Vermont receives $45 million grant for health care reform

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Vermont receives $45 million grant for health care reform

Thu, 02/21/2013 - 9:25am -- tim

Vermont Governor Peter Shumlin today announced that Vermont has received a $45 million grant under the federal government’ s State Innovation Models (SIM) initiative to support health care innovations that will improve dramatically the efficiency and effectiveness of the state’ s health care system.    
‘ This is a tremendous boost to Vermont health reform,’ the Governor said. ‘ With these funds, we can assure that Vermont has the best health care system in the country, resulting in better care, lower costs and a healthier population. I continue to believe that these improvements are essential to the sustainability of our system.’    
The SIM initiative is a $275 million competitive funding opportunity for states to design and test multi-payer payment and delivery models that deliver high-quality health care and improve health system performance.  The program is administered by the Centers for Medicare and Medicaid Services Innovation Center.  The Innovation Center created the SIM initiative for states that are committed to planning, designing, testing, and supporting evaluation of new payment and service delivery models in the context of larger health system transformation. Grant-funded activities will be overseen jointly by the Department of Vermont Health Access (DVHA) and the Green Mountain Care Board (GMCB).   
GMCB Chair Anya Rader Wallack explained that the objective of the state’ s project under the grant is to develop a ‘ high performing health system,’ which will emphasize integration within and between provider organizations, movement away from fee-for-service payment methods toward population-based models, and payment based on quality performance. Wallack said this effort is critical to ensure that health care is affordable and effective for Vermonters in the future. 
The grant will support implementation of three innovative provider payment models:
·         Shared savings accountable care payments, under which a single network of providers takes responsibility for managing the costs and quality of care for a group of Vermonters;
·         Bundled payments, which provide a single payment to a group of providers for the care of a patient surrounding a hospitalization; and
·         Pay-for-performance models, which incorporate in provider compensation consideration of the total costs and quality of care. 
All three models have the potential to encourage better coordination of care across providers, improved quality and better cost-management.  DVHA Commissioner Mark Larson said the grant would be particularly important in addressing the lack of coordination and financial alignment between primary care, specialty care, mental health and substance abuse services and long term services and supports. 
‘ This is an exciting opportunity to improve the system for patients and providers alike,’ Larson said.  
In addition to support for implementation of the payment models, the grant will support key investments in ‘ health system infrastructure’ within Vermont, including:
·         Improved health care data transmission and integration across providers;
·         Expanded measurement of patient experience;
·         Improved capacity to measure and address health care workforce needs;
·         Improved data analytics and predictive modeling to support monitoring health system costs and quality; and 
·         Enhanced telemedicine capabilities. 
‘ In order to ensure that our health care system is the best in the country, we need to develop a health care payment system that enables us to move from a pay-per-procedure system to a system where Vermonters are paying for quality’ said House Speaker Shap Smith. ‘ This federal grant is a significant contribution to these efforts.’  
‘ I am encouraged that the federal government is joining the state in our efforts to improve the quality and delivery of Health Care in Vermont,’ said House Speaker Shap Smith, ‘ this is an important step for the state in moving forward in our work on health care reform.’  
Vermont
Funding Amount: Over the next 42 months, the State of Vermont will receive up to $45,009,480 to implement and test its State Health Care Innovation Plan. Continued funding will be subject to state performance, compliance with the terms and conditions of award, and demonstrated progress towards the goals and objectives of the State Innovation Model initiative.
Description: The state of Vermont proposes to develop a high performance health system that achieves full coordination and integration of care throughout a person’ s lifespan, ensuring better health care, better health, and lower cost for all Vermonters. The Vermont model for health system transformation will: increase both organizational coordination and financial alignment between clinical specialists and Vermont’ s Blueprint for Health advanced primary care practices; implement and evaluate value-based payment methodologies; coordinate with other payment reforms on developing a financing and delivery model for enhanced care management and new service options for Vermonters eligible for Medicare and Medicaid; and accelerate development of a learning health system infrastructure that will support delivery system redesign and state evaluation activities.
Vermont will achieve these goals through three models: a shared-savings ACO model that involves integration of payment and services across an entire delivery system; a bundled payment model that involve integration of payment and services across multiple independent providers; and a pay-for-performance model aimed at improving the quality, performance, and efficiency of individual providers. In addition to supporting implementation of the models described above, the award will fund the following enhancements in health system infrastructure: improved clinical and claims data transmission, integration, analytics, and modeling; expanded measurement of patient experience of care; improved capacity to measure and address health care workforce needs; health system learning activities essential to spreading models and best practices; and enhanced telemedicine and home monitoring capabilities.
 
Governor's office. 2.21.2013