FIRST AMENDED AND RESTATED VERMONT ALL-PAYER ACCOUNTABLE CARE ORGANIZATION MODEL AGREEMENTVermont All-Payer Accountable Care Organization Model Agreement • November 23rd, 2022
This first amended and restated Vermont All-Payer Accountable Care Organization (“ACO”) Model Agreement is entered into by and between the Centers for Medicare & Medicaid Services (“CMS”) and the Governor of Vermont, the Green Mountain Care Board (“GMCB”), and the Vermont Agency of Human Services (“AHS”) (collectively, “State” or “Vermont”). Each Vermont entity and CMS are collectively referred to as “the parties.”
Draft Vermont All-Payer Accountable Care Organization Model Agreement SUMMARYVermont All-Payer Accountable Care Organization Model Agreement • September 28th, 2016
determining performance under this Agreement, including the formulas and adjustments. Lastly, this section sets out the process for making changes to the Agreement through a corrective action plan if Vermont is not meeting the targets. 7 — Vermont Medicare ACO Initiative Under this Agreement, CMS and Vermont will design and launch a state- specific ACO Initiative on January 1, 2019. Prior to that date, CMS and Vermont will offer Modified Next Generation models under Medicare. This section outlines CMS’ duties and the duties of the GMCB in setting aprospective growth rate. 8 — Payer Differential This section provides a hold harmless provision for Vermont, if the state chooses to increase Medicaid reimbursement rates to health care providers by excluding these rate increases from the growth target. This section also ensures that Medicaid beneficiaries receive the same access to services under an ACO as other beneficiaries. 9 — One Time Funding This section and Appendix 2 provide for $9
ContentsVermont All-Payer Accountable Care Organization Model Agreement • November 19th, 2020
Model Agreement and Required Act 113 Oversight Accountable Care Organization (ACO) Budget Review November 2, 2017Vermont All-Payer Accountable Care Organization Model Agreement • November 2nd, 2017
First Amended and Restated Vermont All-Payer Accountable Care Organization Model AgreementVermont All-Payer Accountable Care Organization Model Agreement • April 5th, 2024
This amendment is made to the First Amended and Restated Vermont All-Payer Accountable Care Organization Model Agreement (the “Agreement”) between the Centers for Medicare & Medicaid Services (“CMS”), and the Governor of Vermont, the Green Mountain Care Board (“GMCB”), and the Vermont Agency of Human Services (“AHS”) (collectively, “State” or “Vermont”). Each Vermont entity and CMS are collectively referred to as “the parties.”
Green Mountain Care Board (GMCB)Vermont All-Payer Accountable Care Organization Model Agreement • February 15th, 2019
Vermont All-Payer Accountable Care Organization Model Agreement: History and ContextVermont All-Payer Accountable Care Organization Model Agreement • January 22nd, 2019
Problem Strategy Intervention Result Increase accessto insurance for people who need it most. Remove knownbarriers to access. Eliminate adverse selection, i.e. lack of coverage for pre-existing conditions. Change stateor federal law to prohibit adverse selection. ACA eliminated adverse selection across all states in 2010. Adverse selection isnot allowed. People with serious illnesses are not discriminated against in purchasing insurance. Access is improved if coverage is affordable. Reduce the rate of uninsured. Require people to have health insurance or pay a tax. Change state or federal law to require insurance.ACA created this mechanism, no longer enforced. Reduced the rate of uninsured in tandem with other interventions.
To: Owen Foster, Chair, Green Mountain Care Board Re: Execution of the First Amended and Restated Vermont All-Payer Accountable Care Organization Model Agreement Dear Chair Foster and Members of the Green Mountain Care Board,Vermont All-Payer Accountable Care Organization Model Agreement • November 15th, 2022
The Vermont All-Payer Accountable Care Organization Model Agreement (Agreement) with the Center for Medicare and Medicaid Innovation (CMMI or the Innovation Center) is set to expire on December 31, 2022. The State of Vermont proposed a one-year extension of the Agreement on December 17, 2021.
STATE OF VERMONT GREEN MOUNTAIN CARE BOARDVermont All-Payer Accountable Care Organization Model Agreement • October 31st, 2016
The rising cost of health care imposes unsustainable financial burdens on Vermonters and their families, impedes equitable access to preventive care, and threatens to cripple our State’s economy. Left unchecked and uncontrolled, it will prevent Vermont from reaching its goal to ensure that all of its citizens have access to affordable, high-quality health care. The problem is not unique to Vermont—Congress enacted the Patient Protection and Affordable Care Act of 2010 (ACA), for example, to address our national health care crisis.
