GMCB approves OneCare's budget

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GMCB approves OneCare's budget

Thu, 12/21/2017 - 5:07pm -- tim

Vermont Business Magazine Today, the Green Mountain Care Board (GMCB) voted unanimously to approve OneCare Vermont’s $620 million 2018 Accountable Care Organization (ACO) budget. The budget was approved with a series of conditions that the ACO must meet to better ensure that quality improvement and cost containment efforts are successful. The Board also voted unanimously to submit a Medicare rate trend factor of 3.5 percent for the Centers for Medicare & Medicaid Services’ (CMS) approval, resulting in a blended rate increase, inclusive of Medicaid and commercial insurance, of less than 3.0.

This new wellness program called "All-Payer" will cover an estimated 120,000 Vermonters, or about 20 percent of the population, beginning January 1, 2018. The idea is by keeping people healthier, there will be less chronic disease, fewer major health events, and ultimately a healthier population with resultant lower costs.

These actions follow months of review by the Board, its actuaries, GMCB staff, and input from the Office of the Health Care Advocate and members of the public, and marks the first time the Board has approved an ACO budget as part of the All-Payer ACO Model Agreement. The Agreement, signed with the federal government in late 2016, aims to improve health care quality and to reduce the rate of cost growth in the health care system.

By shifting from fee-for-service reimbursement to a value-based model for ACOs that is consistent across Medicare, Medicaid, and commercial health care payers, the Model provides flexibility and incentives for improving care.

“The Vermont All-Payer Model is a great step forward in working to control costs, while also working to increase health care quality outcomes for Vermonters,” said Kevin Mullin, Chair of the Green Mountain Care Board. “The current cost of health care is unsustainable for Vermonters, and we believe that our approval of the ACO’s budget today will help control the growth of health care across all payers.” 

RELATED STORY: Health Care: All-Payer will change how you get health care

Information on the All-Payer Model ACO Agreement and the OneCare Vermont budget can be found here and here.

Source: Green Mountain Care Board 12.21.2017