The committee approved S.4 after OneCare Vermont, which opposed a previous version, worked out a compromise with Vermont Legal Aid’s Office of the Health Care Advocate and the American Civil Liberties Union of Vermont.
The bill would require OneCare’s board of directors to hold open meetings starting Jan. 1. The board would be able to go into executive session for any of seven reasons, including discussing personnel issues, negotiating contracts and talking about confidential patient information.
A previous version of the bill had named fewer reasons for executive session. But the new version also has more requirements, saying the board of directors must publicly warn meetings and publish either meeting minutes or recordings.
Todd Moore, the chief executive officer of OneCare and the related Vermont Care Organization, said both entities concluded that accountable care organizations are “a unique animal, and that ACOs were poised to be sort of unique types of companies in Vermont.”
“At the end of the day, we thought, given the unique nature of that being a central business model for statewide health reform and trying to improve quality and reduce costs, that it should probably have a unique level of transparency and access that’s different from just a regular nonprofit company,” he said.
OneCare is owned jointly by The University of Vermont Medical Center and Dartmouth-Hitchcock Medical Center. The company has a $93 million contract with the state of Vermont to take care of about 30,000 Medicaid patients for calendar year 2017.
OneCare is in the process of joining with a company that represents community health centers. They will morph into the Vermont Care Organization, or VCO. Once formed, the VCO would become the regulated monopoly that would receive Medicaid, Medicare and commercial payments and give that money to doctors based on the quality of care they provide, not the quantity of procedures performed.
The Green Mountain Care Board, a state regulator that will soon be charged with overseeing the VCO and its annual budget, led a nearly two-year effort that resulted in an agreement in July to have smaller groups of doctors merge into the VCO. The agreement was the basis for the all-payer model, spearheaded by then-Gov. Peter Shumlin.
Mike Fisher, the chief health care advocate at Vermont Legal Aid, said OneCare “came around” on the open meetings bill. Fisher had advocated for the provisions regarding meeting warnings and the publication of minutes.
“We kept asking, ‘What is it that you object to? Is it difficult for you to provide minutes of meetings or notice of meetings or notice of agendas? What is it that’s hard for you to do?’” he said. “And when we really got down to the business of looking at those details, they didn’t have an objection.”
The legislation will be discussed on the Senate floor in the next few days. If the Senate passes the bill, it will move over to the House.