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
Results
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
