Hostetter, M., Klein, S., & McCarthy, D. (2018, May 20). Vermont’s bold experiment in community-driven health care reform. Washington, DC: The Commonwealth Fund.

Year: 2018


This article describes how OneCare, a large accountable care organization (ACO) in Vermont, addresses the social needs of its beneficiaries, under Vermont’s Blueprint for Health. The Blueprint for Health, a statewide initiative, compels public and private payers to support nurses, social workers, community health workers, and others working to help patients manage their chronic conditions, find treatment for addiction and other behavioral health conditions, and connect with social supports. Under the “all-payer” ACO model, the three largest Vermont payers (Medicare, Medicaid, and Blue Cross and Blue Shield of Vermont) steadily increase the number of patients cared for under risk-based contracts and provide additional financial support to OneCare to coordinate care for individuals considered to be high medical risks. In return, OneCare takes on downside financial risk for itself and participating hospitals, a move it hoped would spur the latter to collaborate with community partners in helping patients beyond their institutions’ walls. Early cost-effectiveness and health outcomes results are provided.

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