By linking Fletcher Allen Health Care in Burlington, Dartmouth-Hitchcock Medical Center in Lebanon, N.H., five rural health centers and 14 Vermont hospitals, care providers are creating a new model for serving 42,000 of Vermont's nearly 120,000 Medicare patients. The association, known as OneCare Vermont, aims to provide quality care, while making sure patients aren't subjected to the same costly tests over and over again.
"I think that everybody has realized that we cannot do this by ourselves, no one organization, no one group of providers can do this by ourselves," said Dr. John Butterly of Dartmouth-Hitchcock.
"What we're all about is trying to reach the goal of the highest quality, most accessible, most affordable health care possible for Vermonters," said Dr. John Brumsted of Fletcher Allen.
Over the next six months, the linked providers will begin sharing data, such as patient records. Until that's done, we don't know what the reform will look like.
"We intend to let the data take us where the opportunities for improvement are," said Todd Moore, the CEO of OneCare.
Federal health reform calls for Accountable Care Organizations. Physicians will still be reimbursed as they are today, but any annual savings over Medicare cost estimates would be split between Medicare and an ACO. The goal is to begin budgeting dollars to care for a set number of patients rather than the current "fee for service" system.
Early on, spokespeople say the new model will likely be a blend of the two.
"We're in this together, we will either succeed together or we'll fail together," Butterly said.
Health care providers say renewed emphasis on preventative medicine can improve care while lowering costs. They'll have a few years to make it work, before dollars are truly at stake.
Middlebury's Porter Medical Center is the only Vermont hospital not to take part in the statewide ACO. Spokespeople told legislators they plan to in the future, but are currently too busy with electronic medical records work to take on another challenge.