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Vermont ACO gets $620 million

The OneCare Vermont accountable care organization is taking on capitated risk, with its provider physicians receiving a per member, per month fee.

Susan Morse, Senior Editor

Credit: <a href="https://commons.wikimedia.org/wiki/File:2017-09-11_18_23_13_View_north_at_the_north_end_of_New_York_State_Route_22A_and_the_south_end_of_Vermont_State_Route_22A,_entering_Fair_Haven,_Rutland_County,_Vermont_from_Hampton,_Washington_County,_New_York.jpg">Famartin</a>.Credit: Famartin.

Vermont legislators and the Green Mountain Care Board have approved a $620.8 million budget for OneCare Vermont.

The ACO was formed by the University of Vermont Medical Center and Dartmouth-Hitchcock Hospital.

[Also: Two-sided risk contracts still a challenge for hospitals to manage]

OneCare Vermont is taking on capitated risk. Physicians in the estimated 10 participating hospitals and in clinics receive a per member, per month fee, according to the Burlington Free Press.

Primary care providers get $3.25 per patient per month, and providers caring for the sickest patients receive an additional $15 to $25 each month, according to the Burlington Free Press report.

[Also: Vermont's $44 million health information exchange is in trouble]

OneCare Vermont's extensive network of providers includes several of the state's hospitals, two neighboring New Hampshire hospitals, hundreds of primary and specialty care physicians, rural health clinics, and others facilities, coordinating the healthcare of approximately 102,000 combined Medicare, Medicaid and commercial exchange beneficiaries, Judi Fox, CFO of Rutland Regional Medical Center, said in July.

The program received federal approval in 2016, as a way to control the cost of healthcare.

If the current trend in medical inflation continues, Fox said, the cost of care in Vermont by 2025 could be more than 50 percent of an average Vermont resident's income.

Fox had said that one challenge of the ACO is the technology needed to share information between physicians and health systems.

A recent review by Kentucky-based technology consulting firm HealthTech Solutions found financial and administrative problems with Vermont's health information exchange.

The HIE, which is operated by Vermont Information Technology Leaders, has received $44.3 million in state and federal funding since its launch in 2005. HIEs are seen as critical to the Office of the National Coordinator for Health IT's charge to implement the 21st Century Cures Act.

Conor Kennedy, spokesman for the Green Mountain Care Board, which oversees the healthcare industry in the state, said HIE is a complex issue facing many states.

"The Green Mountain Care Board will continue to review the budget and activities of Vermont Information Technology Leaders (VITL), a charge assigned to the board by the Vermont Legislature in 2015," Kennedy said. "The board has had public meetings to discuss HIE and plans to schedule more meetings to discuss the matter in 2018."

OneCare Vermont CEO Todd Moore said the ACO has been working with the HIE for three years and is now at an important plateau in their progress. The challenge now is to have all of the providers working in an integrated system for more complete and accurate data.

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com

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