Payment Reform Unit

% of total available quality funding earned by the ACO

85.0%2018

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Notes on Methodology

Partners
  • OneCare Vermont ACO
  • various providers
Story Behind the Curve

The Vermont Medicaid Next Generation (VMNG) contract between DVHA and OneCare Vermont contains a quality framework with 13 measures related to preventive care, acute care, chronic disease care, and member experience. OneCare’s performance on ten of those measures impacts the amount of funds withheld for quality performance incentives that can be retained by OneCare and its participating providers. Performance targets have become more rigorous over time, with high-level performance and continuous improvements in care as the goals. Performance improvement is challenging and complex, and is impacted by a number of variables, including population demographics and health behaviors, characteristics of new providers joining OneCare, availability of services, and OneCare’s ability to engage providers in quality improvement initiatives.

Last updated:  11/15/19

Strategy

The Payment Reform Unit will continue to use the VMNG contract with OneCare Vermont to develop incentives that support attainment of quality targets.

Action Plan
Scorecard Result Container Indicator Measure Action Actual Value Target Value Tag S R I P PM A m/d/yy m/d/yyyy