Vermont auditor: Health program missed financial goal

June 21, 2021 GMT

MONTPELIER, Vt. (AP) — An innovative health care program set up to keep patients healthier while reducing costs missed its financial target between 2017 and 2019, a new report by the Vermont State Auditor has found.

The report released Monday by state auditor Douglas Hoffer said that OneCare Vermont, the organization set up to run the program, missed its Medicaid financial targets over the three years by $11.1 million. And the state paid $14.5 million for OneCare’s operating costs to reach a total of $25.6 million total.

Hoffer said the financial costs to run the program exceeded any Medicaid savings attributed to it.

The goal of what’s known as the all-payer model is to keep patients healthier while reducing health care costs by paying a set amount of money for each covered patient rather than paying for each service provided.

“I anticipate the people implementing the All-Payer Model will say the scale and complexity of the reform initiative merit patience before reaching conclusions, and that is reasonable … to a point,” Hoffer said in a statement.


OneCare CEO Vicki Loner said she disagreed with the conclusions of Hoffer’s report, and the organization is proud of the work they are doing “tackling one of the most pressing issues of our time.”

“It fails to capture the benefits of a value-based care transformation in Vermont,” Loner said of Hoffer’s report in a statement. “This work takes time and investment and OneCare’s 4,000 (plus) providers are committed to providing high quality, effective care for Vermonters and have seen positive health outcomes as the result of their joint efforts in OneCare.”

The report only looks at the financial performance of the program, not how well it worked keeping people healthier.

Hoffer said that in the coming months he expected the state would ask federal health care officials to extend the agreement, which began operations in 2018, that governs the program for another five years, even though the federal government will not complete a full evaluation of the program for another three years.