Nine hospitals in Vermont have signed on to participate next year in the state's all-payer pilot.
OneCare Vermont, the accountable care organization that is heading the effort, estimated that 120,000 Vermont residents will be covered under the program in its second year, according to an article from Seven Days, compared with 30,000 in year one.
In all-payer models, providers are reimbursed based on patient outcomes, not on how many procedures are performed.
"It's a huge step—120,000. I'm happy with it," OneCare CEO Todd Moore told the publication.
OneCare announced that a variety of providers would be joining the model for 2018 in addition to the hospitals, according to an article from Vermont Business Magazine. The all-payer program will also include one hospital in New Hampshire, two federally qualified health centers and 19 skilled nursing facilities.
Twenty-four independent physician practices and 30 independent specialty practices have signed on as well, the magazine reports.
However, some major Vermont providers are hesitant, Seven Days reports. Community Health Centers of Burlington, for instance, has passed on joining the program for 2018 because it's not prepared yet. Peter Gunther, the system's chief medical officer, told the publication that joining would "take a lot of work" and officials are concerned that the program could increase the administrative burden on providers.
Vermont isn't the only state to test an all-payer system; Maryland has operated under one for several years. By 2014, 95% of hospital revenue in the state had shifted to alternative payment models. Much of the success was related to its ability to form effective partnerships early on.
But the outlook isn't completely sunny. Economists have argued that the program should shut down, as it's more expensive than other models for operating healthcare.The head of the state's hospital association has also noted that challenges, like allocating resources to mitigate risk, remain for providers.