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System Change

  • Eyes Turn to Vermont as It Sees Success with Health System  Associated Press by Wilson Ring —  A Vermont health care organization working to keep patients healthier while reducing costs is being closely watched because of its rate of success: it was within 1 percent of meeting its financial target in its first year and has now been expanded to cover about 18 percent of the state’s population, officials said. Last year, OneCare Vermont covered about 24,000 Medicaid patients and now covers about 112,000 patients whose health care is provided through Medicare, Medicaid, and commercial insurance. The long-term goal is to expand it so that about 70 percent of health care services provided in Vermont are covered by the system, which encourages patients to stay healthier using specialized care, such as helping them manage chronic conditions like diabetes so they don’t wind up needing more expensive treatment. Officials consider 70 percent a realistic goal. Twelve states have Medicaid programs using variations of the model being used in Vermont, and another nine are planning them, said John McDonough, a health care policy expert at the Harvard T.H. Chan School of Public Health.

  • Heading for the Exit: Rather Than Face Risk, Many ACOs Could Leave Modern Healthcare by Virgil Dickson —  Under Obama-era regulations, ACOs that started in [upside only] Track 1 in either 2012 or 2013 are supposed to move to a risk-based model by the third contract period, which begins next year. There are 561 Medicare ACOs this year, 82 percent of which are in Track 1. Leaving the Medicare Shared Savings Program has consequences, especially for an ACOs whose doctors don't have enough Medicare patients on their own to take part in the Merit-based Incentive Payment System created under MACRA. That means they won't be part of any value-based care initiatives….A mass exodus would likely undermine progress to move Medicare from a fee-for-service to a value-based pay system. ACOs have been critical in providing clinicians a full picture of the care patients receive elsewhere, leading to more informed doctors developing better care plans.

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