[V]ermont’s largest health reform company has resubmitted its first annual budget to state regulators to reflect updated numbers.
OneCare Vermont is now projecting it will control about $599 million in patient care money in calendar year 2018, down from $737 million when the company submitted its original budget in June.
The company is second only to the University of Vermont Medical Center in Burlington in the amount of patient care money it expects to control. The medical center brings in about $1.2 billion from patients each year.
OneCare is what’s known as an accountable care organization, or ACO, with a vision to coordinate care across dozens of health care companies to improve Vermonters’ well-being. The company is jointly owned by the UVM Medical Center and Dartmouth-Hitchcock Medical Center in New Hampshire.
The Green Mountain Care Board, which already regulates hospital budgets and health insurance prices, has been creating a process to regulate ACOs. The company voluntarily submitted its preliminary and updated budgets to help iron out the process. After another ACO’s recent decision to fold, OneCare will be the only one remaining in Vermont.
Todd Moore, the CEO of OneCare Vermont, said the company resubmitted its budget because it has finalized agreements with hospitals, nursing homes, private doctors offices and other entities that want to participate in its health reform programs.
There are more than 160 companies whose providers have signed on to coordinate some aspect of patient care through OneCare. Among them are 10 hospitals, including the UVM Medical Center and Dartmouth-Hitchcock.
The total also includes 19 nursing homes, eight home health agencies, six designated mental health agencies, two area agencies on aging, two community health centers, nine specialty providers and 54 private doctors offices.
The providers are collectively responsible for 120,000 patients. That’s a slight decrease from OneCare’s original projection of 137,000 patients.
Moore said OneCare’s budget has gone down in part because the company originally planned to work with the Community Health Centers of Burlington, one of the largest health care providers in Vermont. However, Moore said the organization told him it is not quite ready for OneCare’s health reform programs.
He said Southwestern Vermont Medical Center in Bennington will participate in fewer programs than anticipated. At the same time, two unexpected organizations — North Country Hospital in Newport and Mount Ascutney Hospital in Windsor — will participate in some programs, Moore said.
Additionally, starting in 2018, Moore said, OneCare will control the patient care money for employees of the UVM Medical Center. The hospital self-insures to pay for health coverage for its employees; Blue Cross Blue Shield of Vermont administers the plan.
“I’m thrilled with the providers, the breadth and depth of providers who have chosen to take this big next step to deliver high-value health care for Vermont,” Moore said. “I truly believe that this is a really big step. This is truly a statewide network, and this is an important and humbling step to take.”
OneCare is still budgeting $12.5 million for operations, according to its filing. OneCare has reduced its $29.3 million budget for population health programs to $27.3 million. Moore said the amount budgeted for those programs is going down only because there are fewer patients who will be affected. The money goes to better fund primary care, coordinate care for some of the sickest patients in Vermont, and invest in housing assistance.
The Green Mountain Care Board is scheduled to discuss OneCare’s budget and the regulatory process Thursday at noon in Montpelier.
