This commentary is from Anya Rader Wallack, Chairman of the OneCare Board of Directors.
OneCare Vermont improves health and reduces healthcare costs for Vermonters. OneCare is an accountable care organization. We partner with health insurers, hospitals, independent medical practices, community health organizations, and local collaborators to improve the quality of care and make it more affordable for Vermonters.
OneCare is an important piece of the puzzle of healthcare reform. OneCare is working. OneCare improves healthcare quality and cuts costs in Vermont.
A major goal of Vermont’s healthcare reform was to shift healthcare costs away from the fee-by-service model, the way most healthcare is paid in the United States.
Service Fee means a separate payment for a particular service such as a visit, operation or test. This model is largely responsible for the unsustainable rise in US healthcare costs.
Vermont’s health care reform aims to move to a value-based payment model instead of paying for each service. It prioritizes and rewards providers based on health rather than service.
In other words, providers are not paid to perform specific services such as running tests or performing surgeries, but for making patients healthy. is the primary means for OneCare was established to manage the transition to value-based payments and manage payment models after implementation.
OneCare has made significant progress toward its goals by holding more than 5,000 Vermont healthcare providers accountable for the cost and quality of care they provide through payment contracts. In fact, by 2023, her 30-40% of Vermont residents will receive care partially related to outcome-based payments.
OneCare can also reduce costs and improve quality by making support services available to providers. Examples include providing data to help identify which Vermonters need outreach and where care needs to be improved. Fund primary care providers through predictable monthly payments. Eliminate regulations that impede quality patient care. Supporting higher quality care through preventive efforts.
And, again, it’s working. Through this work, OneCare has improved the quality of healthcare in Vermonter while reducing costs. Specifically, OneCare results include:
- Significant medical savings. More than $50 million in Medicare savings realized since 2018.
- low cost. Vermont was able to reduce high-cost services such as inpatient and emergency room visits, as well as an increase in overall Medicaid costs. OneCare has achieved reductions in total Medicare spending in every year assessed by the federal government.
- Stable access to primary care. With predictable monthly funding from OneCare, the Vermonter maintains access to primary his care. This is the heart of a better care delivery model. Primary Care Health Her Partners, Vermont’s largest employer of independent primary care physicians, recently wrote: [OneCare] A comprehensive payment reform program, perhaps some of our practices may not exist today.OneCare’s CPR program is the most innovative care program aimed at maintaining independent primary care in the state. I believe it is one of the models.
- high quality. OneCare providers consistently score above average for quality of care. For example, in 2021, OneCare providers achieved the 90th percentile nationally for diabetes management.
- Stakeholder Support. OneCare provides an important unified forum for providers, payers, and states to engage in meaningful discussions and set goals on healthcare reform. The model has also strengthened relationships between various providers, which has proven important during the pandemic.
Overall, OneCare providers offer better quality care and more savings. Healthcare reform is essential and we are moving forward. Healthcare transformation is not easy and won’t happen overnight, but OneCare’s commitment to improving healthcare quality and reducing costs is a big step in the right direction.
