Community, rural hospitals band to battle UVM, Dartmouth-Hitchcock ACO for Medicaid contract

In an effort to challenge "top-down" healthcare reform, Community Health Accountable Care, a Vermont-based accountable care organization, has filed a bid to compete with an ACO owned by the region's two largest hospitals, reports VT Digger.

The bid is related to discussions currently underway between the state and federal government to build a statewide, all-payer healthcare system in Vermont. Under the proposed all-payer model, the state said it would use OneCare as a regulated monopoly to receive monthly payments from Medicaid, Medicare and commercial insurers and then reimburse physicians according to clinical outcomes and quality.

OneCare, a statewide ACO, is jointly owned by University of Vermont Medical Center in Burlington and Dartmouth-HitchcockMedicalCenter in Lebanon, N.H.  

Community and rural healthcare leaders have criticized the deal as a hospital-centric form of healthcare reform. John Hall, executive director of the Champlain Valley Agency on Aging in Essex Junction, Vt., called the all-payer model proposal "a top-down approach to managing healthcare, as opposed to a vision that we think works, a community-based, community-drive approach" that uses home health workers to reduce spending, according to VT Digger.

Community Health Accountable Care filed a bid to compete for a cost control contract with the state's Medicaid agency on June 12. The only other bid came from OneCare Vermont.

Community Health Accountable Care consists of around 300 largely rural primary care physicians. It is backed by UnitedHealthcare's health services platform Optum.

More articles on ACO issues: 

Memorial Hermann Health System, UnitedHealthcare launch ACO

CMS issues final rule for Medicare Shared Savings Program ACOs: 5 takeaways

Oneida to participate in Basset Healthcare's MSSP, commercial ACOs through population health partnership

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