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2023 ACO Oversight

The GMCB's oversight of Accountable Care Organizations (ACOs) consists of 1) certification and 2) annual budget review. These regulatory processes include a review of: programs and investments to facilitate the shift to value-based care; investments in health improvement activities; tools and analytics to support providers and improve health care quality and reduce unnecessary costs; ACO administrative costs; and the alignment of ACO strategies with Vermont’s All-Payer Model goals.

There are two ACOs that the GMCB will oversee in FY23:

OneCare Vermont 

Clover Health Partners

Materials for Certified ACOs

ACOs in Vermont that accept payments from Medicaid or Commercial insurance must be certified in addition to undergoing budget review. Currently, there is only one ACO in Vermont that meets this criteria (OneCare Vermont).

Flow chart showing budget and certification requirements for ACOs that contract with Medicaid or Commercial insurance.

Certification Eligibility Verification Form

Certified ACO Budget Guidance

OneCare Vermont

Materials for Medicare-Only ACOs

ACOs that plan to only accept payments from Medicare do not need to undergo certification. The budget review process depends on the ACO's size. Currently, the only Medicare-Only ACO in Vermont has fewer than 10,000 lives.

Flow chart showing budget and certification requirements for ACOs that contract with only Medicare insurance.

Medicare-Only ACO Budget Review Materials

Clover Health Partners