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Vermont health care regulators approve OneCare’s annual budget, likely its last – VTDigger

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Vermont health care regulators approve OneCare’s annual budget, likely its last – VTDigger


File photo by Erin Mansfield/VTDigger

For likely the last time, state health care regulators at the Green Mountain Care Board on Wednesday approved the annual budget for OneCare Vermont, the accountable care organization that has been the linchpin of Vermont’s “all-payer” health care payment reform efforts since 2018.

OneCare announced in early November that 2025 would be its last year in operation. Dec. 31, 2025, is also the anticipated end date for what the Centers for Medicare and Medicaid Services calls the “Vermont All-Payer ACO Model.”

The care board approved an organizational budget of just under $11.3 million, a reduction of almost $1.5 million from OneCare’s original request, submitted before the nonprofit’s board of managers voted to close its doors. 

Regulators directed OneCare — which since October 2021 has been solely a subsidiary of the University of Vermont Health Network — to redistribute the latter amount to independent health care providers that participate in the organization’s “population health management” programs, including primary care offices, home health agencies and area agencies on aging. 

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Green Mountain Care Board Chair Owen Foster called the approved budget “very fair for OneCare,” given that it was not significantly lower than the organization’s actual spending in 2024.

The reduced budget level-funded salary and benefit expenses from 2024 and eliminated the unfilled position of chief financial officer. Tom Borys, who served in that role, took over as interim chief executive officer after Abe Berman, who served as OneCare’s CEO since May 2023, stepped down earlier this month. 

OneCare Vermont to shut down


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The care board also cut money that was allocated to pay for an annual outside evaluation no longer being required by the board, and for lobbying and board recruitment. 

“It’s obviously a different budget than in prior years with a winddown coming of the operations,” Foster said. 

Borys acknowledged that “the paradigm has changed for us” and accepted the rationale for the cuts in public comments to the board on Dec. 4 and written comments on Dec. 12. The organization’s goal for 2025 was to “do our best for the state, the providers, the patients that they serve, and also be mindful of the cost,” he said. 

Borys added that OneCare expected to continue its full list of activities through the end of 2025. The plan is to spend the first half of 2026 closing down, with the final steps of the shutdown completed by that October, he said. Care board staff said it was currently unclear whether the regulator would need to approve a partial budget for 2026, assuming the federal “all-payer model” ends when expected at the end of 2025.

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The model has been a unique policy framework — and the basis for a legal contract between the federal health insurance agency, Vermont’s Agency of Human Services and the care board — that has allowed Medicare and Medicaid funds to be distributed by an accountable care organization in nontraditional ways. 

The new payment methods have included adding bonus payments for providers who meet certain care quality standards and “per patient per month” payments to independent primary care providers. The strategies were intended to bolster preventative care and reduce overall health care spending. 

For the duration of the model’s contract, which started in 2018, OneCare has been Vermont’s only “all-payer” accountable care organization — meaning it does business with private providers, Medicaid and Medicare — so it has been the only entity capable of carrying out the terms of the agreement. 

In late November, the care board approved the 2025 budgets of Lore Health, Vytalize Health and Aledade Accountable Care as submitted. All three are accountable care organizations operating in Vermont that provide services only to patients insured by Medicare. 

On Wednesday, members of the care board also received an update on negotiations with the Centers for Medicare and Medicaid Services over Vermont’s participation in a new federal reform model called the AHEAD program, which stands for States Advancing All-Payer Health Equity Approaches and Development. 

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Vermont is one of six states that has been selected to participate. The others are Maryland, Connecticut, Hawaii, New York and Rhode Island.  A care board vote on whether to move forward with preparations to participate is expected in mid-January. 

Care board member Thom Walsh questioned whether President-elect Donald Trump’s incoming administration would back the federal reform program’s continued rollout. If it did not, he asked, did leaders at the Agency of Human Services have a backup plan for funding programs that health care providers and their patients have come to rely on?

OneCare did successfully defend one part of its 2025 budget: the continuation of its “regional care representative” program, which the care board had put on the chopping block. 

The $300,000 pays primary care providers within OneCare’s network to work with peers in their region on how best to make use of the data and reports the ACO provides. The program is needed for the organization to maintain a connection with those offices, which is essential for progress towards shared care quality goals, Borys said. 

“I’d like personally to end the all-payer model era on a high note,” he said.

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Vermont

White out: Vermont’s tallest peak buried under record-breaking powder – VTDigger

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White out: Vermont’s tallest peak buried under record-breaking powder – VTDigger


A snowy scene on Mt. Mansfield, the state’s highest peak. Photo by Molly Walsh/CNS

More than 5 feet of snow currently blanket Vermont’s tallest peak — the deepest powder in recorded history for Mount Mansfield on this date.

The Mount Mansfield snow stake hit 63 inches Thursday, said Burlington-based National Weather Service meteorologist Adrianna Kremer, more than 3 feet deeper than the average 22-inch depth expected this time of year. As of Tuesday, the snow depth at the stake was 61 inches, falling 2 inches due to compaction, Kremer added. 

“We do have such a good snow pack early in the season,” Kremer said. “But, as always, there’s a lot of variability as the season goes on.”

Vermont has seen significant snowfall so far this winter, with over 3 feet recorded in November in some areas of the northern Green Mountains, Kremer said. 

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With 192 inches of overall snowfall Tuesday, Jay Peak has been graced with the most snow of any ski mountain in the U.S. so far this season, surpassing West Coast ski resorts in powder.

Northern Vermont ski resorts Smuggler’s Notch and Stowe are also keeping pace, with overall snowfall hitting 116 inches and 108 inches, respectively, as of Tuesday.

But warmer temperatures this Thursday will spur some snow melt. While that may bring modest river rise, Kremer said the service does not expect flooding, as the increase in temperature is predicted to be short-lived and this year’s powdery snow is less dense with liquid. 

Hazardous travel conditions could arrive Friday, though, Kremer warned, as the snap back to colder temperatures brings the potential for a flash freeze and bursts of snow. 





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Visitors spent over $1B in Chittenden County in record VT tourism year

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Visitors spent over B in Chittenden County in record VT tourism year


Vermont’s tourism industry set new records in 2024, with 16 million visitors spending $4.2 billion, according to a community announcement.

The increase in both visitation and spending marks a modest rise from 2023, according to a study by Tourism Economics.

Visitor spending accounted for 9% of Vermont’s gross domestic product, significantly higher than the 2023 national state average of 3%. The tourism sector directly supports 31,780 jobs, or 10% of the state’s workforce, compared to the national average of 4.6%.

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Direct spending by visitors in 2024 included $1.5 billion for lodging, $876 million for food and beverages, $680 million in retail, $678 million for transportation and $462 million for recreation and entertainment. The spending generated $293.5 million in state and local taxes, equivalent to $1,089 per Vermont household.

“As we think about economic impact, it is important to recognize that visitors to Vermont are essentially temporary taxpayers, bringing in outside money that helps to make Vermont more affordable for all of us,” said Department of Tourism and Marketing Commissioner Heather Pelham. “Every guest who buys a meal, stays the night, or heads to the mountain is supporting our businesses, sustaining jobs for Vermonters and funding the essential services that keep our communities strong.”

When considering the broader economic impact, including supply chain purchases and employee spending, the ripple effects of visitor spending amounted to $7 billion in economic activity in 2024.

The report also provided county-specific data, showing increased spending in every county. Chittenden County accounted for the highest share of visitor spending at 24.5%, at well over $1 billion. Lamoille, Rutland and Windsor counties each represented more than 10% of statewide visitor spending.

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In Caledonia County, direct spending from visitors reached $109 million, a 7.7% increase from 2023.

“During the 2024 total solar eclipse, the positive impact of tourism on a rural community like St. Johnsbury was clear,” said Gillian Sewake, director of Discover St. Johnsbury. “An estimated 23,000 people came to our town alone. It was wonderful to feel that vibrancy in our downtown, with visitors filling sidewalks, enjoying the attractions that we know and love, and helping businesses break revenue records.”

In Bennington County, tourism generated almost $300 million in direct spending in 2024.

“Tourism is one of our region’s most powerful economic drivers, supporting nearly 13% of our workforce,” said John Burnham, executive director of the Manchester Business Association. “But its value reaches far beyond jobs. Visitor spending strengthens our economy, sustains small businesses, and helps fund the local services and amenities we all rely on, from restaurants and trails to cultural attractions and community events. Tourism also inspires us to preserve our historic character and adds a vibrancy that enriches everyday life. Simply put, the visitor economy helps keep our region the welcoming, thriving place we’re proud to call home.”

The 2024 economic impact report comes at a time when resident support of tourism is strong. In the University of Vermont Center for Rural Studies 2025 Vermonter Poll, 85% of residents agreed with the statement “Tourism is important to my local economy,” and 78% agreed with the statement “Increased tourism would have a beneficial impact on my local community.”

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To read “Economic Impact of Visitors in Vermont 2024,” learn more about the report’s methodology, and the additional indirect and induced effects of visitor spending, visit the Vermont Department of Tourism and Marketing Tourism Research webpage, accd.vermont.gov/tourism/research.

This story was created by reporter Beth McDermott, bmcdermott1@usatodayco.com, with the assistance of Artificial Intelligence (AI). Journalists were involved in every step of the information gathering, review, editing and publishing process. Learn more at cm.usatoday.com/ethical-conduct.



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Obstacles for Vermont refugees is focus at roundtable

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Obstacles for Vermont refugees is focus at roundtable


BENNINGTON — Sitting in a circle at the Bennington County Multicultural Community Center, Jack Rossiter-Munley shared the story of two families with whom he had worked.

The families had immigrated from South Sudan to Bennington, which was designated as a refugee site in October 2022. Since then, about 205 refugees have immigrated to the town. But the lives that they had hoped for in the United States haven’t necessarily come to fruition.

“These are folks who needed more orientation to work in the United States, but also the line is moving, and so you’re no longer on the line,” said Rossiter-Munley, the director of the Bennington County Multicultural Community Center. “Because their actual work here was unstable, they decided, ‘we’re just going to try to find work somewhere else.’”

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Some of the family members moved to the Midwest, where they hoped to find a larger South Sudanese community and more support from their relatives. Those still in Bennington are looking to follow, he said.

Rossiter-Munley and about a dozen other people were gathered on Dec. 5 at BCMCC for a roundtable on Employment Support for New Americans, part of Gov. Phil Scott’s “Capital for a Day” initiative. That day, Scott and several of his cabinet members stationed themselves around Bennington County, holding meetings and hosting conversations with local leaders as they heard how to better support Bennington County.

The roundtable came at an especially pressing time for local immigrants. On Dec. 2, the U.S. Citizenship and Immigration services under President Trump announced that it would pause its review of applications for green cards, asylum and citizenship following the shooting of two National Guard officers deployed in Washington, D.C. The pause applies to 19 countries — including Afghanistan and the Republic of Congo — from where many new Americans in Bennington emigrate.

People also come to Bennington from Venezuela, South Sudan and Iraq as part of the resettlement programs, Rossiter-Munley said. At the following Monday’s Select Board meeting, he read a statement on behalf of Afghan women in Bennington, condemning the violence in Washington, D.C. and asking for the community’s understanding. And at the roundtable, he was clear about the legal implications for those already living in Bennington: “nothing has changed.”

Kendal Smith, commissioner of the Department of Labor, was in attendance at the Dec. 5 meeting and represented Vermont. She sought to understand how the state could better support immigrants and refugees in Bennington County.

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The biggest challenges Smith identified were language access support, transportation and licensing attainment, she said.

Translation is an area that gets highlighted the most in Bennington because the town is “uniquely deficient” in providing such community support, Rossiter-Munley said. Bennington county was almost 95 percent white, according to the latest census data.

Smith said that the Department of Labor is exploring funding the purchase of more translation devices to help overcome language barriers at work. The state currently contracts with Propio, an AI-based interpretation service. BCMCC uses Boostlingo to translate their speech into languages like Swahili and Dinka.

Another difficulty in Bennington is access to transportation to work. Wendy Morris, the Department of Labor’s regional manager, said that even commutes between Bennington and Manchester can pose serious challenges for new Americans.

“We help them get a job — let’s say we could do that, and we get them to Manchester,” she said. “We do the interview with them. How do we get them there every single day?”

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The Department of Labor will explore “creative ways” to fund and provide driver’s licenses to immigrants and refugees, said Rowan Hawthorne, the policy and legislative affairs director at the Commissioner’s office. The Department will also work with the Office of Professional Regulation to “overcome licensing transfer barriers.”

Nearly every member of the roundtable stressed that immigrants and refugees in Bennington faced difficulties finding jobs that suited their training — for example, as pharmacists or engineers — and often were met with employers who were skeptical about hiring them.

All of it means that volunteers and leaders working with refugees are stretched thin.

“I can’t say enough how everybody in this room is doing more than their job,” said Sean-Marie Oller, director of the Tutorial Center, a Bennington nonprofit that provides adult education and literacy classes.

Still, Rossiter-Munley tries to be optimistic. He cited a study that showed refugee resettlement provided a net benefit of $123.8 billion to local, state and federal economies. And he’s encouraged by the state Department of Labor’s openness to growth.

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“When we are sitting down to meet with employers, or offering support or working alongside the Department of Labor, the more of that knowledge can become just part of the day-to-day work of a how a local department … functions,” he said.

“This is part of how we work, and it’s not a special one-time project.”



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