OneCare Vermont, an accountable care organization aiming to reform how health care in Vermont is paid for, will shut down at the end of 2025, the organization announced Wednesday.
The University of Vermont Health Network subsidiary was the lead organization running the state’s “all-payer” model, a health care reform program that seeks to improve Vermonters’ health and decrease costs. The all-payer model, a federal framework that allows OneCare to accept payments from both Medicare and Medicaid, will conclude at the end of 2025.
That wind-down spurred the decision to shut down OneCare, its CEO, Abe Berman, said in an interview.
“Ultimately, this is such a pivotal point in the region’s health care reform journey,” Berman said. “It made sense, when we talked to UVM and our other board members and colleagues, that it’s the right time for us to sunset this effort and look towards what comes next (for) Vermont.”
OneCare’s goal is to lower health care costs and improve the general health of its patient population, which numbers roughly 200,000. To achieve those goals, OneCare is intended to work by decoupling insurer payments from individual medical procedures, tests or services. Instead, OneCare, by contracting with insurers, aims to provide regular lump sums to providers regardless of how many procedures they conduct.
In addition, the program invests in primary care, works to improve coordination between Vermont providers — roughly 5,000 of which participate in the program — and collects data about care costs and quality.
Berman said that administrators are in discussions with the state to smooth the transition for patients and providers out of OneCare. But, because the organization works with health care providers around the state, patients and practices may notice the change.
“Right now, we provide a ton of support, both monetary and in terms of data and information, to primary care providers and other providers across the spectrum of health care in Vermont,” Berman said. “And absent that funding, patients may notice that they’re not getting the same access to care they got historically.”
He expressed optimism that the state would find a way to replace that funding and those services.
Brendan Krause, director of health care reform for the Vermont Agency of Human Services, said in an emailed statement that the agency is grateful to OneCare “for the many programs they have offered that make a difference in the lives of Vermonters” and is “committed to working with them to determine how best to continue offering programs that are of value to Vermont.”
OneCare spends between $13 and $15 million each year on operations, including roughly $7 million on salaries and benefits in 2024, according to financial documents filed with the Green Mountain Care Board, and the organization has faced criticism that it has consumed money while not measurably improving Vermonters’ health or lowering costs for care.
But Berman touted what he sees as OneCare’s achievements.
“Across the continuum, providers of all stripes can get together and talk about how to improve care for Vermonters in their communities,” he said. “We allowed them to share data effectively and to pinpoint places where we needed to make investments to ensure that people were getting adequate care before they were in acute care, so (a) more preventative care focus. And with our support, we’ve seen millions in shared savings.”
The announcement that the program will shut down comes as Vermont prepares for a separate federal health care reform program, the AHEAD model, that would take a similar tack as OneCare.
The AHEAD model — short for States Advancing All-Payer Health Equity Approaches and Development — also aims to invest in primary care and shift providers to a similar kind of lump sum payment model. Vermont was selected earlier this year for the program, which begins in 2026 and runs through 2034.
Read the story on VTDigger here: OneCare Vermont to shut down.