Supporting Health Care Reform

The Vermont Health Care Innovation Project

Project Summary

The Vermont Health Care Innovation Project (VHCIP) activities are funded through a $45 million State Innovation Models (SIM) Testing grant from the federal Center for Medicare and Medicaid Innovation. The VCHIP activities are dedicated to implementing health delivery system reforms in accordance with the Triple Aim: Improved Population Health, Reduced Per Capita Costs, and Improved Patient Experience. Here in Vermont, reform activities focus on:

  • Payment Model Design and Implementation: Supporting creation and implementation of value-based payments for providers in Vermont across all payers.
  • Practice Transformation: Enabling provider readiness and encouraging practice transformation to support creation of a more integrated system of care management and care coordination for Vermonters.
  • Health Data Infrastructure: Supporting provider, payer, and State readiness to participate in alternative payment models by building an inter-operable system that allows for sharing of health information to support optimal care delivery and population health management.[1]

Additional VHCIP Evaluation and Program Management systems provide the structural support of the grant activities.

The value of all this health care reform activity is to transform the current health care delivery system from a disparate, siloed, uncoordinated volume-driven, illness based system into an active, listening, patient-centered learning health system focused on health, prevention, and improvement. This transformation is necessary in order to advance the intent of the Triple Aim. Reducing waste in the system lowers cost, but you need reliable data provided from a robust health information exchange to study the system and identify the root causes of waste and misuse. Technology solutions enhance productivity, making real-time event notification a critical communications tool, but embracing technology creates challenges to established culture of practice that is difficult to address and mitigate.

The second year of the VHCIP grant brought a re-basing of the organizational structure of the VHCIP workgroups. Vermont’s SIM Core Team and Steering Committee now meet monthly, along with the Payment Model Design and Implementation, Practice Transformation, and Health Data Infrastructure Work Groups. The Workforce Work Group meets bi-monthly, and two additional groups, the Disability and Long-Term Services and Supports (DLTSS) Work Group and Population Health Work Group, meet quarterly to provide subject matter specific expertise on our milestones. These six work groups report up to the Steering Committee and Core Team, and make policy recommendations and funding recommendations to those groups.

VPQHC’s Executive Director, Catherine Fulton, remains Co-Chair for the Payment Model and Design Implementation Work Group along with Andrew Garland of Blue Cross Blue Shield of Vermont (BCBSVT).

Recommendations and Next Steps

As the Vermont Health Care Innovation Project (VHCIP) begins its Year Three activities, multiple efforts continue to be evaluated and implemented in the quest to achieve health care delivery system reforms here in Vermont. Ongoing analyses directed at identifying the specific efforts that led to improvements in care delivery will provide additional information on how the savings were achieved. Additional segmentation of the covered population is required in order to discover “best practices” for broader dissemination and learning across the system. Continuing focus on system opportunities for improvement and spread of best practice will enable additional savings to be garnered as new, specific improvement efforts get underway.

VPQHC will continue to contribute to conversations regarding payment reform efforts, measure review and selection, performance analysis, and dissemination of best practice through continuing participation in payment reform activities.