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+: 

An act relating to increasing the proportion of health care spending allocated to primary care

This bill proposes to require the Green Mountain Care Board to determine the proportion of health care spending currently allocated to primary care, recommend the proportion that should be allocated to primary care going forward, and project the avoided costs that would likely result if that proportion were achieved.  

It would then direct certain payers to provide a plan for achieving the allocation of primary care recommended for them by the Board.

Primary Care Investments Are Top of Mind for Many New England States

Representatives from state agencies in Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont met earlier this month to hear and discuss reports from multi-state workgroups related to Certificate of Need reform and hospital regulatory issues,  improving the value of community benefits reports, data-sharing opportunites, and primary care investments.

News Author: 
Primary Care Spend

Bill Providing Primary Care For All Vermonters Viewed As First Step To Single Payer

A plan to create a publicly financed primary health care system for all Vermonters will be a top priority for the Senate Health and Welfare committee during the 2018 session.

Hagan, Rinehart, & Connolly Pediatricians

Practice Type: 
Primary care practice
Practice Setting: 
Urban
Practice Address: 
128 Lakeside Ave, Suite 115
Burlington, VT 05401

State Officials Pushing For 'All Payer' Health Care System By 2017

State officials say they're hopeful that a new health care payment system can be in place at the beginning of next year. The proposal is designed to reimburse providers to keep their patients healthy and to encourage the expansion of primary care practices.

It's known as the "all payer" system, and it represents a dramatic change in the way that health care is paid for in Vermont.

Currently, under the "fee for service" system, providers are paid for every office visit, procedure or test that's done.

News Author: 
Bob Kinzel

New Report Says Universal Primary Care Could Work for Vermont

Lawmakers and administration officials abandoned their push for a single-payer health care system over a year ago. Advocates of a publicly funded program haven’t given up on the concept, however, and a new report could re-ignite a debate over whether to socialize portions of the health care system in Vermont.

News Author: 
Peter Hirschfeld

The rubber hits the road on cost containment

In 2014 Vermont launched an effort to bring health care providers together to better coordinate care for patients, reduce unnecessary tests, improve health outcomes, and save money in a health care system that is spending it faster than Vermonters can afford. And guess what? It’s working. Earlier this week we received the year-one results showing that the effort helped avoid $14.6 million in health care costs last year alone.

Vermont health care providers brace for an uncertain future

The Green Mountain Care Board anticipates greater detail from the federal government on what a so-called all-payer model could look like by the end of the month. Health care providers are scrambling to best position themselves for the changes such a system will bring.

This fall is widely expected to mark a transitional moment for health care reform in Vermont. Medical providers are bracing for the unknown and looking for safe harbor.

News Author: 
Morgan True

Who controls the data? U.S. Supreme Court agrees to hear healthcare case

The U.S. Supreme Court will hear a case next term on whether a self-funded insurer should have to turn over certain information to the state of Vermont—a case that could have far-reaching implications.

News Author: 
Lisa Schencker

$12 Million health care bill heads toward final approval in the House

The Vermont House gave preliminary approval Thursday to an omnibus health care package that raises $12 million supporters say will strengthen primary care and increase access to medical services. A final vote is scheduled for Friday.

The bill also sets out contingencies should new technology releases for Vermont Health Connect fail to improve its performance, and includes a range of policy initiatives aimed at furthering structural reforms to the state’s health care system.

News Author: 
Morgan True

Pagine

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