Gov. Peter Shumlin is in Washington, D.C., Wednesday negotiating a health care reform deal that has been in the works for nearly two years.
Shumlin is meeting with Sylvia Burwell, the secretary of the U.S. Department of Health and Human Services, and Shaun Donovan, the director of the U.S. Office of Management and Budget.
Shumlin is negotiating terms of the so-called all-payer model, which hinges on an agreement from the federal government to waive several provisions of Medicare law and antitrust laws.
The Shumlin administration and the Green Mountain Care Board have been negotiating the deal since early 2015, shortly after Shumlin abandoned plans for single-payer health care.
The all-payer model would allow OneCare, an organization of doctors and hospitals founded by the UVM Medical Center and the Dartmouth-Hitchcock Medical Center, to accept monthly payments for patients from Medicaid, Medicare, and commercial insurers.
That organization, which is on track to merge with Community Health Accountable Care to become the Vermont Care Organization, would then pay doctors based on the quality of health services, not the number of procedures they perform.
If the new Vermont Care Organization can treat patients inexpensively, they can keep any additional money the insurers give them. If the organization cannot treat patients inexpensively, they must absorb the cost, thus making them “at risk” for the outcomes of their patients’ care.
Vermont would be the first state in the nation to set up this type of system.
