CMS announces Vermont All-Payer ACO Model

The Centers for Medicare & Medicaid Services today announced the Vermont All-Payer Accountable Care Organization Model, which will offer Vermont providers the opportunity to participate in a Medicare ACO initiative tailored to the state. Medicaid and commercial health care payers also will participate in the model, which will focus on achieving health outcomes and quality of care targets in four areas: access to care, management of chronic conditions, substance use disorders and suicides. The six-year model, to begin in January, also sets a target of per capita health care expenditure growth for all major payers to 3.5%, and per capita health care expenditure growth for Medicare beneficiaries to at least 0.1-0.2 percentage points below projected national Medicare growth. ACOs will continue to have payer-specific benchmarks and financial settlement calculations, but the ACO design will be closely aligned across payers. “The goal is to pay for quality instead of quantity, and ideally to improve outcomes and bend the cost curve in the process,” said Jeff Tieman, president and CEO of the Vermont Association of Hospitals and Health Systems. “The provider-led model focuses on community wellness and keeping people healthy, and it includes incentives for care coordination and chronic disease management.”