Vermont is developing a health care system that could offer a unique opportunity to test a new model for improving population health. Four lines of development converged for the system: 1) a published challenge to create a pay-for-population health system; 2) comprehensive state health reform legislation; 3) the Institute for Healthcare Improvement Triple Aim project; and 4) the concept of the accountable care organization (ACO). In phase 1 of pilot testing, three communities serving 10 percent of the population are using the system, which is based on the enhanced medical home model. Planning is under way for phase 2 of the pilot, ACOs that use incentives based on the Triple Aim goals. Vermont has created a conceptual framework for a community health system and identified some of the practical issues involved in implementing this framework.
This article is part of a special supplement of Preventing Chronic Disease: Public Health Research, Practice, and Policy and summarizes the design and implementation of the enhanced medical home pilots and the results of a feasibility study for the ACO pilots. It describes how one state is using a systematic approach to health care reform to overcome some of the implementation barriers to a pay-for-population health system. Vermont will continue to provide a statewide laboratory for a pay-for-population health system.
Special Journal Issue of Preventing Chronic Disease Focuses on Community Partnerships to Improve Population Health
- 1. Challenges and Opportunities for Population Health Partnerships
- 2. Improving Public Health System Performance Through Multiorganizational Partnerships
- 3. Focusing on Solid Partnerships Across Multiple Sectors for Population Health Improvement
- 4. Multisectoral Lessons from Healthy Communities
- 5. Building Multisectoral Partnerships for Population Health and Health Equity
- 6. Multisector Partnerships in Population Health Improvement
- 7. Networks as a Type of Social Entrepreneurship to Advance Population Health
- 8. Improving Population Health
- 9. Designing Vermont's Pay-for-Population Health System
- 10. Observations and Recommendations from the Mobilizing Action Toward Community Health (MATCH) Expert Meeting