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Health Care Reform

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About

The Office of Health Care Reform within the Agency of Human Services coordinates health care reform initiatives across state government.    Vermont’s health care reform efforts are designed around four goals:

  1. Reducing health care costs and cost growth.
  2. Assuring that all Vermonters have access to and coverage for high quality care.
  3. Assuring greater fairness and equity in how we pay for health care.
  4. Improving the health of Vermont’s population.

What do we do?

The Office of Health Care Reform focuses on initiatives that impact health care financing, health care coverage, payment reform, and delivery system reform.  See “How can I get more involved?” for further information about current projects.

Where can I get more information?

Health Care Payment and Care Delivery Reform

  • The All-Payer Accountable Care Organization Model Agreement is an arrangement between Vermont and the federal government that allows Medicare to join Medicaid and commercial insurers to pay differently for health care.  For more information, please visit this the GMC Board Payment Reform Page.
  • Vermont is exploring opportunities for a potential future multi-payer arrangement to continue advancement of health care payment reforms.  A Health Care Reform Work Group, initially convened in July 2022, is actively discussing financial and care model options. For more information about this Work Group and related subgroups, please visit this Vermont Agency of Human Services Reports Page.
  • The Vermont Blueprint for Health designs community-led strategies for improving health and well-being.  It includes Patient-Centered Medical Homes, Community Health Teams, the Hub & Spoke system of opioid use disorder treatment, the Pregnancy Intention Initiative, Support and Services at Home (SASH), Self-Management and Healthier Living Workshops, full population data and analytics for policy makers, communities, and practices, and a series of learning labs for providers and community teams.  For more information, please visit this Blue Print for Health About Page.
  • The Department of Vermont Health Access (DVHA) Payment Reform Unit seeks to transition Vermont Medicaid’s health care revenue model from Fee-for-Service payments to value-based payments with the goal of providing better, more efficient, coordinated care for Vermonters. For more information, please visit this Vermont Health Access' Payment Reform page

The Agency of Human Services and its departments are implementing initiatives to enhance, expand, and strengthen Medicaid home and community-based services using funding from Section 9817 of the American Rescue Plan Act.  For more information, please visit this website. 

  • The federal Center for Medicare and Medicaid Innovation announced a new model called States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model.  The Office of Health Care Reform and Green Mountain Care Board are exploring how this opportunity may help Vermont further achievement of health care reform goals.  For more information, please visit this website.

How can I get involved?

  • You can provide comments or ask questions at any time.  Please submit it them through the Work Group’s Question and Comment Submission Form.
  • The Office of Health Care Reform plans to host at least two virtual town hall-type meetings about the federal AHEAD Model in late 2023 and early 2024, for all who are interested in attending. Information about the meetings will be posted here and will be publicized in other forums.