Center for Medicare and Medicaid Services’ Report Recognizes Vermont’s All-Payer Health Reform

Yue D, Pourat N, Chen X, Lu C, Zhou W, Daniel M, Hoang H, Sripipatana A, Ponce NA
Publication Year: 2019
Population Focus: Medicaid beneficiaries
Type of Literature: Grey


Insights Results

Overview of program

  • The model is an all-payer ACO Shared Savings Programs that served nearly half of Vermont’s total Medicaid population


    • Of 9 CMS State Innovation Model Round 1 awardees, only Vermont’s Accountable Care Organization model yielded relative Medicaid savings of $97 million across the 3 implementation years. The model also had significant reductions in emergency department visits and inpatient admissions

    Key takeaways/implications

    • Vermont’s significant achievements, as outlined by CMS, are a solid platform for providers to assume downside risk in today’s All-Payer ACO Model. The findings demonstrate the positive impact that a coalition of willing heath care providers can have on the healthcare system, especially when leveraging previous reform efforts such as the Blueprint for Health Patient Centered Medical Home infrastructure
    • Lessons learned from the model include the role of prior foundation of reforms and the existing infrastructure in accelerating the program, required willingness to evolve priorities and needs in wide-scale, state-based reforms, and need for significant staff resources for stakeholder engagement and community buy-in