Gov. Peter Shumlin today announced that Vermont has received a $45 million grant under the federal government’s State Innovation Models (SIM) initiative to support health care innovations that will improve dramatically the efficiency and effectiveness of the state’s health care system.
“This is a tremendous boost to Vermont health reform,” the Governor said. “With these funds, we can assure that Vermont has the best health care system in the country, resulting in better care, lower costs and a healthier population. I continue to believe that these improvements are essential to the sustainability of our system.”
The SIM initiative is a $275 million competitive funding opportunity for states to design and test multi-payer payment and delivery models that deliver high-quality health care and improve health system performance. The program is administered by the Centers for Medicare and Medicaid Services Innovation Center. The Innovation Center created the SIM initiative for states that are committed to planning, designing, testing, and supporting evaluation of new payment and service delivery models in the context of larger health system transformation. Grant-funded activities will be overseen jointly by the Department of Vermont Health Access (DVHA) and the Green Mountain Care Board (GMCB).
GMCB Chair Anya Rader Wallack explained that the objective of the state’s project under the grant is to develop a “high performing health system,” which will emphasize integration within and between provider organizations, movement away from fee-for-service payment methods toward population-based models, and payment based on quality performance. Wallack said this effort is critical to ensure that health care is affordable and effective for Vermonters in the future.
The grant will support implementation of three innovative provider payment models:
• Shared savings accountable care payments, under which a single network of providers takes responsibility for managing the costs and quality of care for a group of Vermonters;
• Bundled payments, which provide a single payment to a group of providers for the care of a patient surrounding a hospitalization; and
• Pay-for-performance models, which incorporate in provider compensation consideration of the total costs and quality of care.
All three models have the potential to encourage better coordination of care across providers, improved quality and better cost-management. DVHA Commissioner Mark Larson said the grant would be particularly important in addressing the lack of coordination and financial alignment between primary care, specialty care, mental health and substance abuse services and long term services and supports.
“This is an exciting opportunity to improve the system for patients and providers alike,” Larson said.
In addition to support for implementation of the payment models, the grant will support key investments in “health system infrastructure” within Vermont, including:
• Improved health care data transmission and integration across providers;
• Expanded measurement of patient experience;
• Improved capacity to measure and address health care workforce needs;
• Improved data analytics and predictive modeling to support monitoring health system costs and quality; and
• Enhanced telemedicine capabilities.