In a significant development for Vermont’s healthcare system, state healthcare regulators at the Green Mountain Care Board recently approved OneCare Vermont’s annual budget, marking a major milestone as the organization prepares to cease operations by the end of 2025.
OneCare Vermont has been a cornerstone in Vermont’s “all-payer” healthcare payment reform efforts since 2018. However, it was announced that the year 2025 would be its last in operation. The Green Mountain Care Board approved a budget of just under $11.3 million for OneCare Vermont, reflecting a reduction of almost $1.5 million from the original request. This decision followed OneCare’s board of managers’ determination to close the organization. The reduced budget will see the cut amount redistributed to independent healthcare providers participating in OneCare’s “population health management” programs, including primary care offices, home health agencies, and area agencies on aging.
The budget adjustments included maintaining level funding for salary and benefit expenses from 2024, eliminating the unfilled chief financial officer position, and cutting funds allocated for an annual outside evaluation, lobbying, and board recruitment. These changes are indicative of the organization’s wind-down operations planned for 2025. Tom Borys, interim chief executive officer of OneCare, highlighted the rationale behind the cuts, stressing their objective to serve the state, providers, and patients while being cost-conscious.
OneCare plans to continue all its activities through the end of 2025. The shutdown process is expected to be completed by October 2026, aligning with the close of the “Vermont All-Payer ACO Model” contract with the Centers for Medicare and Medicaid Services (CMS) on December 31, 2025. This model enabled Medicare and Medicaid funds to be distributed by OneCare Vermont in innovative ways, aiming to enhance care quality and lower overall healthcare spending.
Though OneCare has been the sole “all-payer” accountable care organization (ACO) in Vermont, other ACOs like Lore Health, Vytalize Health, and Aledade Accountable Care, which only serve Medicare patients, have had their 2025 budgets approved. This approval indicates a continuity of specific healthcare services despite OneCare’s impending closure.
The Green Mountain Care Board also reviewed updates on Vermont’s participation in a new federal reform model named the AHEAD program (States Advancing All-Payer Health Equity Approaches and Development). Vermont was chosen as one of six states to participate, with a board vote on proceeding with preparations expected in mid-January.
Despite the budget cuts, OneCare managed to uphold its “regional care representative” program. This initiative aims to maintain connections with primary care providers and progress towards collective care quality goals. This decision demonstrates a commitment to ensuring continuity and quality of care during the transition period.
In conclusion, the article encapsulated the approval of what is likely OneCare Vermont’s final budget and the phased wind-down of its operations. It explored the implications for Vermont’s healthcare payment reform efforts and tracked ongoing considerations for future federal healthcare models. The narrative reflected a careful analysis of budget allocations, strategic planning for continuity of care, and the broader impact on Vermont’s healthcare landscape.
