This commentary is by Julie Wasserman of Burlington, a health policy consultant working independently. She worked for Vermont state government for over 25 years; her jobs included director of Vermont’s dual eligible initiative at the Agency of Human Services, division director of policy and planning for the Department of Aging and Disabilities, and legislative staff to the Vermont Senate Health and Welfare Committee. She participated in Vermont’s three-year state innovation models initiative, the precursor to the all-payer model.

Authors from the UVM College of Medicine, UVM Medical Center, and UVM Health Network published a piece in the well-regarded Health Affairs journal on Vermont’s health care reform efforts. The authors discuss Vermont’s all-payer accountable care organization model and the practical issues that arise when a switch is made from volume-based payments to value-based payments. They expertly underscore fundamental challenges and pose important questions to consider.

However, the article perpetuates a longstanding distortion of the value of the all-payer model in controlling Vermont’s health care costs.  continue reading