The “zero year” of the OneCare Vermont system, operated much like an accountable care organization (ACO) on a statewide level, saw the program come within 1 percent of its financial target. With the model now expanded to cover about 18 percent of the state’s residents, other states are watching closely to see if it could be implemented elsewhere in the U.S.
Other states have Medicaid programs structured like OneCare Vermont, but Vermont’s model covers all patients, including the commercially insured. With the budget approved by the state’s Green Mountain Care Board earlier this year, $600 million will be dedicated to patient care throughout the state with providers to be paid a fixed amount on a monthly basis.
Nine of the state’s 14 hospitals are participating, along with one in neighboring New Hampshire, along with providers under Blue Cross Blue Shield plans and the University of Vermont Medical Center employee plans.
Integrating traditional aspects of care on the social determinants of health has helped patients like 57-year-old Toni Potvin, who has struggled with alcoholism and now has a social worker helping her navigate doctor’s orders, appointments and treatment—and keeping her out of the emergency room.
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