VT Digger | February 27, 2017

OneCare pushes back on bill that would require open meetings

Vermont’s largest health care organization is pushing back on a bill in the Senate that would require it to hold open meetings.

The bill, S.4, would require OneCare Vermont, which is set up to become a regulated monopoly representing virtually all doctors in the state, to hold open meetings in most circumstances.

The bill’s language is similar to the Vermont Open Meeting Law. That law requires public bodies, such as selectboards and legislative committees, to hold open meetings, with exceptions such as if the public body needs to discuss contracting or personnel issues.

OneCare is owned jointly by the University of Vermont Medical Center and Dartmouth-Hitchcock Medical Center. The company currently has a $93 million contract with the Department of Vermont Health Access to take care of about 30,000 Medicaid patients for calendar year 2017.

OneCare is in the process of joining with a similar company, Community Health Accountable Care, to morph into the Vermont Care Organization, or VCO. Once formed, the VCO would become the regulated monopoly that would take Medicaid, Medicare and commercial payments and then give that money back to doctors based on the quality of care they provide, not the quantity of procedures performed.

The Green Mountain Care Board, a state regulator that will soon be charged with overseeing the VCO, led a nearly two-year effort to have smaller groups of doctors from community health centers and independent practices merge into the VCO. The agreement was the basis for the all-payer model. [...]

Todd Moore is the chief executive officer of both OneCare and the VCO — and the senior vice president of accountable care and revenue strategy at the UVM Health Network. Moore testified against S.4 in the Senate Health and Welfare Committee on Feb. 3.

“The requirements are tantamount to imposing the Open Meeting Act (and actually offer fewer exceptions than the Act itself), despite the fact that those requirements can only apply to public bodies, and the ACOs don’t qualify as public bodies,” he wrote. “In fact, ACOs are private organizations with voluntary contracts with state and federal governments, not quasi-public.” [...]

Moore said he is working with Mike Fisher, from Vermont Legal Aid’s Office of the Health Care Advocate, and other stakeholders to reach a compromise on the bill. The Senate Health and Welfare Committee has scheduled additional testimony for Friday.

“We are in the middle of discussions, but I am of course supportive of efforts to help OneCare be as transparent and accountable as possible in their decision-making process,” Fisher said Monday.

“We’ve suggested things like, noticing meetings and agendas, definition of a meeting, being tighter on why they might go into an executive session, making sure (there are opportunities) for public comment, and publishing minutes,” Fisher said.

“I think OneCare sees itself as being transparent, and from the consumer advocate side, I am going to be continually be asking for and pushing them to practice that — both in how they run their board meetings, and in the outcomes of this contract with Medicaid,” he said. [...]