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SYSTEM The Vermont Blueprint for Health is a statewide public-private initiative to transform care delivery, improve health outcomes, and enable everyone in the state to receive seamless, well-coordinated care.
KEY INNOVATION Having community health teams work with primary care providers to assess patients' needs, coordinate community-based support services, and provide multidisciplinary care for a general population. A web-based central health registry will capture all patient data.
COST SAVINGS A recent analysis of the first pilot program found significant year-over-year decreases in hospital admissions and emergency department visits, and their related per person per month costs. Further savings are forecast once comprehensive financial reform is in place. When rolled out statewide, the initiative is projected to save 28.7 percent in incremental health spending in the state by its fifth year.
QUALITY IMPROVEMENT RESULTS A qualitative assessment of pilot sites suggests that providers and patients value the role of community health teams in connecting patients with behavioral health, chronic care management, and social services support. Objective assessments suggest early improvements in clinical quality and use, such as better control of hypertension.
CHALLENGES For the initiative to be financially successful, there must be a measurable reduction in avoidable emergency department visits and hospitalizations. Insurers must shift spending away from remote call centers, disease management, and mailings, and into support for community health teams.
Vermont is in the vanguard of states reforming the delivery and funding of health care. With the passage of Vermont's Health Care Affordability Act in 2006 and subsequent health care-related legislation, the state is moving to provide all Vermonters with access to highquality, affordable care. Universal coverage is in progress, largely through expanded access to Medicaid along with subsidized coverage for low-income citizens. Vermontis also one of eight states chosen for the Centers for Medicare and Medicaid Services' (CMS's) patient-centered medical home demonstration project, known as the Multi-Payer Advanced Primary Care Practice Demonstration.1
The Vermont Blueprint for Health, launched in 2006, is an integral part of the state's participation in the CMS project. Based on a foundation of medical homes supported by community health teams, it aims to deliver comprehensive, well-coordinated care to the general population and improve health outcomes while controlling costs. AU citizens in the state will be able to participate, without...