Vermont

Beginning in the 2005-2006 Vermont Legislative Session, health care reform in the State of Vermont was launched through the Blueprint for Health (Blueprint). In 2007, with the participation of Vermont’s three largest commercial payers and Medicaid, the legislature authorized pilots to test an Integrated Health Services Model (the Bluprint model). The Blueprint model includes advanced primary care in the form of Patient Centered Medical Homes (PCMHs), multi-disciplinary support services through Community Health Teams (CHTs) which support PCMHs, multi-insurer payment reforms that fund PCMH transformation community health teams, and activities focused on continuous improvement using comparative valuation (Learning Health System). 

In 2011, Medicare selected Vermont as a participant in its Multi-Payer Advanced Primary Care Practice Demonstration initiative, and agreed to participate in the Blueprint project. The project now includes 79 practice sites serving approximately 360,000 patients, more than half of the state’s population. In 2013, the Blueprint was expanded statewide.

During the last few years, this work continued with enactment of  Act 48 (2011) and passage of Act 171 (H.559), signed by Governor Peter Shumlin on May 16, 2012.  They put Vermont on a path toward an integrated health care delivery system with a budget regulated by the new Green Mountain Care Board, universally available health insurance coverage that is not linked to employment and a single system for administration of claims and payments to providers. 

In addition, Vermont's Request For Proposals for QHPs encourages issuers to include innovative preventive care models in its non-standardized plan designs such as Advanced Primary Care Practices, PCMHs and Community Health Teams. 

CHIPRA: 
Yes
MAPCP: 
Yes
Dual Eligible: 
No
2703 Health Home: 
Yes
CPCi: 
No
SIM Awards: 
Yes
PCMH in QHP: 
Yes
Legislative PCMH Initiative: 
Yes
Private Payer Program: 
Yes
State Facts: 
Population:
620,000
Uninsured Population:
8%
Total Medicaid Spending FY 2013: 
$1.5 Billion 
Overweight/Obese Adults:
61.9%
Poor Mental Health among Adults: 
34.8%
Medicaid Expansion: 
Yes
CPC+: 

S. 53

This legislation directed.the Green Mountain Care Board and Department of Vermont Health Access to identify which health care providers and services constitute primary care, determine the percentage of health care spending currently allocated to primary care by certain public and private payers and by Vermont’s health care system overall, and report the percentages and related information to the General Assembly.

S151 An act relating to pay parity and transparency in health care

This multi-issue bill includes provisions to increase primary care payments and spending. It requires that Medicaid matches 100% of the amount that Medicare pays its providers and that state and large health insurers increase their annual spending on primary care until the total reaches at least 12% of overall health care spending.

H 220 - An Act Relating to Primary Care and Preventive Services

Requires commercial plans covering 500 or more lives, the State Employees Benefit plan and the Green Mountain Care Board to increase the proportion of health care spending allocated to primary care by 1% a year until reaching 12%.

S. 84 An Act Relating to Strengthening Primary Care and Primary Care Providers

This bill proposes to require health insurers, the State Employees’ Health Benefit Plan, and the health plans offered to school employees to increase the percentage of total health care spending they allocate to primary care to at least 15 percent and would require the next all-payer model agreement with the federal government to include a provision requiring annual increases in primary care spending in Medicare.

S. 244

Would require health insurers, the State Employees’ Health Benefit Plan, and the health plans offered to school employees to increase the percentage of total healthcare spending they allocate to primary care to at least 12% and require that Medicaid primary care reimbursement rates match Medicare levels.

As primary care system nears 'breaking point,' Vermont lawmakers consider a rescue plan

If you’ve ever had trouble finding a primary care doctor, or getting an appointment with one when you’re sick, you’re not alone. And some of Vermont’s top medical experts say the primary care shortage is about to get worse.

As state Senate lawmakers consider provisions that would funnel more money into primary care services, doctors are raising some existential questions about the future of preventative care.

News Author: 
Peter Hirschfeld

Safest States During COVID-19

WalletHub study

As the U.S. continues its efforts to overcome the COVID-19 pandemic amid a surge in cases caused by variant strains, staying safe is one of Americans’ top concerns. Safety is also essential for getting the economy back on track, as the lower COVID-19 transmission and deaths are in a state, the fewer restrictions there will be and the more confidence people will have to shop in person. While almost all states have fully reopened, we’ll only be able to completely get back to life as normal once most of the population is fully vaccinated against coronavirus. The good news is that the U.S.

News Author: 
Adam McCann

New England States Issue Regional PC Spend Report

A consortium of New England States, known as NESCSO, recently released a first-of-its-kind regional report on levels of primary care investment across six states.

PCPCC Applauds Colorado and Vermont for Laws that will Measure and Increase Primary Care Investment

The Patient-Centered Primary Care Collaborative (PCPCC) applauds Colorado Governor Jared Polis and Vermont Governor Phil Scott for signing into law legislation in their respective states that will enhance primary care services and payment.

Pagine

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