The Green Mountain Care Board recently approved a cancer care pilot project in the St. Johnsbury area designed to improve quality, enhance patient satisfaction, and reduce costs. PCD Partners has been retained to provide consulting and to deploy a cloud-based, proprietary ISO-style Quality Management System to support this important initiative. PCD’s process and outcomes data will demonstrate best practice adherence among the participating healthcare providers, and aid the players in designing optimal payment reform that aligns incentives between patients, providers, and payors.
Wes Chapman, President and CEO of PCD Partners, said, “PCD is pleased to be part of this oncology based reform initiative that will rationalize healthcare operations and improve quality of care for Vermont cancer patients,” adding, “Since the program is designed to be scalable to other state and federal initiatives, the project is also capable of significant impact on the quality and cost of healthcare nationally.”
Read the full press release below.
St. Johnsbury cancer care program approved as first Green Mountain Care Board payment and delivery system pilot
June 25, 2012 – Montpelier, VT –The Green Mountain Care Board (GMCB) last week approved a health care delivery system and payment reform pilot for cancer care in the St. Johnsbury area. The goals of this three-year pilot are to improve the quality of care for cancer patients residing in the St. Johnsbury area, improve patient experience and satisfaction, reduce avoidable use of services, and reduce growth in overall expenditures related to this care.
The pilot has received funding from Blue Cross and Blue Shield of Vermont, the Division of Vermont Health Access (which oversees Vermont’s Medicaid, Vermont Health Access Plan, and Catamount Health programs), the GMCB, and Northeastern Vermont Regional Hospital (NVRH). The GMCB will seek participation from the federal government through the Medicare program after the pilot is fully developed.
The pilot is a collaboration among the three organizations that treat most of the cancer patients in the St. Johnsbury area: Northern Counties Health Care, Northeastern Vermont Regional Hospital, and Dartmouth-Hitchcock Medical Center’s Norris Cotton Cancer Center, which has a cancer center in St. Johnsbury. The organizations aim to improve the quality of cancer care for an estimated 270 patients during the trial period. Patient participation in the pilot project will be entirely voluntary.
The pilot builds on the framework established by Vermont’s Blueprint for Health, which seeks to create a “medical home” for each Vermonter in his or her primary care physician’s office. Through their involvement in the Blueprint for Health, the primary care practices participating in the pilot have created “Community Health Teams” of health professionals who will coordinate and monitor the care of patients in the pilot. This pilot will test the hypothesis that the quality of care for patients with cancer can be improved through the integration of primary care, cancer care, and palliative care, and that the cost of care can be moderated at the same time.
“This is a perfect example of how we can improve patient experience—reducing the number of trips they make to the doctor, improving communication between their doctors and, most importantly, improving communication with patients about what they want and need,” said Allan Ramsay, M.D., a member of the GMCB who has been involved in the development of the pilot project. “This kind of quality improvement inevitably reduces waste and results in better service for the patient.”
“Doctors want to provide the best care for their patients,” said Anya Rader Wallack, Chair of the GMCB. “But too often we don’t pay them for critical services like care management.”
The pilot anticipates that commercial payers and Medicaid will pay providers an additional monthly fee for collaborating to create and monitor “care plans” for each patient. This close communication between providers involved in the care of these patients is intended to reduce avoidable office visits, tests and procedures and increase adherence to clinical standards and protocols of care. There will also be closer monitoring of prescriptions and other treatments to assure high quality care.
“We appreciate that the health care community in St. Johnsbury is stepping forward to test a truly collaborative system designed to wrap around each individual patient in the way we expect care to work in small Vermont communities,“ said Wallack.
“We believe that we can provide our community better cancer care and reduce costs if we find ways to work more closely together,” said Paul Bengtson, CEO of Northeastern Vermont Regional Hospital. “This makes sense for our patients.”
About the Green Mountain Care Board (GMBC): Vermont’s Health Reform law, Act 48, charges the GMCB with controlling the rate of growth in health care costs and improving the health of Vermonters. The GMCB approves hospital budgets, major health care capital investments, health insurer rates increases, all-payer rates for all providers, and minimum health benefit requirements.
For more information, contact Anya Rader Wallack at (802) 828-2160.
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