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:
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).
Certification Eligibility Verification Form
- FY23 Certification Eligibility Verification Form (6/22/2022)
- FY23 Certification Eligibility Verification Workbook Attachment A (6/22/2022)
- FY23 Certification Eligibility Verification Attachment B Executive Oath (6/22/2022)
Certified ACO Budget Guidance
- FY23 Certified ACO Budget Guidance (6/22/2022)
- FY23 Certified ACO Budget Guidance Workbook (06/22/2022)
- FY23 Certified ACO Budget Guidance Scale Target Initiatives (06/22/2022)
- FY23 Certified ACO Budget Guidance Scale Target Initiatives Appendices A and B (06/22/2022)
- FY23 Certified ACO Budget Guidance Chair Oath (6/22/2022)
- FY23 Certified ACO Budget Guidance CEO and CFO Oath (6/22/2022)
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.
Medicare-Only ACO Guidance
- FY23 Medicare-Only ACO Budget Guidance (6/22/2022)
- FY23 Medicare-Only ACO Budget Guidance Workbook Appendices (6/22/2022)