ACO Certification and Budget Review

In 2016, the Green Mountain Care Board was given the authority to develop rules and standards to regulate Accountable Care Organizations (ACOs) through Vermont’s Act 113: ‘An act relating to implementing an all-payer model and oversight of accountable care organizations.’ The GMCB has adopted, Rule 5.000: Oversight of Accountable Care Organizations, which establishes standards and processes the GMCB will use to certify ACOs and annually review, modify, and approve their budgets, and mechanisms by which the GMCB will monitor and oversee the activities performance of ACOs. As a test year to prepare for 2018, the GMCB has provided ACOs with an Annual Reporting and Budget Guidance. 

Medicaid Advisory Rate Case - OneCare Vermont 

• GMCB Medicaid Advisory Rate Case - Review of OneCare Vermont's All-Inclusive Population-Based Payment

Medicare ACO Agreement - OneCare Vermont

• Next Generation ACO Model Participation Agreement - Vermont Modified Next Generation ACO

Rule 5.000: Oversight of Accountable Care Organizations

• Rule 5.000 As Adopted

2018 ACO Budget Guidance

• GMCB ACO Budget Guidance and Letter (May 3, 2017)
  • Appendix A & B: Program Arrangements Between ACO and Payer (Excel Format)
  • Appendix C: ACO Budget Review Templates (Excel Format)
  • Appendix D: ACO Initiatives to Address All-Payer Model Quality Measures
• Correspondence from Health Care Advocate
• GMCB Correspondence with OneCare Vermont

2018 ACO Budget Submissions

2018 ACO Budget Orders 

• OneCare Vermont 2018 Budget Order 

OneCare Vermont's 2018 Budget Submission

• OneCare Vermont 2018 Attribution Data (March 21, 2018)
• OneCare Vermont ACO 2016 Shared Savings Program Performance Results Table
• OneCare Vermont ACO 2016 CMS Public Reporting 
• OneCare ACO Budget Revised Submission (Submitted 10/20/2017)
  • Section 1
  • Section 2: Provider Network Summaries in Excel and Section 2
  • Section 3: Payer Program Elements in Excel and Section 3
  • Section 4 and Section 4: 2016 Shared Savings Resulsts for Medicaid and Commercial Programs in Excel and Section 4: Complete OneCare Projected Cost and Revenue Data Package in Excel
  • Section 5
• OneCare ACO Budget Submission
• OneCare Final Financial Statement and Balance Summary Sheet
• OneCare Grievance and Appeals Policy
• OneCare Board of Managers
• OneCare 2016 Shared Savings Results for Medicaid and Commercial Programs
• OneCare ACO Initiative to Address All-Payer ACO Model Quality Measures
• OneCare Governance Structure
• OneCare Payer Program Elements
• OneCare Projected Cost and Revenue Data Package
• OneCare Governance Bylaws
• OneCare Value Based Quality Incentive Fund Policy
• OneCare Provider Network Summaries
• OneCare Staff Organization Chart
• OneCare Population Health Programs Grid
• OneCare Concept P & L for Entire Budget
• OneCare Vermont 2018 Savings / Losses Sharing Model

Community Health Accountable Care (CHAC)'s 2018 Budget Submission

**Withdrawn From Consideration 10/19/2017**

• CHAC Organization Chart
• CHAC CMS ACO Contract
• CHAC Audited Financials 2016
• CHAC MSSP Performance Year 2015 Results
• CHAC Grievance and Complaint Policy
• CHAC Participating Organizations
• CHAC ACO Budget Guidance Narrative
• CHAC Appendix C Budget
• CHAC Appendix D ACO Initiatives to  Address All-Payer ACO Quality Measures
• CHAC Appendix D Supplement - Clinical Guidelines
• CHAC Appendix D Supplement - Clinical Programs and Guidelines
• CHAC Appendices AB ACO Provider Network and Other Arrangements