CMS evaluates the Vermont All-Payer model: the first results are “promising”

Results include reduced Medicare costs and hospital readmissions, suggesting cost savings and improvements in care coordination

Vermont Business Magazine The federal Centers for Medicare & Medicaid Services (CMS) released an assessment and summary of findings from the first two years of performance (2018 and 2019) of the Vermont All-Payer Model (APM), finding promising results that indicate the APM and Responsible Care of Vermont. The OneCare Vermont organization is on track to transform the way healthcare is paid for and delivered.

The evaluation of the first two years of the model was conducted by NORC at the University of Chicago, an independent research institution, and assesses the implementation and measurement of the effects of APM.

The five-year APM was launched on January 1, 2017 to assess whether an all-payer model including Medicare, Medicaid, and commercial payers and implemented by an accountable care organization (ACO) statewide can reduce health care spending while maintaining or improving the quality of care. OneCare Vermont is the statewide ACO and has worked to meet the goals set out in the APM by aligning payments to providers with incentives that improve care and the overall health of the population, especially for people with a chronic or complex disease.

The program also improves coordination between providers, provides data to support best practices to make care more consistent, and invests in wellness and prevention through primary care.

“These results are a very encouraging validation of the critically important work our suppliers are doing to improve preventive care, reduce costs and support patients with complex illnesses,” said Vicki Loner, RN.C, CEO of OneCare . “We have a long way to go to fully realize the MPA vision, but we are on the right track and must continue to make steady progress for the people of Vermont.”

The main conclusions of the APM evaluation are as follows:

  • While the Vermont All-Payer model did not meet its all-payer and Medicare scale targets, in its first two years of performance, the model achieved statistically significant reductions in gross Medicare spending. at the ACO and state level, as well as net Medicare spending. state-level reductions.
  • There were statistically significant declines in acute care stays (at the ACO and state level) and 30-day readmissions at the state level.
  • The evaluators found that stakeholders agree that the APM provides an important and convening forum for providers, payers and the state to engage in meaningful discussions on healthcare reform and set goals. APM also strengthens relationships between hospitals, community organizations, designated mental health agencies, primary care practices, and other providers.

“This evaluation of the Vermont All-Payer model is another example of a successful ACO model. We know from other CMS models that ACOs both reduce the cost of care and improve the quality of patient care, ”said Clif Gaus, Sc.D., President and CEO of the National Association of ACOs (NAACOS). “This report adds to the growing body of evidence that shows that if you hold providers accountable for the total cost of patient care and give them time to adjust practice models, positive results will follow. “

Providers participating in OneCare Vermont ACO understand the challenge of evolving the healthcare system into a system that allows providers to practice the way they have been trained to deliver care, in a more patient-centered model that enables care. holistic and coordinated.

“Changing the healthcare system will take time and I am happy that the findings of this report show that we are moving in the right direction. OneCare provides the structure and tools for providers to work together across organizational lines and supports our work to improve the health of Vermonters through innovative data, analytics and payment models, ”said Toby Sadkin, MD, family physician at St. Albans Primary Care, president. of Primary Care Health Partners and OneCare Board Manager.

Health care reform is an ongoing process with an ongoing opportunity to build on collective experiences and make the necessary adjustments to strengthen APM. Several areas of opportunity identified in the report were addressed in years three and four of the APM, including integrating more federally accredited health centers into the ACO and committing to invest and further support independent primary care.

“This report provides a structured, research-based and informed analysis of our collective work in Vermont and demonstrates that the progress made in the early years is valuable, thanks to the cooperative effort of thousands of providers working together within of ACO OneCare, ”Loner continued. . “We learned a lot in the early years and will continue to learn and evolve as the model matures. It’s hard work and we are confident that the work we are starting as part of our strategic plan will allow us to focus and accelerate our progress as we continue to implement meaningful payments and care reform. health care for Vermonters. “

About OneCare Vermont
OneCare partners with healthcare providers to transform the healthcare system into one focused on health goals and promoting better outcomes for all. By providing healthcare providers with actionable data and analytics, paying for healthcare value, and managing ACO network performance, OneCare supports participating providers in their work to deliver excellent healthcare to people. Vermont residents. Through this partnership, OneCare is moving Vermont towards a reliable and equitable healthcare system where patients and providers work together to achieve optimal health and an exceptional care experience. Learn more at onecarevt.org.

Source: 9.3.2021. Colchester, Vermont. OneCare Vermont

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