Payment Reform Unit

% of total available quality funding earned by the ACO

100.0%2020

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Notes on Methodology

Partners
  • OneCare Vermont ACO
  • various providers
  • DVHA quality measure vendor (currently Cotiviti)
Story Behind the Curve

This measure is important because it reflects the quality of care provided by the providers participating in the Vermont Medicaid Next Generation (VMNG) program for Accountable Care Organization (ACO) attributed Medicaid members.

The VMNG ACO program contract between DVHA and OneCare Vermont contains a quality framework with 13 measures related to preventive care, acute care, chronic disease care, and member experience. OneCare’s performance on ten of those measures impacts the amount of funds withheld for quality performance incentives that can be retained by OneCare and its participating providers.  Performance targets have become more rigorous over time, with high-level performance and continuous improvements in care as the goals. Performance improvement is challenging and complex, and is impacted by a number of variables, including population demographics and health behaviors, characteristics of new providers joining OneCare, availability of services, and OneCare’s ability to engage providers in quality improvement initiatives.

Despite the increase in rigor, the trendline suggests that OneCare’s performance has improved over time.

Narrative last updated:  12/22/2020

Action Plan
Scorecard Result Container Indicator Measure Action Actual Value Target Value Tag S R I P PM A m/d/yy m/d/yyyy