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.

It is clear that Vermont’s ill-advised plan to turn our health care system over to an expensive, unnecessary and for-profit accountable care organization (ACO) is failing.

The ACO, OneCare Vermont, has failed to show any meaningful reduction in health care expenditures over five years, in spite of tens of millions invested in administration and infrastructure. According to a well-researched document submitted as a comment to the Green Mountain Care Board, since 2014 the total reported losses in Medicare, Medicaid and commercial insurance totaled $70 million, with only two instances of coming in below budget for Medicaid in 2014 and 2017 for a total of $5.8 million.  Most recently, in 2018 the ACO lost money in Medicaid and commercial insurance. For Medicare the ACO claims $5.6 million in savings. These losses came while spending $9 million in 2017 and $12 million in 2018 on additional administrative costs. For 2019, the current year, OneCare is predicting a loss of $8 million in Medicaid, and a savings of $7.9 million in Medicare, while spending $16 million in new administrative costs. For 2020, OneCare’s budget calls for $20 million in administrative costs. In addition, for 2020, OneCare is asking the Legislature for an additional $13.3 million subsidy. How can anyone call this a success? How is this lowering the cost of health care?

By the way, no one should accept the argument that this initiative is just beginning. OneCare has been a functioning ACO since 2013. There were additional payments and grants of state and federal dollars to OneCare in the period 2014-2016, but those numbers are not available. continue reading