Green Mountain Care Board backs all-payer model

MONTPELIER — The Green Mountain Care Board on Wednesday voted to advance a draft agreement with the federal government that seeks to transform the way health care providers are paid in Vermont, paving the way for the state and federal government to begin implementation.

Al Gobeille, right, discusses the all-payer model. (File photo)


Al Gobeille, right, discusses the all-payer model. (File photo)

Gov. Peter Shumlin and his top health care officials negotiated for nearly two years with the federal government on the so-called all-payer model. It will be based on the Accountable Care Organization model — groups of doctors, hospitals and other health care providers that come together to provide coordinated care. The concept is intended to provide better information about a patient’s medical history among providers.

The all-payer model includes private insurance as well as government programs like Medicaid and Medicare as payers. The draft agreement provides waivers available under the federal Affordable Care Act, or Obamacare, to allow it to include those government programs.

Under the system providers will no longer be paid for each service or procedure they perform. Instead, they will be paid under a global budget based on health outcomes. Shumlin and other advocates say it will help slow the rate of growth in health care spending and should lead to better health outcomes for patients.

After announcing a draft agreement in late September, the Shumlin administration held several public forums to help Vermonters understand the system. The Green Mountain Care Board also held hearings around the state.

The five-member board’s unanimous approval Wednesday will allow Chairman Al Gobeille to sign the draft agreement.

“This is an important next step in provider-led health care reform,” Gobeille said in a statement. “Now we can begin the important work of implementing the all-payer model with guidance and insight from providers who care for Vermonters every day.”

The draft agreement must also be signed by Shumlin and Sylvia Burwell, secretary of the U.S. Department of Health and Human Services. Shumlin’s office announced the governor intends to sign the document Thursday afternoon in his ceremonial office at the State House.

“Vermont will now become the first state in America to ensure that your doctor can focus on keeping you healthy, rather than running tests or procedures,” Shumlin said in a statement. “By shifting the focus away from the current fee-for-service system to one that rewards primary care and prevention, we will help Vermonters lead healthier lives and more effectively manage chronic diseases, allow doctors to better treat their patients and identify health issues before they become severe, and reduce costs in a health care system that, if left unchecked, will bankrupt our state and Vermont families.”

Shumlin, who will leave office in January after declining to seek a fourth term, has pushed hard to get an agreement in place before both he and President Barack Obama leave office early next year. New administrations in Montpelier and Washington, D.C., will have plenty of work left to do to successfully transform the health care payment system.

“This agreement is historic, but it is only the first step. We have a lot of work to do to implement the agreement so it fulfills the promise of a health care system that works for all Vermonters. I look forward to continuing that hard work in the coming months,” Shumlin said.

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