment Reform Development and Management:
OneCare designs and manages payment reform initiatives.
Key Tasks: Negotiating payment reform opportunities; designing models; piloting and scaling; contracting; claims monitoring; reconciliations.
Risk Management:
OneCare centrally manages value-based program risk and facilitates settlement between payers and providers.
Key Tasks: Risk model development; allocation; settlement transactions; mitigation arrangements; reinsurance; education.
Financial Negotiation and Settlement Validation:
OneCare manages actuarial processes and ensures accurate settlement calculations.
Key Tasks: Target negotiation; actuarial analysis; performance monitoring; financial reporting; settlement validation.
Contract Negotiation and Management:
OneCare negotiates value-based care contracts and terms on behalf of providers.
Key Tasks: Aggregated contracting; payer negotiations; provider negotiations; contract management; dispute resolution.
Compliance:
OneCare leads compliance efforts for federal, state, and contractual requirements.
Key Tasks: Risk assessments; auditing; reporting; training; monitoring.
Value-Based Care Policy and Operations Expertise:
OneCare monitors and integrates changes in the value-based care landscape.
Key Tasks: Maintaining expertise; workforce training; model evaluation; provider support; payer input.
Conclusion
Providers and provider organizations need support as the state pursues new healthcare delivery approaches and structures. Infrastructure to build connections, manage continuous improvement initiatives, provide data, alleviate administrative burden, and align priorities is a useful and replicable model. Our recommendation is that Vermont finds new ways to reproduce or sustain this work. Much has been learned over the last decade, and it is important that we continue moving forward.
Please feel free to reach out if you have questions about any of these functions or would like to discuss alternative ways to support similar efforts.
About OneCare Vermont
OneCare Vermont Accountable Care Organization, LLC, a 501(c)(3) organization, is a part of the University of Vermont Health Network. OneCare partners with over 5,000 health care providers across the continuum of care and offers tools for better delivering and coordinating patient care to improve quality within a fixed budget. OneCare aims to improve the health and wellbeing of all Vermonters by connecting providers and communities across Vermont. Learn more about OneCare Vermont at https://www.onecarevt.org/.
About Heidi Health
Heidi’s AI-powered medical scribe streamlines time-intensive administrative tasks to reduce the cognitive load on healthcare providers. Serving nearly 2 million patient interactions a week, Heidi's technology transcribes and processes conversations between doctors and patients to produce clinical notes and follow-up materials – from referral letters to assessments. The tool allows doctors to work more efficiently and focus more on patient care – reducing the risk of burnout. Heidi Health was built with safety and compliance at its foundation – not tacked onto the end. Heidi ensures data security through end-to-end encryption, strict clinician-controlled access with patient consent, global regulatory compliance (HIPAA, GDPR, PIPEDA, APP), certified security standards (ISO27001, SOC2), permanent data deletion upon request, and dedicated support for facilitating patient consent.
Learn more about Heidi’s AI scribe at https://www.heidihealth.com.
9.25.2025. COLCHESTER, Vt.--(BUSINESS WIRE)--Heidi Health
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