Article | Partnerships and Value

Payer-provider clinical alignment in Vermont

Article | Partnerships and Value

Payer-provider clinical alignment in Vermont

In Vermont, policymakers have brought together payers and providers to establish meaningful quality measures to improve access to primary care, reduce deaths from suicide and drug overdose, decrease rates of chronic disease and improve chronic disease management. Early results are promising: A 2018 Commonwealth Fund report, Vermont’s Bold Experiment in Community-Driven Health Care Reform, found:

  • High-risk Medicare beneficiaries covered under the state’s all-payer accountable care organization, OneCare Vermont, are using primary care, behavioral health and pharmacy benefits to a greater degree than high-risk beneficiaries not covered under the ACO.
  • Emergency department visits and hospitalizations have decreasedsignificantly among covered beneficiaries.

About the Author

Emad Rizk, MD,

is chairman, president and CEO of Cotiviti, Atlanta (emad.rizk@cotiviti.com). 

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