The blind spots in health care reform

January 15, 2018


Editor’s note: This commentary is by Allan Ramsay, MD, who has been a family physician in Vermont for 38 years. He is currently medical director of the People’s Health and Wellness Clinic in Barre. Dr. Ramsay was a member of the Green Mountain Care Board from 2011-2016.

As the 2018 Vermont legislative session begins, there is significant concern about health care policies proposed by the federal government. These concerns should not cause Vermont’s legislators and health care leaders to lose sight of critical issues facing Vermonters. We cannot have a blind spot for new ways to approach improving the health care system.

Since 2015, Vermont has decided delivery system and payment reform efforts would be based on a statewide accountable care organization model (OneCare). Payment will gradually transition from fee-for-service to value-based payment for all payers (Medicare, Medicaid, commercial insurance). Paying for value to improve the health outcomes of a population certainly makes sense and over time may stabilize the growth in health care costs.

Those of us who are providing health care know that value should primarily be defined by the patient..........

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