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Vermont receives accolades in new CMS report

April 13, 2019
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One thing that drew me to Vermont when I began my work for the hospital association was the state’s standout health care system. Here in the Green Mountains, policy makers, health care providers, payers, advocates and others have banded together over the years to help ensure that Vermonters have access to affordable, high-quality care.

From the very first attempts to eliminate cherry-picking in insurance through community rating to Dr. Dynasaur and Catamount Health, which provided care to thousands of previously uncovered children and adults, to the Green Mountain Care Board, created to provide oversight, Vermonters have shown wisdom and compassion in their health care planning.
 
Our latest, and perhaps most innovative health reform effort is the all-payer model, which focuses on primary care, chronic condition prevention and management, collaboration among providers and, ultimately, lower cost. This work is coordinated by our partners at OneCare, an Accountable Care Organization (ACO) that brings together diverse providers to bring Vermonters the right care in the right place at the right time.
 
The system, made possible by a 2016 agreement between Vermont and the federal government, also waives certain federal rules to enable simpler connections among providers that benefit patients and save time and money.
 
Last week, Vermont received a report card of sorts for our work on the State Innovation Model, which laid the groundwork for the all-payer model. Our state was at the top of the class among the eight other alternative payment models tested by the Centers for Medicare and Medicaid Services (Read the report).
 
Only Vermont’s ACO model yielded relative Medicaid savings (or slowed Medicaid growth), saving $97 million across the three implementation years. Our program also saw significant reductions in emergency department visits and inpatient admissions to the hospital.
 
 “Although still in its early implementation phase, Vermont’s All-Payer ACO Model, which was developed under and informed by the SIM [State innovation Model] Initiative, is expected to continue the momentum of payment and delivery model reform across the state,” CMS’ report concluded (p. F-63).
 
The report also noted the strong stakeholder and provider involvement that fuels this work. I have seen this first-hand as hospitals think and work in new ways and with new partners to create a value-based system of care.
 
I know it takes many years before one is no longer new to Vermont, but as I approach three years here, I am certainly a proud state resident eager to see what progress we post next.

Read the full CMS report here.
Read a summary here.

Jeff Tieman, VAHHS President and CEO