Vermont has new plan to slow health care costs

MONTPELIER, Vt. (AP) - More than 2,500 health care providers that serve Vermonters could be working together to help control costs by focusing on keeping people healthy rather than being paid to treat patients when they are sick, Gov. Peter Shumlin and other top officials said Wednesday.

The two new “shared savings programs” offered through health insurance plans offered by Vermont Health Connect and the state’s Medicaid program are designed to move away from the traditional fee-for-service model of health care to encourage providers to work together, keep people healthier and as a result reduce the growth of health care costs.

Shumlin said the three-year-program getting underway in Vermont is the first such statewide program in the country.

“Right now we have a health care system that most folks agree is not sustainable. It’s not sustainable because costs are rising faster than Vermonters’ incomes,” Shumlin said at a Montpelier news conference at the headquarters of the Green Mountain Care Board, which is overseeing the overhaul of Vermont’s health care system.

“If left unchecked, if we continue to do business as we always have it will continue to consume too much income of middle class Vermonters who are struggling enough, of small businesses and large businesses, of all of us together,” he said.

The goal of the programs is to encourage health care providers to keep patients healthy rather than provide expensive, sometimes unneeded tests, officials said.

As an example Al Gobeille, chair of the Green Mountain Care Board, said that if a hospital expected to spend $25 million to care for a group of patients and they provided that care for $22 million, the providers would be able to share in the savings if they meet certain requirements.

“They’ve saved money from what we thought they would spend and they get part of it back to invest in their practice,” Gobeille said.

One of the programs will be offered through health insurance programs offered by Vermont Health Connect, the state website that provides access to insurance as part of the federal health overhaul efforts, and Vermont’s Medicaid program, which provides health insurance to low income and disabled Vermont.

“The spirit of this is to provide a health care delivery system that’s coordinated around the needs of a patient and communicating with them as a whole person rather than a series of bits and parts that they might touch if they are ill” said Todd Moore, CEO of OneCare Vermont, one of the existing networks that will participate in the Medicaid shared savings program. “That’s as essential to this revolution as anything.”