State seeks changes to 2020 OneCare Vermont budget

Published: Dec. 11, 2019 at 5:56 PM EST
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Vermont has to decide what to do with $1.3 billion which will impact how you get your health care.

Regulators are mulling over next year's budget for the state's group of doctors, providers and hospitals tasked with rolling out Vermont's new health care system. Our Calvin Cutler breaks down OneCare Vermont's budget and what state regulators want to see in it.

The Green Mountain Care Board, which oversees health care policy in Vermont, pitched their recommendations for OneCare's budget Wednesday morning.

They're calling for more transparency and accountability of OneCare in gathering standardized data about patients, expenses and success rates in Vermont's new health care system.

Regulators want OneCare to be straightforward with their data by creating a user-friendly online dashboard where the public can see their goals and where they are in completing them. It will also give people the ability to see the total cost of OneCare, its quality and its return on investment.

Some have doubted the state's new health care model and whether it's actually working but providers say it will take time because we're reimagining the whole system.

OneCare Vermont is a collection of doctors, physicians and hospitals tasked with rolling out the state's new all-payer model. In it, doctors are paid a flat monthly rate instead of by individual procedures.

We spoke with a provider in St. Albans about what the all-payer model looks to accomplish. They say it's about promoting healthy living and regular checkups instead of expensive visits to the emergency room.

"It's something that you need to look toward a larger organization, such as OneCare, to really move toward the goal. It's not something we can do as an independent practice or even as primary care health partners or even as one hospital service area in the state. It's something that takes something much bigger and for us to work together on it," said Dr. Toby Sadkin of St. Albans Primary Care.

OneCare's proposed $1.3 billion budget is a collection of federal Medicare, Medicaid and private insurance dollars. Much of the money already existed in Vermont's health care system before OneCare took over, so it's not necessarily new dollars.

This year, OneCare is asking the state for an additional $13 million to expand health care access, chronic care management and suicide prevention.

State regulators are expected to take a vote on the budget next week.

OneCare is going into its fourth year. This year's budget is a 33 percent increase over last year but that's because the budget is increasing incrementally as OneCare grows and more providers sign on.

This year, there are around 175,000 Vermonters in the program. OneCare wants to grow that number to 250,000 people next year.