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Hospitals join to take big health overhaul step

Published on NewsOK Modified: January 18, 2013 at 3:34 pm •  Published: January 18, 2013

MONTPELIER, Vt. (AP) — The two big academic medical centers serving Vermont, often seen as rivals in the past, announced Friday they are joining forces with 13 other Vermont hospitals and health clinics to form a new "accountable care organization" — OneCare Vermont — to focus on efficiency and quality in health care.

"OneCare Vermont represents a huge shift in medical practice in Vermont," said Dr. John Brumsted, president and chief executive officer of Fletcher Allen Health Care.

The federal Affordable Care Act of 2010 called for the creation of such ACOs, which are designed to change the way doctors and hospitals are paid. Right now, most health care is done on a "fee for service" basis, meaning that more procedures mean more income for the provider.

An ACO sets a budget target for caring for a certain population over the course of the year. The provider has two goals: deliver care that meets a series of 33 quality indicators — things ranging from patient satisfaction to answering yes to questions about whether certain preventative health steps were taken; and hold costs down. If the ACO can come in under its budget target, it gets to share in the savings.

Friday's announcement followed approval of the new ACO by the Centers for Medicare and Medicaid Services, the division of the Department of Health and Human Services that is leading much of the implementation of the ACA. OneCare will include the providers delivering care to 42,000 of Vermont's roughly 118,000 Medicare beneficiaries, and officials said it was the first in the country with statewide reach.

"This is the first time that we've been able to arrange for so many hospitals, physicians, and community-based health care services throughout the state to work together to ensure that patients, especially those with chronic conditions such as diabetes or congestive heart failure, will be followed more closely by their primary care provider to reduce the need for hospital admissions or visits to an emergency department," Brumsted added. "This means a healthier patient and a better quality of life."

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