Editor’s note: This commentary is by Don George, who is president and CEO of Blue Cross and Blue Shield of Vermont.
[A]s the only Vermont-based health care plan, it is Blue Cross and Blue Shield of Vermont’s responsibility to help build a better health care system for all Vermonters. A new system is dependent upon collaboration and time. Health plans, providers, hospitals and policymakers are working collectively to deliver better access to affordable, high quality health care and Blue Cross and Blue Shield of Vermont is a committed partner.
Reforming our health care system — including the way we pay for care — is essential to our goal of making health care coverage accessible, affordable, and accountable. These relationships and reforms change the way we work with health care providers, the way we pay for health care, and the way Vermonters engage with their health care benefits.
For this reason, Blue Cross and Blue Shield of Vermont has partnered with OneCare Vermont — Vermont’s only accountable care organization. Through this partnership, we are sharing risk for our members, including our individual and small group populations and our self-insured population in a shared risk program with OneCare Vermont.
What does this mean? It means that Blue Cross and Blue Shield of Vermont, OneCare Vermont, and the physicians and hospitals in OneCare’s network now have shared accountability for the cost of care for all of the members participating in the OneCare Vermont program. It means that all of us are combining our expertise, our resources and our programming to deliver better results. It means that we now have new incentives and opportunities for all of the stakeholders in our health care system to work together to address the forces increasing medical costs and premiums and to jointly develop effective interventions that benefit the whole system. Our partnership with OneCare is what the all-payer model is really about — making a better health care system by changing the way we consume, pay for, and deliver health care.
Our partnership with OneCare will continue to grow. As OneCare expands its provider network, and we jointly demonstrate success, BCBSVT will be able to include more of its membership — insured and self-insured — in the program.
For Blue Cross and Blue Shield of Vermont this is not new work, but it is an exciting new phase. For nearly a decade, we have advanced innovative payment models such as bundled-payments for inpatient surgeries, case rates focusing on consistent pricing for specific outpatient procedures, and payments for services with demonstrated value, such as care coordinators for the treatment of substance use disorders. During that time, we also supported the growth and development of the BluePrint for Health, and partnered with policy makers on multiple pilot programs to improve the functionality of our health care system. In many cases, we have been the only commercial health plan at the table. We have also worked with OneCare Vermont for the last four years on a shared savings program for our exchange members and we are the only commercial health plan to contract with OneCare on a risk sharing basis.
At the same time, Blue Cross and Blue Shield of Vermont has also undertaken two very significant reform efforts. In partnership with the Brattleboro Retreat, we have launched Vermont Collaborative Care, a joint venture that integrates medical and mental health data, programming and treatment to provide holistic care support to our members. We have also launched Accountable Blue, a workplace health and wellness population health initiative that is helping over 80 organizations and 70,000 Vermonters build healthier workplaces and live healthier lives every day.
Even with all of the positive work we’ve participated in over the past decade, we believe that this next phase of collaboration with OneCare Vermont, through the all-payer model, offers a tremendous, and perhaps unprecedented opportunity to improve our health care system. That being said, there is still more work in front of us if we are going to seize that opportunity and truly deliver on the potential to create a better, more affordable health care system. Real progress and change takes time and it is more important to get it done right than it is to race to the finish line. This is especially true in health care reform, where the journey does not have a finish line — as new medications and therapies arrive each day, providing relief and even curing debilitating illnesses while at the same time making it harder to achieve affordability.
Vermonters can count on Blue Cross and Blue Shield of Vermont to do everything we can to make health care reform successful. Over the past decade our partnerships have helped shape the health care landscape because we care about the health of Vermont.
