The first two years of a Vermont program designed to keep patients healthy while cutting costs saved Medicare patients money and kept more people out of the hospital, an evaluation of the program found.
Commissioned by the Centers for Medicaid and Medicare Services and released this week, the report looked at the first two years of Medicare’s participation in Vermont’s so-called all-payer model of health care.
the report found that in 2018 and 2019, Medicare patient costs were saved about 4.7% year over year in the system under study. For all Medicare patients in Vermont, the system saved about 6.5% year over year.
In 2019, the system reduced the acute hospital stays of people in the system by almost 18%, it reduced the acute treatment days of patients in the hospital by 14.7% and the number of people re-admitted to hospital within 30 days by 12, 4%.
“These declines are very encouraging,” said Ena Backus, director of health care reform in Vermont, on Friday.
The same report found that the project run by the OneCare Vermont organization did not enroll as many people to join the system as hoped. In 2019, it was hoped the program would cover 75% of eligible Medicare patients, but it only hit 47%.
Vicki Loner, CEO of OneCare, said the overall results are encouraging.
“We still have a long way to go to fully realize the (all-payer) vision, but we are on the right track and we 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 total pay model is to maintain patient health while reducing healthcare costs by paying a fixed amount of money for each insured patient rather than for every service provided.
To achieve this goal, medical providers, and in some cases social workers, work closely with patients to ensure they are receiving the best possible care.
The report commissioned by CMS from an organization affiliated with the University of Chicago looked only at the Medicare population of Vermont participating in the all-payer model. It also looked at the impact of the system on Vermont’s Medicare program as a whole.
Medicare is the state health insurance for people over the age of 65.
According to the report, the system provides an important, unifying forum for providers, payers and the state to work towards health reform.
“The widespread transformation of long-term care will take time,” the report says.
OneCare also works with Medicaid, an insurance company for low-income Americans, and some of the patients privately insured through the Blue Cross Blue Shield of Vermont.
Future reports will look at the performance of both Medicaid and private insurance companies, Backus said.
The five-year program is slated to run through 2022, but Backus said Vermont officials will request an extension of the program to 2023 by the end of this year.
Earlier this year, Vermont auditor Doug Hoffer released a report that found OneCare missed its Medicaid financial targets by $ 25.6 million between 2017 and 2019.