Regulators ensure OneCare Vermont avoids antitrust problems

Vermont Business Magazine The Green Mountain Care Board is now reviewing the 2018 budget of ACO OneCare Vermont, a network of health care providers that includes hospitals, federally qualified health centers and independent practitioners. This group is responsible for the quality, cost and overall care of the patients attributed to it. The Vermont Legislature in 2016 charged the Green Mountain Care Board with the oversight of Accountable Care Organizations (ACOs). Health care providers participating in an ACO can collaborate with each other, rather than compete, in an effort to lower overall health care costs, coordinate patient care, and improve patient outcomes. To avoid antitrust challenges, the state must provide sufficient oversight to ensure that the ACO is acting in the public’s interest—consistent with a clearly articulated public policy as expressed by the legislature—not in its own.

Budget hearings are open to the public and all budget information, and a link to provide comment, are available on the Board’s website at gmcboard.vermont.gov/

The Green Mountain Care Board provides regulatory oversight of ACO budgets and certification, and the Board has recently promulgated a rule that outlines the processes and the requirements that must be met by an ACO to operate in Vermont. The Vermont Office of the Health Care Advocate plays an important watchdog role in ACO certification and budget review as a voice for Vermont consumers. In addition, the Attorney General retains enforcement authority for any potential antitrust violations and will act to protect Vermonters.

“Access to affordable health care is a consumer protection issue.” said Attorney General TJ Donovan. “I support the goal of lowering costs and increasing accessibility for Vermonters with healthcare needs. However, no one involved in this process is ‘exempt’ from antitrust law. We will continue to ensure that the public’s interest is served.”

“In order to effectively evaluate whether an Accountable Care Organization is in the public interest, we must assure that there are active consumer education and feedback opportunities to assure that both successes and potential challenges are identified,” said Michael Fisher, the Chief Health Care Advocate. “The Office of the Health Care Advocate will continue to focus on consumers’ experiences and is always interested in Vermonters’ perspectives and experiences with all access to care issues.”

Kevin Mullin, Chair of the Green Mountain Care Board, stated: “The Board’s oversight of Accountable Care Organizations and implementation of the All-Payer Model serves to further our goal that all Vermonters receive timely, high quality health care at the lowest cost, and in the most appropriate health care setting. Having the Health Care Advocate and the Attorney General also safeguarding consumers’ interests will help ensure that the citizens of our State will receive affordable, high quality care.”

Source: Vermont AG 11.8.2017