Vermont Health Program Reduces Hospital Stays, Saved Money | Vermont News


By WILSON RING, Associated Press

The first two years of a Vermont program put in place to keep patients healthier while reducing costs have saved Medicare patients money and avoided hospitalization for more large number of people, revealed an evaluation of the program.

The report commissioned by the Centers for Medicaid and Medicare Services and released this week looked at the first two years of Medicare’s involvement in Vermont in what’s known as the all-payer healthcare model.

The report found that in 2018 and 2019, costs for Medicare patients in the study system saved about 4.7% from the previous year. For all Medicare patients in Vermont, the system saved about 6.5% from the previous year.

In 2019, the system reduced acute care hospital stays by almost 18% for people in the system, it reduced the number of acute care days that patients stayed in. hospital by 14.7% and the number of people readmitted to hospital within 30 days by 12.4%.

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“These declines are very encouraging,” Ena Backus, director of health care reform for Vermont, said Friday.

The same report found that the project run by the OneCare Vermont organization had not signed up as many people to participate in the system as had been hoped. In 2019, it was hoped the program would cover 75% of Medicare-eligible patients, but it only reached 47%.

OneCare CEO Vicki Loner said the overall results were encouraging.

“We have a long way to go to fully realize the vision of the (all payers model), but we are on the right track and must continue to make steady progress for the people of Vermont.”

The report covers 2018 and 2019, the first two years of the five-year program.

The goal of the all payer model is to keep patients healthier while reducing health care costs by paying a set amount for each covered patient rather than paying for each service provided.

To help achieve this goal, medical providers, including in some cases social workers, work closely with patients to ensure they receive the best possible care.

The report by an organization affiliated with the University of Chicago, commissioned by CMS, only looked at the Medicare population in Vermont participating in the all payers model. But he also looked at the system’s impact on Vermont’s Medicare program as a whole.

Medicare is the federal health insurance plan for people over 65.

The report says the system provides an important and unifying forum for providers, payers and the state to work on health care reform.

“Widespread transformation in the delivery of care will take time,” the report says.

OneCare also works with Medicaid, insurance for low-income Americans, and some of the patients covered by private insurance through Blue Cross Blue Shield of Vermont.

Future reports will examine the performance of Medicaid and private insurance, Backus said.

The five-year program is set to run until 2022, but Backus said Vermont officials will apply by the end of this year to extend the program to 2023.

Earlier this year, Vermont auditor Doug Hoffer released a report that OneCare missed its Medicaid financial goals by $ 25.6 million between 2017 and 2019. The auditor’s report didn’t examines only the financial performance of the program, not its effectiveness in keeping people healthier. .

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