MONTPELIER, Vt. — Vermont’s health care regulator approved a $620 million plan designed to revolutionize how the state’s health care providers are reimbursed by placing a greater emphasis on preventive care and wellness programs rather than paying providers for the tests and procedures they perform.
The budget approved this week by the Green Mountain Care Board for the OneCare accountable care organization covers about 120,000 patients or about 20 percent of the state’s population.
“This is a major step in what we hope will be a transformation of the health care system in Vermont,” Board Chair Kevin Mullin told Vermont Public Radio .
It is also a major change in how health care providers are paid. It creates “a system where prevention and wellness and overall health is put at the top burner and providers will be able to practice in a way that just doesn’t reimburse them based on how many procedures and tests and things like that that they do,” Mullin said.
The plan calls for OneCare to provide the patients it is covering with all of their health care needs during 2018 for $600 million. The additional money will pay other expenses and programs.
The system is designed to pay participating health care providers a set fee for each patient in the program. Although there are limits, if that person’s care costs more than the fee, the provider will have to make up the difference. If it costs less, the provider will benefit.
Vermont Health Care Adovcate Mike Fisher says he wants to be sure there are procedures in place to ensure that patients are getting the care that they need.
“Making sure that there’s adequate transparency, patient protections, and really the kind of quality measures in place so that we can evaluate this project and make sure that it really does result in better care for Vermonters,” he said.
Information from: WVPS-FM, http://www.vpr.net