About the Office of Health Care Reform

The Office of Health Care Reform within the Agency of Human Services coordinates health care payment and care delivery reform initiatives across state government. Vermont’s health care reform efforts are designed around four goals: 

1. Reducing health care costs and cost growth. 
2. Assuring that all Vermonters have access to and coverage for high quality care. 
3. Assuring greater fairness and equity in how we pay for health care. 
4. Improving the health of all Vermonters. 

What do we do? 

The Office of Health Care Reform focuses on initiatives that meet these four goals, including: 

• The Vermont Blueprint for Health is the state’s nationally-recognized, longstanding community-driven health care reform initiative that is focused on improving the health and well-being of Vermonters. It supports advanced primary care and improves integration of health and human services for people with complex needs. This work began with support for patient-centered primary care and community health teams. It has evolved to include a system of opioid use disorder treatment in conjunction with the Vermont Department of Health, which includes primary care and specialty practices as well as additional programming to support pregnancy intention. The Blueprint is expanding support to address mental health, substance use disorder, and health-related social needs. For more information, visit the Vermont Blueprint for Health. 

• “All-Payer Model Agreements” between Vermont and the federal government, which allow Medicare to join Medicaid and commercial insurers to pay differently for health care to support better care. The Office collaborates closely with the Green Mountain Care Board (GMCB) on these models. Examples include: 

  • The Vermont All-Payer Accountable Care Organization (ACO) Model Agreement, which has been in place since 2016. For more information, visit the Green Mountain Care Board’s Payment Reform page. 
  • A new program called States Advancing All-Payer Health Equity Approaches and Development Model – or “AHEAD.” The federal government selected Vermont and Maryland as the first two states to explore participation in this program. It would allow Medicare to join Vermont’s health care reform efforts after the All-Payer ACO Model ends. For more information, visit the Agency of Human Services AHEAD Model page. 

• Enhanced Home and Community-Based Services (HCBS) Funding: Vermont received additional federal funding to enhance, expand, and strengthen Medicaid HCBS under Section 9817 of the American Rescue Plan Act of 2021. The Office of Health Care Reform administers these funds and works with partners across the Agency of Human Services and service providers throughout Vermont to implement a wide range of programs, policies, and system improvements. Please visit the Enhanced Funding for Home and Community-Based Services page for additional details. 

• Health Care Workforce Development: The Office of Health Care Reform supports initiatives to ensure that Vermont has the health care workforce necessary to provide quality care to all Vermont residents. The goal is to improve the availability of health care workers to meet the needs of all Vermonters across the lifespan and care continuum. Promoting permanent health care employment and residency in Vermont and connecting workers to the education and resources necessary to obtain stable, high-quality, family-sustaining health care careers will ensure high quality care for all Vermonters and create economic mobility, enabling the state’s residents to remain and thrive in their communities. Please visit the Health Care Workforce Development page for additional details. 

• The Health Care Reform Work Group was convened in July 2022 and several subgroups have formed to address specific topics, including the Short-Term Health Care Provider Stability Subgroup, the Primary Care Subgroup, the Medicare Waivers Technical Advisory Group, and the Payer Advisory Subgroup. For more information about the Health Care Reform Work Group and related subgroups, please visit the Vermont Agency of Human Services Reports page.

How can I get involved?

• You can provide comments or ask questions at any time.  Please submit it them through the Work Group’s Question and Comment Submission Form.