- December 20, 2020
- Posted by: samdenis
According to the AHS`s Director of Health System Reform, the state has begun preliminary work on a subsequent all-pay agreement with CMS. AhS and GMCB expected them to formally partner with stakeholders in July 2020 to meet the December 31, 2021 deadline for a five-year contract proposal that would expire in 2027. The ACO model is a federal-federal test to determine whether these risk-based contracts and other provisions of the model reduce the growth of health care costs in Vermont, while improving quality and access to care in the state. In addition, a formal independent assessment of the MPA is required by federal law and will include an analysis of the state`s five-year performance on the total cost of the MPA for care, quality and scale. To conduct this evaluation, the Center for Medical Innovation and Health (CMMI) is working with the bipartisan NORC research organization at the University of Chicago. Unfortunately, due to the availability of data, the final results of this evaluation will not be available in time to inform about the continued implementation of the MPA or the development of a possible subsequent agreement (“APM 2.0”); Final results are expected in spring 2023. GmCB intends to use all relevant elements of the MPA`s first years of performance reports (z.B 2018 and 2019, which are expected to be available by the end of 2020) to inform, if possible, APM 2.0. There is no formal state-funded evaluation of this caliber, but if one of them were created, it would suffer from the same data delay as the federal assessment. The ACO model is based on the fact that insurers pay suppliers who use both pay-as-you-go and monthly lump sum payment structures. OneCare is financially responsible for meeting health care cost and quality targets and spreads financial risk among participating hospitals. Ultimately, the model aims to reduce growth in health care spending and improve the quality and access of Vermonters to care. Vermont has invested considerable public funds to implement OneCare Vermont and the ACO model.
As proposed by the Green Mountain Care Board, OneCare`s 2020 budget includes more than $13 million in Medicaid funds to continue building the model.