Vermont’s Experiment in Community-Driven Health Reform
<p>Vermont is undertaking an ambitious effort to move away from traditional fee-for-service health care and to a value-based payment system that rewards hospitals, physicians, and other providers for controlling costs and improving health outcomes. Medicaid, Medicare, and Blue Cross and Blue Shield of Vermont have each agreed to enter into contracts that require providers to assume risk for meeting financial targets and performance benchmarks. </p><p>A new Commonwealth Fund case study takes a deep dive into OneCare Vermont, a large accountable care organization (ACO) that is a key player in the state’s plan. The ACO’s mission is to unite the physical health, mental health, and social services sectors to better serve patients with complex needs.</p>
<p>Martha Hostetter, Sarah Klein, and Douglas McCarthy describe OneCare’s community-driven approach to care coordination, which the ACO piloted in 2017 among a portion of the state’s Medicaid beneficiaries. The authors say Vermont’s experiment in forging partnerships among payers, health care organizations, and social service providers offers lessons about wringing value out of a fragmented health system.</p>