Vermont ACO model ties payer, provider payment to care quality
Health Finance
Nestled between New Hampshire and upstate New York, Vermont is a quiet, mostly rural state.
But it's the site of a federal test of an alternative payment model in which the most significant payers from throughout the state – Medicare, Medicaid, and commercial healthcare payers – incentivize value and quality, with a focus on health outcomes, under an ACO model that has seen some success since its 2017 implementation.
The Vermont All-Payer Accountable Care Organization (ACO) Model, spearheaded by the federal Centers for Medicare and Medicaid Services, is a value-based care initiative that ties provider payment to the quality of care given rather than to the number of tests, procedures or office visits. All providers in the state are paid the same amount for a service or a procedure, whether that money comes from Medicare, Medicaid or commercial payer dollars.