State to reboot all-payer model in response to warning from feds

The Centers for Medicare and Medicaid Services issued a warning notice to the state this week for failing to meet targets for the all-payer model, the state’s health care reform initiative.

For two years in a row (2018 and 2019), the reform model has fallen woefully below goals for participation in the all-payer system.

The all-payer model is an experiment that combines money from Medicare, Medicaid and commercial insurance to fund health care services on a per-patient basis, rather than a fee for services rendered. The objective is to incentivize preventive care and to lower the growth of health care spending. OneCare Vermont, a pass-through, for-profit hospital and provider group, manages the all-payer system.

In just two more years, 526,000 Vermonters are supposed to be in the program. OneCare has not met step targets toward that goal. So far, only about 30% of that target has been met. About 160,000 Vermonters are part of OneCare.

Read more: https://vtdigger.org/2020/09/18/state-to-reboot-all-payer-model-in-response-to-warning-from-feds/