Despite recent confusion around federally mandated health care exchanges, work continues around the state to assure that we will have a single-payer system in 2017 that will result in more people getting better coverage for less money. This process doesn’t get much media attention, which is too bad because it is good news.
In an effort to reduce the growth of health care costs, the Green Mountain Care Board has pending proposals with the Centers for Medicare and Medicaid Services to test several payment models based around shared savings, accountable care organizations, bundled payments, and pay for performance.
The GMCB coordinated and helped design several payment reform models. In St. Johnsbury the board is guiding a coordinated oncology care project that is somewhat experimental, with doctors and providers helping design the future payment contracts and Dartmouth Hitchcock researchers tracking performance.
In Rutland, the GMCB is working with doctors, the hospital and the federally-funded health clinic to develop better payment systems. The GMCB is also developing standards for accountable care organizations and integrated care networks that can cover both insured Vermonters and Medicaid members.
The GMCB also used a process open to public comment and worked with the department of financial regulation on setting insurance rates in 2012. Having the medical community deeply involved in designing the single-payer system will help assure quality will not be sacrificed while costs are controlled.