Perhaps for the last time, state health care regulators from the Green Mountain Care Commission announced Wednesday that OneCare, the responsible care organization that has been the linchpin of Vermont’s “all-pay” health care cost reform efforts since 2018, said: – Approved Vermont’s annual budget.
OneCare announced in early November that 2025 will be its last year of operation. December 31, 2025 is also the expected end date for what the Centers for Medicare and Medicaid Services calls. “Vermont’s All-Payer ACO Model.”
The Cares Committee approved an organizational budget of just under $11.3 million, a reduction of nearly $1.5 million from OneCare’s original request, submitted before the nonprofit’s governing board voted to close.
Regulators will allocate the latter amount to OneCare, which has been a sole subsidiary of the University of Vermont Health Network since October 2021, to independent businesses participating in the organization’s “population health management” program, including primary care offices and home health care. and directed the reallocation to healthcare providers who Government and community agencies on aging.
Green Mountain Care board chairman Owen Foster said the approved budget is “very fair to OneCare” given that it is not significantly less than the organization’s actual spending in 2024. Ta.
Starting in 2024, salaries and benefits for the level budget will be reduced, and the unfilled position of chief financial officer will be abolished. After Abe Berman, who had served as OneCare’s CEO since May 2023, resigned earlier this month, Tom Boris, who had been in that role, became interim CEO.
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The Care Commission also cut funding that was earmarked for annual external reviews, lobbying and director recruitment, which the Commission no longer needed.
“This is definitely a different budget than we’ve had in the past because we’re approaching a downsizing,” Foster said.
Mr Boris accepted the rationale for reducing public comments to the December 4 and December 4 board meetings, acknowledging that “the paradigm has changed for us”. Comments written The organization’s goal for 2025 is to “do what’s best for our state, our health care providers and the patients we serve, while also being mindful of costs,” he said.
Boris added that OneCare plans to continue working on the full list until the end of 2025. The plan is to spend the first half of 2026 closing, with the final phase of closure to be completed by October of the same year, he said. Care Commission staff say it is currently unclear whether regulators will need to approve a partial budget for 2026, assuming the federal government’s “all-pay model” ends as planned at the end of 2025. said.
This model is a unique policy framework and the basis of legal agreements between the Federal Health Insurance Administration, the Vermont Department of Human Services, and the Medical Board that allow accountable care organizations to engage with Medicare in nontraditional ways. It made it possible to distribute Medicaid funds. method.
New payment methods include the addition of bonus payments for providers who meet certain quality of care standards and “per patient/month” payments to independent primary care providers. These strategies aimed to enhance preventive care and reduce overall health spending.
During the model agreement, which began in 2018, OneCare is Vermont’s only “full payer” accountable care organization, meaning it deals with private health care providers, Medicaid, and Medicare, so OneCare is the only organization that can: Terms and conditions.
In late November, the Board of Health approved the fiscal year 2025 budgets for Lore Health, Vytalize Health, and Aledade Accountable Care as submitted. All three are accountable care organizations operating in Vermont and serve only patients insured by Medicare.
On Wednesday, Cares Committee members also received an update on Vermont’s negotiations with the Centers for Medicare and Medicaid Services to participate in a new federal reform model. AHEAD programstands for State Advocating for All-Payer Health Equity Approaches and Developments.
Vermont is one of six states chosen to participate. The remaining states are Maryland, Connecticut, Hawaii, New York, and Rhode Island. The care committee’s vote on whether to proceed with preparations to participate is expected to take place in mid-January.
Cares Committee member Tom Walsh questioned whether President-elect Donald Trump’s incoming administration would support continued rollout of federal reform programs. If not, he asked, did Human Services Agency leaders have a backup plan for the funding programs that providers and their patients rely on?
OneCare succeeded in preserving part of the 2025 budget, namely the continuation of the ‘Community Care Representatives’ programme, which the Care Commission had been in trouble with.
This $300,000 will go to primary care providers within the OneCare network to collaborate with peers in the region on how to best utilize the data and reporting provided by ACOs. The program is necessary for the organization to maintain connections with these offices, which is essential to moving toward shared quality of care goals, Boris said.
“Personally, I want to end the era of the all-pay model on a positive note,” he said.
