OneCare Vermont sought to identify which of its patients were at the highest risk of serious illness or mortality from COVID-19 and which of its patients with chronic healthcare problems needed care for medical issues other than COVID-19. Leveraging its data platform, OneCare Vermont enabled rapid identification of at-risk patients. Providers and care teams use the risk-stratification care coordination tool to proactively conduct patient outreach, including telephone calls and telemedicine virtual visits, ensuring patients receive needed social support and medical care during the pandemic.
OneCare Vermont, an accountable care organization (ACO), is focused on reducing costs by reforming payment models. As the organization methodically and rapidly moves toward value-based payments, it is challenging current delivery methods and seeking to engage providers and patients in new care models. To be successful, OneCare needed to implement strategies to effectively drive change. With robust data analytics, it was able to prioritize opportunities for improvement and ultimately change the way care is coordinated and delivered throughout its network. Results include nearly $20M in positive, value-based financial results in just one year.