Vermont

Beginning in the 2005-2006 Vermont Legislative Session, health care reform in the State of Vermont was launched through the Blueprint for Health (Blueprint). In 2007, with the participation of Vermont’s three largest commercial payers and Medicaid, the legislature authorized pilots to test an Integrated Health Services Model (the Bluprint model). The Blueprint model includes advanced primary care in the form of Patient Centered Medical Homes (PCMHs), multi-disciplinary support services through Community Health Teams (CHTs) which support PCMHs, multi-insurer payment reforms that fund PCMH transformation community health teams, and activities focused on continuous improvement using comparative valuation (Learning Health System). 

In 2011, Medicare selected Vermont as a participant in its Multi-Payer Advanced Primary Care Practice Demonstration initiative, and agreed to participate in the Blueprint project. The project now includes 79 practice sites serving approximately 360,000 patients, more than half of the state’s population. In 2013, the Blueprint was expanded statewide.

During the last few years, this work continued with enactment of  Act 48 (2011) and passage of Act 171 (H.559), signed by Governor Peter Shumlin on May 16, 2012.  They put Vermont on a path toward an integrated health care delivery system with a budget regulated by the new Green Mountain Care Board, universally available health insurance coverage that is not linked to employment and a single system for administration of claims and payments to providers. 

In addition, Vermont's Request For Proposals for QHPs encourages issuers to include innovative preventive care models in its non-standardized plan designs such as Advanced Primary Care Practices, PCMHs and Community Health Teams. 

CHIPRA: 
Yes
MAPCP: 
Yes
Dual Eligible: 
No
2703 Health Home: 
Yes
CPCi: 
No
SIM Awards: 
Yes
PCMH in QHP: 
Yes
Legislative PCMH Initiative: 
Yes
Private Payer Program: 
Yes
State Facts: 
Population:
620,000
Uninsured Population:
8%
Total Medicaid Spending FY 2013: 
$1.5 Billion 
Overweight/Obese Adults:
61.9%
Poor Mental Health among Adults: 
34.8%
Medicaid Expansion: 
Yes
CPC+: 

Health Care Package Shrinks Again

on mar, 2015-04-21 00:00   lisabeth

A house health care package has been pared down again as lawmakers careen toward adjournment. In all, lawmakers plan to raise $12 million for a health care bill that has languished in House Appropriations for several weeks.

What started out as Gov. Peter Shumlin’s grand plan to help poor Vermonters get better access to hospitals and physicians has shrunk over the past four months to an attempt to shore up a weakened primary care system and provide subsidies to low-income Vermonters.

Story Date: 
April 21, 2015
News Author: 
Morgan True
Source Link: 
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Vermont Act 48 (VT LEG 270379.1)

The Act put Vermont on a path toward an integrated health care delivery system with a budget regulated by the new Green Mountain Care Board, universally available health insurance coverage that is not linked to employment and a single system for administration of claims and payments to providers.

Act 171 (H.559)

The act expresses legislative intent that access to and payments for community health teams should begin at least six months before a medical practice is scheduled to be scored for Blueprint recognition, that the Blueprint director increase payments to medical homes because of new qualification requirements, and that all health plans, including the multistate plans required under the ACA, should participate in the Blueprint for Health.

Universal Primary Care Proposal Makes Legislative Debut

on ven, 2015-02-13 00:00   lisabeth

A tri-partisan group of House lawmakers has introduced a bill that would publicly finance universal access to primary care services in Vermont.

The bill, H.207, would create a dedicated Universal Primary Care Fund within the Treasury to make capitated payments to health care providers that would cover primary care for all Vermont residents.

Story Date: 
February 13, 2015
News Author: 
Morgan True
Source Link: 
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The Promise and Pitfalls of State-Based Payment Reform

2015-02-27 13:00 - 14:30

Many states across the nation are in the process of designing and implementing multi-payer payment reform initiatives. The goals of these initiatives are to lower health care costs, improve health outcomes, and enhance the quality of care. States are receiving significant federal funds to accelerate payment and delivery system transformation: the Center for Medicare and Medicaid Innovation recently announced more than $660 million to 32 states (including DC and three territories).

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Announcement Type: 
Webinar

New Shumlin Health Care Plan Could Expand Access To Primary Care

on mar, 2015-01-06 00:00   lisabeth

Gov. Peter Shumlin says he'll unveil a major health care initiative later this week that's designed to strengthen Vermont's primary care physician network. A second goal of the plan is to lower the cost of private health insurance premiums.

The governor says his decision not to pursue a single-payer health care system this year doesn't mean that he won't propose some key health care reform plans.

Story Date: 
January 6, 2015
Source Link: 
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Low reimbursements threaten Blueprint for Health despite promising results

on jeu, 2014-10-16 00:00   lisabeth

Vermont's Blueprint for Health program continues to reduce health care costs by improving preventive and primary care, but that success is threatened by low incentive payments, according to a new report.

Blueprint participation required substantial upfront investments by primary care practices. The program also created a network of multidisciplinary health teams that use social workers, dietitians and others to keep patients healthy.

Those costs were defrayed with grant money, but the ongoing incentive payments may not be enough to keep providers involved in the program.

Story Date: 
October 16, 2014
News Author: 
Morgan True
Source Link: 
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Don't Rush to Judgment: Medical Homes Can Improve Outcomes, Save Lives

on jeu, 2014-03-20 00:00   lisabeth

We live in an age of immediacy, fueled by 24/7 news cycles and a robust social media environment. We find humor in watching a cat chase a laser pointer, but our pursuit of the new and shiny is no less present. One negative review can lead people to drop everything and change course. A restaurant can have a bad night, get a couple of negative reviews on Yelp, and find itself with empty tables as potential customers take their business elsewhere.

Story Date: 
March 20, 2014
News Author: 
Kenneth Thorpe
Source Link: 
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Vermont Hub and Spokes Health Homes

Vermont has an approved state plan amendment for a 2703 Medicaid Health Home program. The Hub and Spokes Health Homes program creates a coordinated, systemic response to the complex issues of opioid addiction among Vermont's Medicaid population, focusing specifically on medication assisted therapy (MAT) for individuals with opioid dependence.

Vermont Blueprint for Health

The Blueprint for Health (Blueprint) is Vermont’s state-led initiative charged with implementing sustainable health care delivery reform. Blueprint was originally codified in Vermont statute in 2006, then modified further in 2007, 2008, and finally in 2010 with Vermont Act 128 amending 18 V.S.A. Chapter 13.

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