Vermont health insurer ends affiliation with reform group

December 20, 2022 GMT

MONTPELIER, Vt. (AP) — Vermont’s largest private health insurance provider is ending its affiliation with an organization that has been working to change the way health care is paid for in the state, the company said Tuesday.

Blue Cross and Blue Shield of Vermont said it would forego a contract with OneCare Vermont for 2023 due to the lack of tangible quality outcomes, inability to reduce costs and what it feels is a “new data approach” that introduces concerns about security and privacy.

“Despite our best efforts, we were unable to arrive at an arrangement that serves our members for the next plan year,” Blue Cross Vice President Andrew said in a statement.

The insurer said that none of its members whose care had been covered, or attributed, to OneCare would see any change in their plan benefits. Just under 25% of Blue Cross’s 200,000 members are currently covered through the program, the company said.

OneCare CEO Vicki Loner said they’d worked with Blue Cross for nine months to reach a deal and they were disappointed they couldn’t agree on a contract, but they remain committee to improving health outcomes in Vermont.

“When insurance companies walk away from health reform, patients lose,” she said. “Through OneCare, we are seeing proof that Vermont is on the right track, as documented in multiple federal evaluations. We remain committed to improving outcomes in partnership with the State and provider community.”

The goal of what’s known as the all-payer model is to keep patients healthier while reducing health care costs by paying a set amount of money for each covered patient rather than paying for each service provided.