Low reimbursements threaten Blueprint for Health despite promising results

Vermont's Blueprint for Health program continues to reduce health care costs by improving preventive and primary care, but that success is threatened by low incentive payments, according to a new report.

Blueprint participation required substantial upfront investments by primary care practices. The program also created a network of multidisciplinary health teams that use social workers, dietitians and others to keep patients healthy.

Those costs were defrayed with grant money, but the ongoing incentive payments may not be enough to keep providers involved in the program.

Lawmakers requested the report to see if it makes sense to increase Blueprint payments, which have remained level since 2008. A measure to increase payments became a sticking point in passing a health care bill last session. The report was co-authored by Robin Lunge, the state's director of health care reform, and Blueprint director Craig Jones.

Participating providers say current payments are inadequate to support "clinical services in accordance with (the program's) demanding yet important standards," according to the report.

"If it's saving all this money for the state, why isn't the state willing to reinvest some of that with the people that are generating those savings?" said Paul Harrington, director of the Vermont Medical Society.

Vermont's incentive payments are lower than those in other states experimenting with similar care management initiatives, Harrington said.