From Single-Payer to All-Payer: Why Vermont's Reform Efforts Matter to U.S. Nurses and Their Patients

In October 2016, the State of Vermont signed an unprecedented agreement (The All-Payer Accountable Care Model) with the Federal Government to completely reform how health care is delivered and paid for in Vermont. This innovative agreement builds on sweeping 2011 legislation that set Vermont on a co...

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Published inNursing economic Vol. 35; no. 2; pp. 100 - 103
Main Authors Rambur, Betty, Holmes, Jessica
Format Journal Article
LanguageEnglish
Published United States Jannetti Publications, Inc 01.03.2017
Anthony J. Jannetti, Inc
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ISSN0746-1739

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Abstract In October 2016, the State of Vermont signed an unprecedented agreement (The All-Payer Accountable Care Model) with the Federal Government to completely reform how health care is delivered and paid for in Vermont. This innovative agreement builds on sweeping 2011 legislation that set Vermont on a course towards payment reform designed to eliminate the fragmentation, overtreatment, and high costs associated with fee-for-service reimbursement. The strong emphasis on care coordination, preventative care, the patient experience, and population health ensures a crucial and growing role for nurses in this innovative environment and provides a model to inform the nation. Such state-led reform may have particular importance during the Trump administration, given the expected emphasis on state's rights and state leadership.
AbstractList [...]Vermont's all-payer SSP still relied on fee-for-service and policymakers recognized that moving the health reform effort would entail a movement away from volume-based payments. [...]in 2015, the legislature authorized the GMCB and Secretary of Administration to "jointly explore an all-payer model" (Act 54 of 2015, Sec. 1). The value-based fixed revenue or capitation model reverses this scenario, as such unnecessary illnesses and accidents would hopefully be prevented. [...]unnecessary illness events create revenue loss, not revenue enhancement. Notably, provider selection of a payment pathway is not limited to physicians; NPs, clinical nurse specialists, and physician assistants must either be in an Advanced Alternative Payment Model or be subject to MIPS, excluded only if they bill less than $30,000 to Medicare, provide care to less than 100 Medicare patients per year, or 2017 is their first year as a Medicare provider (CMS, n.d.). In Vermont, NPs may be attributed providers for individuals with commercial insurance coverage and Medicaid.) The system redesign will reward the coordinated care delivered by nurses and NPs. [...]the work of nurses will be essential to meeting the 20 carefully selected population health goals outlined in the agreement within three overarching aims (improved access to primary care, reduced prevalence and morbidity of chronic disease, lower deaths due to suicide and drug overdose).
> In October 2016, the State of Vermont signed an unprecedented agreement (The All-Payer Accountable Care Model) with the Federal Government to completely reform how health care is delivered and paid for in Vermont.
> In October 2016, the State of Vermont signed an unprecedented agreement (The All-Payer Accountable Care Model) with the Federal Government to completely reform how health care is delivered and paid for in Vermont. > This innovative agreement builds on sweeping 2011 legislation that set Vermont on a course towards payment reform designed to eliminate the fragmentation, overtreatment, and high costs associated with fee-for-service reimbursement. > The strong emphasis on care coordination, preventative care, the patient experience, and population health ensures a crucial and growing role for nurses in this innovative environment and provides a model to inform the nation. > Such state-led reform may have particular importance during the Trump administration, given the expected emphasis on state's rights and state leadership.
In October 2016, the State of Vermont signed an unprecedented agreement (The All-Payer Accountable Care Model) with the Federal Government to completely reform how health care is delivered and paid for in Vermont. This innovative agreement builds on sweeping 2011 legislation that set Vermont on a course towards payment reform designed to eliminate the fragmentation, overtreatment, and high costs associated with fee-for-service reimbursement. The strong emphasis on care coordination, preventative care, the patient experience, and population health ensures a crucial and growing role for nurses in this innovative environment and provides a model to inform the nation. Such state-led reform may have particular importance during the Trump administration, given the expected emphasis on state's rights and state leadership.In October 2016, the State of Vermont signed an unprecedented agreement (The All-Payer Accountable Care Model) with the Federal Government to completely reform how health care is delivered and paid for in Vermont. This innovative agreement builds on sweeping 2011 legislation that set Vermont on a course towards payment reform designed to eliminate the fragmentation, overtreatment, and high costs associated with fee-for-service reimbursement. The strong emphasis on care coordination, preventative care, the patient experience, and population health ensures a crucial and growing role for nurses in this innovative environment and provides a model to inform the nation. Such state-led reform may have particular importance during the Trump administration, given the expected emphasis on state's rights and state leadership.
In October 2016, the State of Vermont signed an unprecedented agreement (The All-Payer Accountable Care Model) with the Federal Government to completely reform how health care is delivered and paid for in Vermont. This innovative agreement builds on sweeping 2011 legislation that set Vermont on a course towards payment reform designed to eliminate the fragmentation, overtreatment, and high costs associated with fee-for-service reimbursement. The strong emphasis on care coordination, preventative care, the patient experience, and population health ensures a crucial and growing role for nurses in this innovative environment and provides a model to inform the nation. Such state-led reform may have particular importance during the Trump administration, given the expected emphasis on state's rights and state leadership.
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Author Rambur, Betty
Holmes, Jessica
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Snippet In October 2016, the State of Vermont signed an unprecedented agreement (The All-Payer Accountable Care Model) with the Federal Government to completely reform...
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SubjectTerms Accountable care organizations
Agreements
Asthma
Capitation
Chief executive officers
Cost control
Drug abuse
Emergency medical care
Evaluation
Fees & charges
Forecasts and trends
Governors
Health care expenditures
Health care policy
Health care reform
Health Care Reform - economics
Health Care Reform - legislation & jurisprudence
Health insurance
Health Policy - economics
Health Policy - legislation & jurisprudence
Hospitalization
Humans
Innovations
Internal medicine
Laws, regulations and rules
Legislatures
Medicaid
Medical economics
Medicare
Medicine
Mental health
Monetary incentives
Nurse's Role
Nurses
Nursing
Pilot projects
Population
Primary care
Quality
Reimbursement
Single-Payer System - economics
Single-Payer System - legislation & jurisprudence
Social Change
State budgets
State Health Plans - economics
State Health Plans - legislation & jurisprudence
Suicides & suicide attempts
Taxes
United States
Vermont
Title From Single-Payer to All-Payer: Why Vermont's Reform Efforts Matter to U.S. Nurses and Their Patients
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