Vermont All Payer Model Agreement

“In the Chairman`s response to our audit report, he did not directly address our two recommendations. These recommendations are simple and I am concerned that the Board of Directors, in its dual role as a reformer in the health sector and the regulator, does not take the latter role as seriously as the former. The ACO model ultimately aims to improve the value of health care in Vermont by controlling cost growth and improving the quality of care. If Vermonters are unable to determine whether this program achieves these goals for extra effort and additional risk, this will pose problems for the sustainability of these efforts. Our recommendations are intended to ensure that the GMCB achieves these objectives and conducts an evaluation of OneCare`s performance. The GMCB has developed reports that allow it to evaluate different aspects of the ACO model, such as cost growth and specific quality measures. However, as the state prepares to make the important decision to enter into a subsequent agreement with CMS for an ACO model, this review revealed that: public funds are also paid to OneCare because of the exceptionally favourable terms it has negotiated with the Department of Vermont Health Access. For example, unlike Medicare and private policyholders, Medicaid OneCare initially provided a monthly management payment for each Medicaid recipient assigned to the ACO program. Legislators have every reason to exercise caution and obtain the best advice. The impact of the ACO payer model on the Medicaid program is crucial because it provides the safety net for Vermont`s most vulnerable and expensive citizens. Yes, that`s right. The ACO model of all numbers is already approaching the finish line under the first agreement of the Centers for Medicare and Medicaid (CMS), which expires at the end of 2022. If Parliament intends to define the conditions for the extension, as they have done overall with the current agreement, they must commission an independent study before the 2021 meeting.

1. How much has Vermont invested in the ACO model, which takes into account public funds and assets from all sources, including, but not limited to, delivery system reform funds, health information technology, blueprint, SASH (Support and Services at Home), support to VITL (Vermont Information Technology Leaders) and the cost of staff engaged in the Agency Board? “While descriptive, this audit contains two important recommendations to the Green Mountain Care Board. The first recommendation is that the Board of Directors develop and implement a transparent method to measure the financial results of the Vermont All-Pay ACO model and determine whether they outweigh OneCare`s operating costs. This method and provision should be established prior to the approval of a subsequent ACO model agreement and, where possible, take into account the quality results available.