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Have You Heard Of OneCare Vermont?

Jun 20, 2018 02:33PM ● By Linda Ditch
You might not have heard of One Care Vermont, but this organization may be responsible for you receiving high-quality health care at affordable prices.

OneCare Vermont is a statewide Accountable Care Organization (ACO). Through Vermont’s All-Payer ACO Model, OneCare works with Medicare, Medicaid, commercial health care payers (like Blue Cross and Blue Shield of VT), and several self-funded insurances to improve health care outcomes. This group of doctors, hospitals, and other health care providers works together to provide coordinated, high-quality care for their patients. Providers benefit if they help keep health care costs under control and keep quality high. OneCare brings together health care and other service providers across the state to keep patients healthy and provide more coordinated care.

Just what is the All-Payer ACO? Vermont is partnering with the federal government in an effort to shift nearly all payment for medical services from a fee-for-service model to a value-based one. This rewards providers for achieving the state’s cost-containment and quality- improvement goals.

OneCare Vermont helps make this happen. Amy Bodette, Senior Programs, and Policy Administrator, explains, “We provide funding and tools to care coordinators and providers. Vermont has set a ‘Triple Aim’ goal: to improve the health of Vermonters, lower health care costs, and improve the individual patient experience of care.”

More than 112,000 Vermonters are having their health care coordinated through OneCare. The ACO’s network of providers who have contracted with them includes hospitals in Vermont and New Hampshire, hundreds of primary and specialty care physicians, federally qualified health centers, agencies for mental health and substance use, skilled nursing facilities, home health agencies, and area agencies on aging. The goal is to have 90 percent of all Medicare beneficiaries and 70 percent of commercially insured patients covered by the ACO by 2022.

So why is this important, and why should you care? Often, patients who need a lot of care are served by social workers, nurses, and other care professionals who work independently of each other and with limited funds. OneCare provides training and technology to help them collaborate, and the state’s three largest payers have committed to providing them with additional financial support.

What if you’re healthy? OneCare wants you to stay that way, so it is providing education and programs that highlight disease prevention. They will facilitate access to services that promote not only physical well-being but also mental health.

OneCare’s services do not change your insurance benefits. Your eligibility and benefits are the same as when you signed up. You can see any doctor you want, as long as he or she is in your insurer’s network.         

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