NVRH Hopes to Join OneCare

Details

Created on Friday, 28 September 2012 19:55

Written by Joseph Peters

ACROSS THE NEK - Hospitals across Vermont - including Northeastern Vermont Regional Hospital (NVRH) in St. Johnsbury - have banded together in an attempt to establish an accountable care organization (ACO) known as OneCare. Assuming this proposal is approved, OneCare would be fully operational by January 1, which could radically change the way Vermont does health care.

"OneCare really offers the first real bona fide opportunity for us to, in fact, operate as a system," said Paul Bengtson, CEO of NVRH. "In this case, it's for Medicare patients."

The idea behind OneCare is simple enough. The hospitals and private practices involved in OneCare will work together to share informations and save costs.

"This is really an access to information revolution as much as it is anything else for us," said Todd Moore, Senior Vice President of Fletcher Allen Health Care, at a Joint Health Care Oversight Committee meeting on Sept. 20. "This gives us access to the full claims set for the first time to Medicare beneficiaries that we treat … to understand how they seek care, how often they go to [the doctor] - whether it be at Fletcher Allen or at Northwestern Medical Center or in Florida."

The idea behind this sharing - both of information and of services - is that it will reduce the amount of overlap experienced by patients. The patients themselves won't notice much of a difference. They'll receive the same quality of care at the same price.

"We can actually take a concept like this and apply it to the whole state," Bengtson said, "and basically become an example for the rest of the country in terms of how something like this can be put in place to improve the health of our population while reducing costs."

At this point, all but one of Vermont's community hospitals would be participating in OneCare, a project driven by Fletcher Allen Health Care and Dartmouth-Hitchcock Medical Center. The proposed entity would serve almost all of Vermont's 105,000 Medicare beneficiaries. The proposal falls under the Medicare Shared Savings Program, allowing the hospitals to create revenue by saving money.

Here's how it works: The Center for Medicare and Medicaid Services (CMS) sets a cost point based on the hospitals' last three years of Medicare service. If the hospitals fall below that cost point, they receive 50% of the savings. If they rise above the cost point, then they are responsible for a percentage of the overage.

"I think it's probably one of the most significant steps in the evolution of Vermont's health care," said Paul Harrington, executive vice president of the Vermont Medical Society, in an interview with Vermont Digger. "We don't have a health care system, so this clearly is an attempt to form one - not based on mergers, but rather a statewide partnership platform to better serve Vermont's seniors. It could be transformational in what Vermont's health care system looks like in the future."