Ver­mont’s all-payer ACO set to start in Jan­uary

Modern Healthcare - - REGIONAL NEWS - —Shan­non Much­more

In Jan­uary, Ver­mont will be­come the first state in the na­tion to move to a vol­un­tary, all-payer ac­count­able care or­ga­ni­za­tion model.

The pro­gram is mod­eled af­ter a sim­i­lar one from Mary­land that cov­ers only hos­pi­tals. The Ver­mont ACO will cover Medi­care, Med­i­caid and com­mer­cial pay­ers, re­quir­ing those who par­tic­i­pate to pay sim­i­lar rates for all ser­vices.

The CMS is giv­ing Ver­mont $9.5 mil­lion in startup fund­ing to sup­port the tran­si­tion. The demon­stra­tion, funded through an 1115 waiver, will last five years.

“This model is his­toric in terms of its scope, aim­ing to in­clude al­most all providers and peo­ple through­out the state in an all-payer ACO model to drive im­proved qual­ity, bet­ter care co­or­di­na­tion, health­ier peo­ple and smarter spend­ing,” CMS Chief Med­i­cal Of­fi­cer Dr. Pa­trick Con­way said in a state­ment.

Ver­mont Gov. Peter Shum­lin ear­lier this year trav­eled to Wash­ing­ton to ne­go­ti­ate a deal with HHS Sec­re­tary Sylvia Mathews Bur­well.

The state aims to have 70% of its in­sured res­i­dents cov­ered by an ACO by 2022. The model will be con­sid­ered an ad­vanced al­ter­na­tive pay­ment model un­der the new Medi­care re­im­burse­ment pro­gram, mak­ing par­tic­i­pants el­i­gi­ble for a per­for­mance bonus.

Ver­mont Gov. Peter Shum­lin

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.