MIDDLEBURY — Porter Hospital has recently agreed to join with all other Vermont hospitals, as well as Dartmouth-Hitchcock Medical Center, in the newly formed OneCare Vermont Accountable Care Organization (ACO).
An ACO is “a group of health care providers who have agreed to share responsibility for the quality of a specific group of patients with the goal of improving their overall health; and is part of the ongoing commitment by Vermont hospitals and providers to enhance quality of patient care and improve communication and coordination of care,” explained Porter Medical Center (PMC) spokesperson Ron Hallman.
The essential work of this ACO network will revolve around the sharing of information via a statewide computerized health information exchange/electronic health record system, which will collect and report information to all ACO members on 33 specific quality health indicators established by the Center for Medicare and Medicaid Services (CMS). Through this tracking and sharing of clinical information, the goals are to provide better and more coordinated patient care services for individual patients, especially those suffering from chronic health conditions such as diabetes, high blood pressure and other conditions that require ongoing monitoring and care and, eventually, to improve the overall health status of entire communities.
The OneCare Vermont ACO has been in existence since January of 2013 and now includes all 14 Vermont hospitals, Dartmouth-Hitchcock Medical Center, two Federally Qualified Health Centers, five Rural Health Clinics, 58 private medical practices, 280 individual primary care physicians and 1,800 specialist physicians. 
The focus of the OneCare Vermont ACO is to better coordinate the health care of approximately 42,000 of Vermont’s 118,000 Medicare beneficiaries.
“Coordinated care helps ensure that patients, especially those with chronic conditions, get the right care, at the right time and in the right place,” said PMC President James L. Daily. “OneCare Vermont represents an opportunity to develop the clinical relationships that will enable all member health care organizations to be successful in the emerging accountable care environment.
“Any patient who has multiple doctors probably understands the frustration of duplicated medical procedures or having to share the same information over and over again with different providers,” Daily continued. “ACO’s are designed to help lift this burden from patients, while improving the partnership between patients and providers and allowing patients to have better information and control over their health care.”
Accountable Care Organizations were created by the Affordable Care Act in 2010 and are intended to create incentives for health care providers to better collaborate, communicate and work together to treat an individual patient across different settings — including physicians’ offices, hospitals and long-term care facilities. As a member of the OneCare Vermont ACO, Porter will have representation on the Clinical Advisory Board by members of the local medical community.
“Improving coordination and communication among providers will help enhance the care of our Medicare patients, while also taking steps to begin to reduce costs,” Daily said. According to a recent analysis by the U.S. Department of Health and Human Services, ACO’s could potentially save the Medicare program as much as $960 million over three years.
“Although our collaboration in this new agreement is focused primarily on sharing information via electronic health records to improve quality and care coordination throughout Vermont, it is important for our Addison County patients to know that this arrangement in no way changes their Medicare benefits or their relationships with their providers or our hospital,” Daily said. “From the perspective of the patient, this arrangement will not in any way affect their access to their provider, but will, over time, improve their overall patient experience.”
“Porter Hospital continues to be governed by our local board of directors and we remain independent from a financial and governance perspective,” said Daily, “but through this arrangement, we are taking a step toward the type of health care reform initiative that is both good and necessary to improve care and reduce costs over time.”