Vermont takes step towards all-payer, ACO-like system

The state of Vermont has tentative approval from the federal government to change provider reimbursement to an all-payer model emphasizing value-based care. 

VTDigger reported the state’s healthcare regulatory agency, the Green Mountain Care Board, hasn’t yet signed off on the agreement, but plans to hold several public hearings and meetings until Oct. 13 to collect public opinion on the proposal.

The new system would be dubbed the Vermont All Payer Accountable Care Organization Model and would be the first of its kind in the nation. Set up like an accountable care organization, physicians would be paid on a monthly basis for serving Medicare, Medicaid, and commercially-insured patients, with the focus on patient outcomes rather than fee-for-service payment.

According to Vermont Gov. Peter Shumlin, the proposal could save $10 billion in healthcare costs over 10 years, by capping growth of certain healthcare costs at 3.5 percent annually.

“I don’t think any reasonable person would look at these numbers and say, ‘Let’s just keep doing what we’re doing and hope for the best,’” Shumlin said, according to VTDigger.

Providers wouldn’t be required to join and could stick to traditional fee-for-service payment. Green Mountain Care Board Chair Al Gobeille said providers may be compelled to join with Medicare payment changing thanks to the Medicare Access and CHIP Reauthorization Act (MACRA), predicting Medicaid and commercial insurance would soon move to a similar value-based care system.

“Providers are going to get to vote with their feet as to whether or not they sign up for this,” Gobeille said.

For more on how many primary care providers the state is aiming to involve by 2018, and how the state’s next governor could opt of the deal, click on the link below: