The Vermont Medicaid Next Generation (VMNG) Accountable Care Organization (ACO) Program, which began in 2017, is an agreement between the Department of Vermont Health Access (DVHA) and OneCare Vermont (an ACO) that supports healthcare reform and its goal of transitioning from a fee-for-service payment model to a value-based payment model. As an evolution of the Vermont Medicaid Shared Savings Program (VMSSP), this program creates a structure for provider organizations and other suppliers to join together under an ACO to voluntarily contract with DVHA to assume accountability for the cost and quality of care for Vermont’s Medicaid beneficiaries, and for ACOs to distribute payments to their contracted network providers for any covered services rendered on behalf of Vermont Medicaid beneficiaries using alternatives to fee-for-service reimbursement. The goal of this agreement is to improve the quality and value of the care provided to the citizens served by the State of Vermont’s public health care programs.
The VMNG program represents the Medicaid component of the All-Payer Model Agreement, which is Vermont’s contract with the federal Centers for Medicare & Medicaid Services (CMS) to enact ACO-based reform. Through the APM Agreement, CMS provides payment flexibility and local control in exchange for meeting quality, financial, and scale targets, as well as alignment across payers (including Medicare, Medicaid, and commercial insurers). The program provisions of the VMNG are designed to align with the Medicare Next Generation ACO program as much as possible. For more information on the All-Payer Model Agreement, please visit the Green Mountain Care Board website.