Editor’s note: This commentary is by Susan Aranoff, J.D., who is a senior planner and policy analyst for the Vermont Developmental Disabilities Council.

Judging from a recent uptick in VTDigger commentaries about health care reform, Vermonters have many questions about our state’s experiment known as the All-Payer Accountable Care Organization (ACO) Model. None is more pressing, however, than this: What can the Legislature do to evaluate the work of OneCare Vermont in preparation for the potential extension of our state’s unique approach to managing health care costs and population health.

Yes, that’s correct. The all-payer ACO model is already approaching the finish line under its first agreement from the Centers for Medicare and Medicaid (CMS), which expires at the end of 2022. If lawmakers intend to define the terms of renewal, as they did broadly for the current agreement, then they need to commission an independent study prior to the 2021 session.

Lawmakers have every reason to proceed with caution and to seek the very best advice. Of critical importance is the impact of the all-payer ACO model on the Medicaid program because it is the safety net for Vermont’s most vulnerable, and costly, citizens. continue reading