Editor’s note: This commentary is by Patrick Flood, the former commissioner of the Department of Mental Health, the Department of Disabilities, Aging and Independent Living and former deputy secretary of the Agency of Human Services. He is now retired and lives in East Calais.

Finally. Thanks to Auditor Doug Hoffer, the people of Vermont finally have an unbiased and accurate assessment of the current so-called health reform effort and the accountable care organization designated to implement it. And the picture, as many of us have been maintaining for years, is not pretty.

The Auditor’s report does not dig that deeply into the problems with the effort or the ACO, but he did not have to dig deep to find a shocking lack of accountability. His report states unequivocally that after almost three years of operation, the Green Mountain Care Board does not even have a method for determining if the effort is cost effective. Three years into a five-year pilot, tens of millions of tax dollars spent on administration, and no reliable, accurate method for determining the costs of running the pilot compared to savings for Vermonters.

Those of us who have been monitoring this effort for years could have told the Auditor: The financial information that is public shows convincingly that the ACO model is a failure. Savings have been miniscule compared to losses, with all three payers (Medicare, Medicaid and commercial insurance).

To make it worse, the state has not released the 2019 financial results, even though we are halfway through 2020. How can anyone evaluate the model with that kind of reporting? Does the Green Mountain Care Board have something to hide? They just might. Although not released officially by the state, it is a fact that the ACO was $17.4 million over budget in Medicaid for 2019. It is understandable why the state might not be in a hurry to let us know about this failure. continue reading