CMS Releases All Vermont Payers Model Assessment, With Promising First Results


Photo: Joseph Sohm / Getty Images

The Centers for Medicare & Medicaid Services released an assessment and summary of findings from the first two years of performance – 2018 and 2019 – of the Vermont All-Payer Model.

These found promising results, indicating that the MPA and the organization responsible for Vermont care, OneCare Vermont, are on track to change the way health care is paid for and delivered.

The evaluation of the first two years of the model was conducted by NORC at the University of Chicago, an independent research institution, and assesses the implementation and measures the effects of PMA.

WHAT IS THE IMPACT ?

The five-year APM was launched on January 1, 2017 to assess whether an All-Payer model including Medicare, Medicaid, and commercial payers, and implemented by an ACO across Canada. the state, could reduce health spending while preserving or improving the quality of care.

OneCare Vermont is the statewide ACO and has worked to meet the goals set out in the APM by aligning payments to providers with incentives that improve care and the overall health of the population, especially for people with a chronic or complex disease. The program also improves coordination between providers, provides data to support best practices to make care more consistent, and invests in wellness and prevention through primary care.

One of the key findings of the evaluation is that the APM achieved statistically significant reductions in gross Medicare spending at the ACO and state level, as well as reductions in net Medicare spending at the government level. the state.

Additionally, there were statistically significant declines in acute care stays (at the ACO and state levels) and 30-day readmissions at the state level.

The evaluators also found that stakeholders agree that the APM provides an important and convening forum for providers, payers and the state to engage in meaningful discussions on healthcare reform and set goals. APM also strengthens relationships between hospitals, community organizations, designated mental health agencies, primary care practices, and other providers.

Several areas of opportunity identified in the report were addressed during years three and four of the APM, including integrating more federally accredited health centers into the ACO and committing to invest and further support independent primary care.

THE BIGGEST TREND

OneCare Vermont received federal approval in 2016 as a way to control the cost of health care.

Its extensive provider network includes several state hospitals, two neighboring New Hampshire hospitals, hundreds of primary and specialist care physicians, rural health clinics and other facilities, coordinating the health care of approximately 102 000 combined Medicare, Medicaid and trade beneficiaries.

ON THE RECORD

“These results are a very encouraging validation of the extremely important work our providers are doing to improve preventive care, reduce costs and support patients with complex illnesses,” said Vicki Loner, CEO of OneCare. “We have a long way to go to fully realize the MPA vision, but we are on the right track and must continue to make steady progress for the people of Vermont.”

Twitter: @JELagasse
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