Experts say Vermont health care reform efforts on track

Published: Jan. 30, 2020 at 4:30 PM EST
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Health care reform experts on Thursday said early results of overhauling Vermont's system are solid but there's still room for improvement.

The governor's budget calls for $5.5 million for the state's new all-payer model to make improvements to what is already viewed by some as one of the most efficient reform efforts in the country. The all-payer model calls for patients to receive more preventative care instead of expensive trips to the emergency room. Experts say OneCare, the organization managing Vermont's program, is efficient because it works well with Medicare, Medicaid and private insurance.

"It's not just Medicaid off on its own trying to be the 10 percent saving money, but Medicaid working hand-in-hand with other payers to get a care transformation that keeps people healthier," said Dr. Joshua Sharfstein with Johns Hopkins Bloomberg School of Public Health.

"We want to know what's going on. This is a lot of money. I happen to believe, I'm cautiously optimistic how this would help that at least changing the trajectory of health care costs in the state. We all need to know what we're doing," said Governor Phil Scott.

The governor and other lawmakers are pushing OneCare to become a nonprofit. He says the the organization needs to be as open as possible, including sharing how much its employees make. Right now it's in the process of becoming a federally recognized nonprofit but it could run into roadblocks at the state level.

OneCare is still falling short of its membership targets. By now they had predicted they'd serve three-quarters of Medicare patients in the state but they only serve about half.