Vermont Will Try an ‘All-Payer’ System Starting in January

Vermont is going to try following Maryland’s lead by testing an all-payer reimbursement system for healthcare providers in 2017. Where Maryland’s long-held policy covers only hospitals, though, Vermont plans to use an accountable care organization (ACO)-type structure to cover all providers, regardless of setting (including urgent care). All-payer systems require all insurers, whether private, Medicare, or Medicaid, to pay similar rates for services. The goal is to increase the quality of care while decreasing the state’s costs. Under the state’s proposal, which is modeled on Medicare ACOs, providers would be paid global rates based on patient populations and health outcomes. Fee-for-service payments would cease to exist. Vermont had to get the blessing of Health and Human Services Secretary Sylvia Mathews Burwell before moving ahead with its plans. If all goes according to plan, the 5-year demonstration will run from January 1, 2017 through December 31, 2021.