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    Hospitals join to take big health overhaul step

    MONTPELIER — The two big academic medical centers serving Vermont, often seen as rivals in the past, announced Friday they are joining forces with 13 other Vermont hospitals and health clinics to form a new “accountable care organization” — OneCare Vermont — to focus on efficiency and quality in health care.

    “OneCare Vermont represents a huge shift in medical practice in Vermont,” said Dr. John Brumsted, chief executive of Fletcher Allen Health Care.

    The federal Affordable Care Act of 2010 called for the creation of organizations designed to change the way doctors and hospitals are paid. Most health care is currently done on a “fee for service” basis, meaning that more procedures mean more income for the provider.


    An accountable care organization sets a budget target for caring for a certain population over the year. The provider has two goals: to hold costs down and to deliver care that meets 33 quality indicators ranging from patient satisfaction to answering yes about whether certain preventative health steps were taken. If the organization comes in under its budget target, it gets to share the savings.

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    Friday’s announcement followed approval of the new accountable care organization by the Centers for Medicare and Medicaid Services, the division of the Department of Health and Human Services that is leading much of the implementation of the Affordable Care Act. OneCare will include the providers that care for 42,000 of Vermont’s roughly 118,000 Medicare beneficiaries.

    “This is the first time that we’ve been able to arrange for so many hospitals, physicians, and community-based health care services throughout the state to work together to ensure that patients, especially those with chronic conditions such as diabetes or congestive heart failure, will be followed more closely by their primary care provider to reduce the need for hospital admissions or visits to an emergency department,” Brumsted added. “This means a healthier patient and a better quality of life.”

    The announcement was welcomed by Governor Peter Shumlin, who said it squared with his push for a streamlined, universal health care system.