All pediatrician Brad Friesen wants to do is care for kids.

The business of keeping his primary care practice afloat makes it difficult. Profit margins are thin in the best of times at Pediatric Medicine, where he is a partner, and Friesen said Covid has left the South Burlington practice on tenuous financial footing.

On Aug. 11, Friesen signed onto a letter saying that his office, and 13 other primary care practices in the state, would drop out of OneCare Vermont. The organization, in charge of reforming Vermont health care, is meant to save costs and keep doctors in business — but the program is making it harder for independent physicians to survive, Friesen said.

Starting next year, OneCare will cut regular monthly payments to primary care practices such as Friesen’s. Instead of paying a set fee of $3.25 per patient per month, OneCare would offer a range between $1.75 and $4.25 a month.

“The proposed reduction in payments for independent primary care is presented to us just as our incomes have dropped dramatically and our overhead has soared due to the pandemic,” the letter reads. “The concept of putting independent primary care at more risk is antithetical to any hope for a more efficient and cost-effective health system.”

OneCare CEO Vicki Loner said the change, which will affect about 125 practices, will encourage doctors to be more cost-efficient. If OneCare saves money on health care, doctors, including Friesen, would get a portion of those savings and earn $4.25 per patient per month; if OneCare loses money, the doctors would stay at $1.75. continue reading