Vermont All-Payer ACO Model aims to deliver better healthcare, decrease costs

The state of Vermont and the Center for Medicare & Medicaid (CMS) jointly declared today that the Vermont All-Payer Accountable Care Organization (ACO) Model, a latest initiative targeted at increasing better delivery system reform for the residents of Vermont. The most primary payers throughout the state under this proposed model – Medicare, Medicaid, and commercial healthcare payers – will encourage healthcare value and quality, with a primary concentration on the health results, under the similar payment structure for the majority of providers throughout the care delivery system of the state. 

A 5-year extension of Vermont’s section 1115(a) Medicaid demonstration has been approved by CMS today, which, in addition to extending the state’s comprehensive demonstration of states, involves the authorities required to make Medicaid a complete partner in the Vermont All-Payer ACO Model.  

 “This model might allow eligible clinicians and other physicians in the Vermont to qualify for Advanced Alternative Payment Model bonus payments from the Quality Payment Program provided their devotion to be accountable and improve care for sufferers”, stated by Patrick Conway, M.D., CMS principal deputy administrator and chief medical officer.

For the last 3 years, CMS has been partnering with Maryland as part of the Maryland All-Payer Model to alter hospital payments to global budgets that gives priority to value rather than volume. By expanding statewide healthcare transformation beyond the hospital, the Vermont All-Payer Model builds on Maryland All-Payer Model and it will give worthy insight for other state-driven all-payer payment and care delivery transformation attempts.

ACOs are being offered by the Vermont All-Payer ACO Model in Vermont the opportunity to engage in a Medicare ACO initiative tailored to the state and will give Vermont start-up funding of $9.5 million to help medical providers with the care coordination and boost up their cooperate with community-based providers.

The Affordable Care Act permits for the testing of innovative payment and service delivery models through the establishment of the Center for Medicare and Medicaid Innovation, like the Vermont All-Payer ACO Model, to shift the healthcare system toward one that rewards clinicians based on the quality, not quantity, of better care they give to patients.

For further information on the Vermont All-Payer ACO Model and the section 1115(a) Medicaid demonstration extension, please do consider the links mentioned below:

• Vermont All-Payer ACO Model: https://innovation.cms.gov/initiatives/vermont-all-payer-aco-model/
• Vermont’s Green Mountain Care Board: http://gmcboard.vermont.gov/payment-reform/APM
• Vermont All-Payer ACO Model Fact Sheet: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-10-25.html 
• Vermont section 1115(a) demonstration extension: Fact Sheet and CMS Approval Letter.