Vermont, New Hampshire receive innovation grants for health care reform

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The Department of Health and Human Services (HHS) has awarded health care reform innovation grants to Vermont and New Hampshire. New Hampshire has been awarded up to $1.6 million in federal funds to develop a State Health Care Innovation Plan to improve quality and reduce growth in health care costs through improved coordination. Vermont has received a $45 million grant under the federal government’s State Innovation Models (SIM) initiative to support health care innovations that will improve the efficiency and effectiveness of the state’s health care system.

With the award, New Hampshire will work on developing a strategy to transform the health care delivery system through multi-payer payment reform and other state initiatives. New Hampshire’s plan will lay out a framework for aligning consumer access across delivery system “silos,” payer support for outcomes-based long term care services, and global accountability for cost-effectiveness and outcomes.

The new plan will target individuals who are either in need of or at-risk for needing long-term support services; this population will be targeted due to the complex health needs and the cross-cutting nature of the services and payments needed to coordinate their care. New Hampshire has six months to submit its plan to the Centers for Medicare and Medicaid Services and will use its Health Care Innovation Plan to apply for an anticipated second round of awards.

Vermont’s award falls under a different program – the SIM initiative is a $275 million competitive funding opportunity for states to design and test multi-payer payment and delivery models that deliver high-quality health care and improve health system performance. The program is administered by the Centers for Medicare and Medicaid Services Innovation Center. The Innovation Center created the SIM initiative for states that are committed to planning, designing, testing, and supporting evaluation of new payment and service delivery models in the context of larger health system transformation. Grant-funded activities will be overseen jointly by the Department of Vermont Health Access (DVHA) and the Green Mountain Care Board (GMCB).

As CivSource reported last year, Vermont is moving toward a single payer health care system as passed by their legislature. They have adopted all of the state requirements under Obamacare and are working to find ways to expand access to health care and create more affordability in the system.

GMCB Chair Anya Rader Wallack explained that through this project the state will get closer to the single payer goal and create a “high performing health system,” which will emphasize integration within and between provider organizations, movement away from fee-for-service payment methods toward population-based models, and payment based on quality performance. The grant project will foster the creation of three payment options. Those options include – shared savings accountable care payments, under which a single network of providers takes responsibility for managing the costs and quality of care for a group; bundled payments, and pay-for-performance models. Some of the funds will also go toward improvements in the state’s health care infrastructure, including enhanced telemedicine services and better patient data transmission.