OneCare Vermont has had a challenging fall.
The group, which manages the state’s health care reform efforts, is nearly three years into a five-year effort to shift the way that medical care is funded. OneCare collects money from private insurance companies, Medicaid, and Medicare, and funnels it to hospitals in monthly per-patient payments.
The approach is meant to save money by focusing on primary care and by making it more lucrative for hospitals and doctors to focus on quality, rather than quantity, of care.
In the last several months, the group has faced pushback from doctors, hospitals, the federal government, and the public.
During budget hearings, several hospital officials criticized the effort as administratively burdensome and too costly. In September, the federal Centers for Medicare & Medicaid Services sent a letter warning the state that it was behind on its targets. Fewer people than expected have participated in the system; OneCare needs the vast majority of the state’s population to opt in for the approach to be successful.